Berhanu Leykun, Daba Chala, Desye Belay, Geto Abebe Kassa, Berihun Gete
Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia.
PLoS One. 2025 Aug 7;20(8):e0330077. doi: 10.1371/journal.pone.0330077. eCollection 2025.
Trachoma is the leading infectious cause of blindness worldwide, primarily affecting populations in low-income countries with poor sanitation and hygiene conditions. The World Health Organization has set a goal to eliminate trachoma as a public health problem. However, progress towards this goal has been uneven across different regions. This systematic review and meta-analysis aimed to synthesize the available evidence on the association between the presence of latrine facilities and unclean child faces with the prevalence of active trachoma among children aged 1 to 9 years in low-income country settings. The findings from this study can help guide the design of more targeted interventions to reduce the burden of trachoma in vulnerable populations.
A total of 2695 articles were searched from PubMed, Hinari, African Online Journals, Google, Google Scholar, Science Direct, and Semantic Scholar and exported to STATA version 17 for analysis. The levels of heterogeneity among studies were assessed using I2 and p-values. The findings of the meta-analysis were presented using a table, graph, and forest plot with a 95% confidence interval. A P-value of less than 0.05 was considered statistically significant.
Among 2695 articles searched, 16 of them were selected for meta-analysis. The pooled prevalence of active trachoma was 21.10 (95% CI; 14.18, 28.02). The finding indicated high heterogeneity among the included studies (I2 =99.3%, p<0.0001). There was a statistically significant association between the presence of a latrine (POR=0.10, 95% CI: 0.00, 0.19) and unclean child face (POR=1.30, 95% CI: 1.08, 1.53) and the pooled prevalence of active trachoma among children aged 1 to 9 years in low-income countries.
The present study revealed that the pooled prevalence of active trachoma was high as compared to the WHO trachoma eradication goal. The presence of latrine facility and unclean child face were significantly associated with the prevalence of active trachoma among children aged 1 to 9 years in low-income countries. Hence it is recommended to improve access to latrines, promote child facial hygiene, and intensify overall trachoma control in low-income countries.
沙眼是全球失明的主要传染性病因，主要影响卫生条件差的低收入国家的人群。世界卫生组织已设定消除沙眼这一公共卫生问题的目标。然而，不同地区在实现这一目标方面的进展并不均衡。本系统评价和荟萃分析旨在综合现有证据，探讨在低收入国家环境中，厕所设施的存在以及儿童面部不清洁与1至9岁儿童活动性沙眼患病率之间的关联。本研究结果有助于指导设计更具针对性的干预措施，以减轻沙眼对弱势群体的负担。
从PubMed、Hinari、非洲在线期刊、谷歌、谷歌学术、科学Direct和语义学者中总共检索到2695篇文章，并导出到STATA 17版本进行分析。使用I2和p值评估研究之间的异质性水平。荟萃分析的结果以表格、图表和森林图的形式呈现，并带有95%置信区间。p值小于0.05被认为具有统计学意义。
在检索到的2695篇文章中，有16篇被选入荟萃分析。活动性沙眼的合并患病率为21.10（95%置信区间；14.18，28.02）。结果表明纳入研究之间存在高度异质性（I2 =99.3%，p<0.0001）。在低收入国家，厕所设施的存在（比值比=0.10，95%置信区间：0.00，0.19）和儿童面部不清洁（比值比=1.30，95%置信区间：1.08，1.53）与1至9岁儿童活动性沙眼的合并患病率之间存在统计学显著关联。
本研究表明，与世界卫生组织的沙眼根除目标相比，活动性沙眼的合并患病率较高。在低收入国家，厕所设施的存在和儿童面部不清洁与1至9岁儿童活动性沙眼的患病率显著相关。因此，建议在低收入国家改善厕所使用情况，促进儿童面部卫生，并加强整体沙眼控制。
