Prevalence and associated factors of active trachoma among children aged 1-9 years old in mass drug administration graduated and non-graduated districts in Northwest Amhara region, Ethiopia: A comparative cross-sectional study

BACKGROUND: Mass drug administration has implemented to reduce trachoma since 2001, however, trachoma is still the major public health problem in Amhara Region, Ethiopia. However, credible evidence on the prevalence of trachoma and its associated factors after the implementation of mass drug administration is limited. OBJECTIVE: To assess the prevalence and associated factors of active trachoma among children aged 1–9 years old in mass drug administration graduated and non-graduated districts in the Northwest Amhara Region. METHODS: A comparative cross-sectional study was conducted from October to November, 2019. A stratified multistage random sampling was used to select 690 households having children aged 1–9 years. Data were collected using a pretested structured questionnaire. Data were entered into Epi-data version 3.1 and exported to SPSS version 20.0 for analysis. Bivariate and multivariable logistic regressions were employed to identify factors associated with active trachoma. Crude and adjusted odds ratios with 95% confidence interval were computed to assess the degree of association between the independent variables and active trachoma. RESULTS: The overall prevalence of active trachoma was 8.3% (95% CI: 6.2% –10.5%) and showed a significant variation between graduated [3.5% (95% CI: 1.8% –5.6%)] and non-graduated [13% (95% CI: 9.7%–16.8%)] districts. Living in graduated districts (AOR = 7.39, 95% CI: 3.19, 17.09), fly presence in the house (AOR = 3.14, 95% CI: 1.43, 6.89), presence of more than two children in the family (AOR = 3.78, 95%CI: 1.79, 7.98), did not wash face daily (AOR = 6.31, 95% CI: 1.81, 21.98), did not use soap during face washing (AOR = 3.34, 95% CI: 1.37, 8.15), presence of sleep in eyes (AOR = 3.16, 95% CI: 1.42, 7.02) and presence of dirt on child face (AOR = 2.44, 95% CI: 1.08, 5.50) increased the odds of having active trachoma. CONCLUSION: The prevalence of active trachoma was high in the study area and showed a significant variation between graduated and non-graduated districts with mass drug administration. Living in non-graduated districts, fly presence in the house, more than two children in a household, did not wash the face daily, did not use soap during face washing, presence of sleep in eyes, and dirt on the child’s face were the significant predictors of active trachoma. Therefore, the identified modifiable factors are the area of intervention to reduce the burden of active trachoma.