Assessment of Factors Associated With Active Trachoma in Children Aged One to Nine Years in Loima Sub-County, Turkana County, Kenya

Abstract

Trachoma is an infectious eyes disease caused by the bacteria Chlamydia trachomatis. In Kenya, trachoma is the second leading cause of blindness and is hyper-endemic in West Pokot, Baringo, Kajiado, Marsabit and Turkana. Children are often reservoirs of active trachoma, an infectious stage. A previous survey in Loima sub-County within Turkana County documented a 67% prevalence of trachoma, well above the WHO threshold of 10% prevalence. Interestingly, although Trachoma intervention projects exist in Loima subCounty, factors that have contributed to sustaining the high endemicity in the sub-County are poorly understood. This study therefore investigated the risk factors associated with active trachoma among children aged 1-9 years in Loima sub-County, Turkana County. A crosssectional study that selected 520 children using a cluster-sampling technique was adopted. The sampling involved random selection of 13 sub-Locations, then households were randomly picked from eachselected sub-Location with proportional representation. In total, 520 children were enrolled. Closed Questionnaires were used to collect quantitative data. Observation method was used to examine the conjunctiva of both eyes of the child for clinical signs of active trachoma. Data was analysed using SPSS v20, while descriptive statistics and bivariate logistic regression methods were used for analysis. Results showed that 284(54.6%) out of 520 children who participated in the study had signs of active trachoma. The prevalence of trachoma varied by age, ranging from 30.8% in children between 1-5 years to 79.5 % in 6-9 years old (P=0.001). Bivariate logistic regression analysis identified predictors of active trachoma among children as: 1) family size (odds ratio [OR] 2.382, 95% confidence interval [95% CI] 1.318-4.34;.P=0.004), 2) source of domestic water (OR 2.151, 95% CI 1.418-3.263; P<0.001), 3) household income (OR, 5.181; 95% CI, 1.621- 16.559; P=0.006), 4) housing types (OR, 2.362; 95% CI, 1.311-4.204; P=0.005), 5) duration taken to fetch water (OR 1.822, 95% CI, 1.275-2.603; P=0.001), 6) distance between animal shed and house (OR 1.712, 95% CI 1.141-2.570; P=0.009) and 7) households where animals share houses with humans (OR 2.221, 95% CI 1.446-3.412; P<0.001):hf conclusion, the study shows a high prevalence of active trachoma among children 1-9 years in Loima subCounty and therefore a disease of public health importance that involves both socialeconomic (family size, housing structures and household income) and environmental (water, sanitation and livestock) related factors. Control strategies to mitigate Trachoma in Loima sub-County should integrate identified social-economic and environmental factors to complement the existing prevention measures