Gebreselassie Getachew, Negash Kasahun, Woga Dawit, Makonnen Misrak, Deneke Baye, Desalegn Muluken, Ali Seada, Beckwith Colin L, Tadesse Fentahun, Seife Fikre, Kiflu Genet, Kebede Fikreab
Amref Health Africa, Addis Ababa, Ethiopia.
Afar Regional Health Bureau, Semera, Ethiopia.
BMC Infect Dis. 2025 Jan 2;25(1):5. doi: 10.1186/s12879-024-10410-3.
Following interventions to eliminate trachoma in the Afar region of Ethiopia, our goal was to reassess the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF) at the woreda level, and to identify factors associated with the disease.
Cross-sectional community-based surveys were conducted in 26 trachoma-endemic woredas, employing a standardized approach. Households were selected as the secondary sampling unit. Surveys involved interviews with household heads, direct assessment of water, sanitation, and hygiene (WASH) access, and clinical examination of eligible household members for trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF).
Overall, 18 out of the 26 woredas (69%) achieved the World Health Organization-recommended threshold for active trachoma elimination, with a prevalence of trachomatous inflammation-follicular (TF) below 5% in children aged 1-9 years. Additionally, 14 woredas (54%) met the threshold for trachomatous trichiasis (TT) elimination, with a prevalence of TT cases unknown to the health system below 0.2% in adults aged 15 years and older. However, access to improved drinking water sources within a 30-minute trip was limited to only 17% of households, and merely 9% had access to improved latrines. Addressing these WASH (Water, Sanitation, and Hygiene) challenges remains critical for sustaining progress in trachoma control and achieving long-term public health improvements in the Afar region.
In seven woredas, further rounds of antibiotic mass drug administration are required, complemented by initiatives to promote facial cleanliness and improve environmental conditions. Additionally, surgical campaigns for trachomatous trichiasis (TT) are needed in 12 woredas. There is a critical need to enhance access to improved Water, Sanitation, and Hygiene (WASH) facilities across all surveyed woredas to consolidate gains in trachoma control and achieve sustained public health improvements.
在埃塞俄比亚阿法尔地区采取消除沙眼的干预措施后，我们的目标是在县一级重新评估沙眼性倒睫（TT）和沙眼性滤泡性炎症（TF）的患病率，并确定与该疾病相关的因素。
在26个沙眼流行县开展了基于社区的横断面调查，采用标准化方法。家庭被选为二级抽样单位。调查包括与户主访谈、直接评估水、环境卫生和个人卫生（WASH）状况，以及对符合条件的家庭成员进行沙眼性倒睫（TT）和沙眼性滤泡性炎症（TF）的临床检查。
总体而言，26个县中有18个（69%）达到了世界卫生组织推荐的活动性沙眼消除阈值，1-9岁儿童的沙眼性滤泡性炎症（TF）患病率低于5%。此外，14个县（54%）达到了沙眼性倒睫（TT）消除阈值，15岁及以上成年人中卫生系统未知的TT病例患病率低于0.2%。然而，在30分钟行程内能够使用改善饮用水源的家庭仅占17%，只有9%的家庭能够使用改善的厕所。应对这些水、环境卫生和个人卫生（WASH）挑战对于维持沙眼控制的进展以及在阿法尔地区实现长期公共卫生改善仍然至关重要。
在7个县，需要进一步开展多轮抗生素群体给药，并辅以促进面部清洁和改善环境条件的举措。此外，在12个县需要开展沙眼性倒睫（TT）手术活动。迫切需要在所有调查县增加改善水、环境卫生和个人卫生（WASH）设施的可及性，以巩固沙眼控制成果并实现持续的公共卫生改善。
