Prevalence of Active Trachoma and Its Associated Factors among Rural and Urban Children in Dera Woreda, Northwest Ethiopia: A Comparative Cross-Sectional Study

BACKGROUND Trachoma is the most common infectious cause of blindness worldwide. Once an epidemic in most parts of the world, it has largely now disappeared from developed countries. However, it continues to be endemic in many developing countries like Ethiopia. Even if several studies were conducted in different parts of Ethiopia, most of them did not show the independent predictors for rural and urban children separately. Therefore, this study aimed at assessing the prevalence and associated factors of active trachoma in urban and rural children. METHODS Community based comparative cross-sectional study was conducted in Dera woreda. Multistage sampling technique was used to select 671 children of one up to nine years of age. Data were collected by face to face interview and observation using a structured and pretested questionnaire. Binary Logistic Regression Model was fitted to consider adding independent predictors of outcome. RESULTS Out of 671 children, 20 (9.3%) of urban and 85 (18.6%) of rural children were positive for active trachoma. Having discharge on eye (AOR = 6.9, 95% CI: 1.79-27.89), presence of liquid waste around the main house (AOR = 5.6, 95% CI: 1.94-16.18), and living in households without latrine (AOR = 4.39, 95% CI: 1.39-13.89) were significantly associated with active trachoma of urban children. Rural children who had discharge on their eye (AOR = 5.86, 95% CI: 2.78-12.33), those who had unclean face (AOR = 4.68, 95% CI: 2.24-9.81), and those living in households with feces around their main houses (AOR = 1.94, 95% CI: 1.04-3.62) were significantly associated with active trachoma. CONCLUSION The result showed that the prevalence of active trachoma in urban areas of the district was below WHO threshold of 10% to determine trachoma as public health problem. However, in rural areas of the district it is far from elimination of trachoma as a public health problem. Thus, in order to improve awareness of the community there is a need of health education programs regarding facial cleanliness, utilization of latrine, and proper solid waste and liquid waste disposal using multidisciplinary approach.