Abstract:
Background: There are an estimated 1.8 million people infected with Trachoma
globally, with most being in Africa due to poor water supply and poor sanitation. In
Kenya, there are 7 million people living within endemic regions, and 85,000 people at
risk of contracting the disease. World Health Organization (WHO) defines prevalence
of active trachoma or trachoma inflammation follicular (TF) as a public health problem
when the prevalence is ≥ 5% in children 1-9 years of age and has targeted to eliminate
it by 2020 using the SAFE strategy. Following a baseline study conducted in Laikipia
in 2007 that identified an overall TF prevalence of 9.5% with some hotspots Sub-
location like Ngarendare (70.0%), Mumonyot & Ruguta (46.7%) and Kurikuri (30.0%).
The study sought to estimate the prevalence and risk factors associated with Active
Trachoma in Laikipia after implementation of the SAFE strategy intervention from
2007.
Methods: The study was a cross-sectional community-based study that sort to estimate
the prevalence of active trachoma (TF) among children aged 1-9years and the
associated risk factors. The participants were randomly selected from 30 households
from each of the randomly selected 30 villages within each of the three evaluation units.
Using Cochran’s formula and a non-response rate of 10%, we calculated a minimum
sample size of 1,000 aged 1-9 years from each evaluation unit. TF was defined as
presence of five or more follicles in the upper tarsal conjunctiva and using x2.5
magnifying loupes under ample lighting, eyes were examined for signs of TF. A
standardized questionnaire assessing the risk factors was administered to the household
head and water and sanitation facilities observation checklist filled. Descriptive
statistics analysis was done and bivariate and multivariate analysis undertaken using
Odds ratio as measure of association and chi-square for statistical significance. Factors
with p value <0.05 were considered statistically significant.
Results: A total of three thousand one hundred and ninety-three (3,193) aged 1-9 years
were selected to participate in the study. Among all examined participants 1,625
(50.9%) were male. TF prevalence among the examined aged 1-9 years was estimated
at 2.5% (n-112[95%CI 0.87- 4.8]) of whom 62 (55.4%) were male. Laikipia North EU
accounted for 63(56.3%) of all the participants with TF signs. The TF signs among age
1-9 year were associated with lack of having a defecation amenities (aOR=5.64, 95%CI
3.55 – 8.95%, aOR=5.64, 95%CI 3.55 – 8.95%, P value <0.001), getting drinking water
more than one hour away (aOR=3.31, 95% CI 2.27 – 4.83%, P value <0.001).
Conclusion: In all evaluation units, TF prevalence were below the WHO elimination
threshold as a public health problem. Poor access to clean safe water and defecation
amenities were associated with presence of active trachoma.
Recommendation: There is need to scale up community sensitization on facial
cleaning, use of clean water improved sanitation and hygiene measures at the
community level. As well as the county sustaining the gains made through the
implementation of SAFE strategy with the hope of elimination of trachoma.