Risk factors of trachoma among children aged 1 to 9 of Naroosura location in Narok - South district, Kenya

Abstract

Background: Trachoma is a major cause of blindness in the developing nations especially in Africa, Asia and Middle East. It is a communicable disease caused by Chlamydia trachomatis serotypes A, B and C. Serotypes D to K are sexually transmitted. In Kenya, Trachoma is reported to be endemic in areas of the Rift Valley, North Eastern and Eastern Provinces. Problem statement: Trachoma prevalence in Kenya varies widely from region to region. High prevalence is associated with high climatic aridity, and lower prevalence is associated with areas of greater rainfall, sustainable agriculture, and a higher general standard of living. Within high-risk regions, there are wide variations in age-specific prevalence and severity of the disease, Trachoma is reported to be endemic in areas of the Rift Valley, North Eastern and Eastern Provinces. Prevalence in Kenya has been established but it is estimated to have contributed up to 19% of the total cases of the preventable blindness. Survey done in six districts of the total 18 affected by trachoma in Kenya showed Samburu District to be the leading in prevalence of active trachoma with 34%. Narok had 30.5%, Kajiado 28%, Baringo had 15.6% and the other districts had prevalence of greater than 6.5%. A goal of the survey was to determine the prevalence of trachoma and its risk factors among children aged 1-9 years in Narok-South District. Justification: Previous studies have shown the estimated prevalence of 30.5% in Narok District, but did not relate it to the risk factors. The study therefore aims at relating the prevalence to the risk factors and provides information on what further interventions can be put in place to reduce the prevalence of trachoma in the region. Methods: Using simple random and systematic household technique 326 children aged 1-9 years, in Naroosura location were identified. The simplified clinical coding system proposed by the World Health Organization was used. The mother or caretaker of each child was questioned about personal and environmental risk factors. At the time of examination, facial cleanliness and the presence of flies on the face were noted. Data was analyzed using the statistical package for social science (SPSS). Frequencies and Pearson χ2 were used Results: The prevalence of trachoma in Naroosura Location was 44.8% with Naroosura sub – Location having the lowest (32.7%). Children with dirty faces were more likely to have trachoma than those with clean faces. There was a statistically significant association between facial hygiene (p=0.000), lack of access to pit latrines (p=0.018), Education status p=(0.043) and trachoma. Conclusion: Of all the risk factors examined, facial cleanliness had the strongest association with the prevalence of trachoma. This was followed by lack of access to pit latrines and education status of the parents. It is likely that hygiene education and environmental improvement could have a very significant impact on the prevalence of trachoma in Naroosura Location.