PDF(Pubmed)
Abstract：
BACKGROUND: Trachoma is the most prevalent eye disease in Ethiopia, especially among children aged 1-9 years and continues to be a public health concern. Nevertheless, in Ethiopia\'s rural Jamma district in South Wollo Zone of Amhara Regional State, factors associated with trachomatous inflammation-follicular (TF) among children aged 1-9 years have not yet been studied.
METHODS: A community-based cross-sectional study was conducted among 616 children aged 1-9 years in rural Jamma district in Ethiopia from January-March, 2019. Data were collected using a pre-tested structured questionnaire, an observation checklist and clinical examination of study participants for active trachoma. The presence of TF and trachomatous inflammation-intense (TI) was clinically assessed by integrated eye care workers using the World Health Organization simplified grading system. Data were analysed using SPSS (Statistical Package for Social Sciences) Version 25.0. A logistic regression model with 95% CI was used. From the multivariable analysis, variables with p-value < 0.05 were declared as associated factors of TF.
RESULTS: The prevalence of TF was 10.9% (95% CI [8.6 - 13.6%]) among the rural children aged 1-9 years. The mean family size was 5.5 ± 1.9 persons. About one-fifth (20.6%) of households kept domestic animals overnight in the same room as family. Almost one-sixth (17.5%) of the children involved in this study had an ocular discharge. Two-thirds of the children (68.8%) washed their hands once per day and just over half (55.8%) washed their faces once per day. From multivariable analysis, we found that the presence of domestic animals kept overnight in the same room as the family (adjusted odds ratio [AOR] = 4.32; 95%CI [2.49-9.52]), mother\'s/caregiver\'s illiteracy (AOR = 2.01; 95%CI [1.11-4.67]), household size (> 7 persons) (AOR = 3.50; 95%CI [1.66-8.50]), washing of children\'s hands and face without soap (AOR = 2.41; 95%CI [1.29-5.18]), feces observed in the compound (AOR = 5.10; 95%CI [2.01-10.14]), presence of ocular discharge (AOR = 7.23, 95%CI [4.10-12.51]) and nasal discharge (AOR = 4.54, 95%CI [1.95-9.26]) were significantly associated with TF.
CONCLUSIONS: The prevalence of TF among rural children aged 1-9 years in this study was almost two times higher than the WHO-recommended threshold (TF < 5%) for trachoma elimination and beyond the trachoma control target (TF < 10%). Presence of domestic animals kept overnight in the same room as the family, mother\'s/caregiver\'s illiteracy, household size (> 7 persons), washing of children\'s hands and face without soap, feces observed in the compound, presence of ocular and nasal discharge were significantly associated with TF. We recommended interventions that will help household income to be improved to enable families to be able to construct separate rooms in which to keep animals overnight. Furthermore, we also recommend to policy makers to design mechanisms for enhancement of behavioural change among householders to keep household compounds clean and creating awareness among mothers/caregivers about prevention of trachoma.
METHODS: A community-based cross-sectional study was conducted among 616 children aged 1-9 years in rural Jamma district in Ethiopia from January-March, 2019. Data were collected using a pre-tested structured questionnaire, an observation checklist and clinical examination of study participants for active trachoma. The presence of TF and trachomatous inflammation-intense (TI) was clinically assessed by integrated eye care workers using the World Health Organization simplified grading system. Data were analysed using SPSS (Statistical Package for Social Sciences) Version 25.0. A logistic regression model with 95% CI was used. From the multivariable analysis, variables with p-value < 0.05 were declared as associated factors of TF.
RESULTS: The prevalence of TF was 10.9% (95% CI [8.6 - 13.6%]) among the rural children aged 1-9 years. The mean family size was 5.5 ± 1.9 persons. About one-fifth (20.6%) of households kept domestic animals overnight in the same room as family. Almost one-sixth (17.5%) of the children involved in this study had an ocular discharge. Two-thirds of the children (68.8%) washed their hands once per day and just over half (55.8%) washed their faces once per day. From multivariable analysis, we found that the presence of domestic animals kept overnight in the same room as the family (adjusted odds ratio [AOR] = 4.32; 95%CI [2.49-9.52]), mother\'s/caregiver\'s illiteracy (AOR = 2.01; 95%CI [1.11-4.67]), household size (> 7 persons) (AOR = 3.50; 95%CI [1.66-8.50]), washing of children\'s hands and face without soap (AOR = 2.41; 95%CI [1.29-5.18]), feces observed in the compound (AOR = 5.10; 95%CI [2.01-10.14]), presence of ocular discharge (AOR = 7.23, 95%CI [4.10-12.51]) and nasal discharge (AOR = 4.54, 95%CI [1.95-9.26]) were significantly associated with TF.
CONCLUSIONS: The prevalence of TF among rural children aged 1-9 years in this study was almost two times higher than the WHO-recommended threshold (TF < 5%) for trachoma elimination and beyond the trachoma control target (TF < 10%). Presence of domestic animals kept overnight in the same room as the family, mother\'s/caregiver\'s illiteracy, household size (> 7 persons), washing of children\'s hands and face without soap, feces observed in the compound, presence of ocular and nasal discharge were significantly associated with TF. We recommended interventions that will help household income to be improved to enable families to be able to construct separate rooms in which to keep animals overnight. Furthermore, we also recommend to policy makers to design mechanisms for enhancement of behavioural change among householders to keep household compounds clean and creating awareness among mothers/caregivers about prevention of trachoma.
摘要：
背景：沙眼是埃塞俄比亚最常见的眼病，特别是在1-9岁的儿童中，并继续成为公共卫生问题。然而，在阿姆哈拉地区州南沃洛地区的埃塞俄比亚农村Jamma区，与1-9岁儿童的沙眼炎症-滤泡（TF）相关的因素尚未研究。
方法：从1月至3月，对埃塞俄比亚Jamma地区农村地区的616名1-9岁儿童进行了一项基于社区的横断面研究，2019.使用预先测试的结构化问卷收集数据，观察清单和临床检查研究参与者的活动性沙眼。综合眼科护理人员使用世界卫生组织简化的分级系统对TF和沙眼瘤炎症强度（TI）的存在进行了临床评估。使用SPSS(社会科学统计软件包)25.0版分析数据。使用具有95%CI的逻辑回归模型。从多变量分析来看，p值<0.05的变量被宣布为TF的相关因素。
结果：1-9岁农村儿童TF患病率为10.9%（95%CI[8.6-13.6%]）。平均家庭人数为5.5±1.9人。大约五分之一（20.6％）的家庭将家畜与家庭在同一房间过夜。参与这项研究的儿童中几乎有六分之一（17.5％）有眼部放电。三分之二(68.8%)的儿童每天洗一次手，略多于一半(55.8%)的儿童每天洗一次脸。根据多变量分析，我们发现家畜的存在与家庭在同一房间过夜（调整后的优势比[AOR]=4.32;95CI[2.49-9.52]），母亲/照顾者的文盲（AOR=2.01；95CI[1.11-4.67]），家庭人数（>7人）（AOR=3.50；95CI[1.66-8.50]），不用肥皂清洗儿童的手和脸（AOR=2.41;95CI[1.29-5.18]），在化合物中观察到的粪便（AOR=5.10;95CI[2.01-10.14]），眼分泌物(AOR=7.23,95CI[4.10-12.51])和鼻分泌物(AOR=4.54,95CI[1.95-9.26])的存在与TF显著相关。
结论：本研究中1-9岁农村儿童的TF患病率几乎是WHO推荐的沙眼消除阈值（TF<5％）的两倍，超出了沙眼控制目标（TF<10％）。家畜的存在与家人在同一房间过夜，母亲/照顾者的文盲，家庭大小（>7人），洗孩子的手和脸没有肥皂，在化合物中观察到的粪便，眼和鼻分泌物的存在与TF显着相关。我们建议采取干预措施，以帮助改善家庭收入，使家庭能够建造单独的房间，让动物过夜。此外，我们还建议决策者设计机制，加强住户的行为改变，以保持住户的清洁，并提高母亲/照顾者对预防沙眼的认识。
方法：从1月至3月，对埃塞俄比亚Jamma地区农村地区的616名1-9岁儿童进行了一项基于社区的横断面研究，2019.使用预先测试的结构化问卷收集数据，观察清单和临床检查研究参与者的活动性沙眼。综合眼科护理人员使用世界卫生组织简化的分级系统对TF和沙眼瘤炎症强度（TI）的存在进行了临床评估。使用SPSS(社会科学统计软件包)25.0版分析数据。使用具有95%CI的逻辑回归模型。从多变量分析来看，p值<0.05的变量被宣布为TF的相关因素。
结果：1-9岁农村儿童TF患病率为10.9%（95%CI[8.6-13.6%]）。平均家庭人数为5.5±1.9人。大约五分之一（20.6％）的家庭将家畜与家庭在同一房间过夜。参与这项研究的儿童中几乎有六分之一（17.5％）有眼部放电。三分之二(68.8%)的儿童每天洗一次手，略多于一半(55.8%)的儿童每天洗一次脸。根据多变量分析，我们发现家畜的存在与家庭在同一房间过夜（调整后的优势比[AOR]=4.32;95CI[2.49-9.52]），母亲/照顾者的文盲（AOR=2.01；95CI[1.11-4.67]），家庭人数（>7人）（AOR=3.50；95CI[1.66-8.50]），不用肥皂清洗儿童的手和脸（AOR=2.41;95CI[1.29-5.18]），在化合物中观察到的粪便（AOR=5.10;95CI[2.01-10.14]），眼分泌物(AOR=7.23,95CI[4.10-12.51])和鼻分泌物(AOR=4.54,95CI[1.95-9.26])的存在与TF显著相关。
结论：本研究中1-9岁农村儿童的TF患病率几乎是WHO推荐的沙眼消除阈值（TF<5％）的两倍，超出了沙眼控制目标（TF<10％）。家畜的存在与家人在同一房间过夜，母亲/照顾者的文盲，家庭大小（>7人），洗孩子的手和脸没有肥皂，在化合物中观察到的粪便，眼和鼻分泌物的存在与TF显着相关。我们建议采取干预措施，以帮助改善家庭收入，使家庭能够建造单独的房间，让动物过夜。此外，我们还建议决策者设计机制，加强住户的行为改变，以保持住户的清洁，并提高母亲/照顾者对预防沙眼的认识。
