Abstract:
Objective: To determine the factors associated with active trachoma among children aged 1-9 years in Ol Donyo Nyokie, Kajiado County.
Methods: This was a descriptive cross-sectional study which utilized both quantitative and qualitative techniques for data collection and was carried out at Ol Donyo Nyokie, Kajiado County. Sequential sampling procedure was used to select study participants. A total of 345 mothers together with their children were sampled. The random start was adopted using lottery method and then every 3rd household until a desired sample size of 345 had been achieved. In households with more than one child, one among them was selected by lottery method. Physical examination on the children’s eyes was done while their respective mothers participated in the questionnaire survey supported by observation checklist. Two Focus group discussions were also conducted among mothers and Key Informant interviews among healthcare providers.
Results: The overall prevalence of active trachoma was found to be 15.7%. Stratified by age and sex, the younger age group (1-5) years had a 2.13-fold risk of getting active trachoma (χ2 (1) =5.93, p< 0.017; AOR=2.13 [95%: CI=1.15-3.96] compared to the older group (6-9) years. There was however no significant difference between males and females (P>0.05). In the final logistic regression model; Face washing frequency (P<0.001), child’s dirty face(P<0.005), water access >30 mins(P<0.006), mother’s level of education(P<0.017), age of child(P<0.021), monthly income(P<0.029), pit latrine ownership(P<0.039), open defecation(P<0.054) and pit latrine usage (P<0.055) were identified as the predictors of active trachoma. In the Focus Group Discussion, about three quarters (74%) of the mothers were aware of trachoma. Majority of the mothers who were aware of trachoma indicated that water was a major challenge in the area without which trachoma could not be eliminated. Majority of the respondents did not own pit latrines and few of them also disregarded their use. From the Key Informant Interviews most of the respondents confirmed that water, lack of formal education and poverty were the major problems facing the community in the study area.
Conclusion: The prevalence was found to be high, which indicates that active trachoma is still a major public health concern in the study area. Poor socio-economic and environmental conditions exacerbate the suffering of the community and make it difficult to prevent and control trachoma. Enhancement of interventions, therefore, particularly of facial cleanliness and environmental sanitation should be addressed to ensure effective prevention and control of trachoma and to bring down the prevalence levels below the WHO threshold of (>10 % prevalence). Community participation in education and outreach services are also crucial.
