Factors affecting trachoma control and prevention among pastoralist in Kirisia sub-county, Samburu county, Kenya

Abstract

Trachoma is still a public health and socioeconomic problem, majorly in sub-Saharan Africa. Trachoma control and prevention efforts have over the past few decades realized significant progress. However, numerous challenges remain to be circumvented in order to achieve effective control and prevention of this disease in endemic communities. Though this disease is preventable and treatable, its prevalence in Samburu County as well as Kirisia Sub-county remains high above the WHO recommended threshold of 10% and 1% in children between 1-9 years and individuals above 15 years, respectively. Moreover, there is a gap in knowledge on the factors contributing to the sustained high trachoma prevalence in the area. This cross-sectional study focused on the assessment of socioeconomic, cultural and health system factors affecting trachoma control and prevention among pastoralist in Kirisia, Samburu County. A multistage sampling technique on 446 respondents comprising of household heads aged 18 years and above was explored. Quantitative and qualitative techniques were used to collect data which was analyzed using SPSS windows version 28.0 at P≤0.05 level of significance. Findings from this study revealed that majority of the respondents (63%) were female, 43.8% had not completed any level of formal education, 51% were low-income earners and 33.4% were unemployed. The median average age and SD of the informants was 38.9±13.5. Individual level factors that increased the risk of trachoma transmission included the level of income (P>0.05), level of knowledge on trachoma transmission, prevention and control (P>0.05), level of education (P>0.05), occupation (P>0.05), distance to water sources (P>0.05). Healthcare facilities were reported to be significantly far from households (P<0.05). Additionally, behaviors predisposing the informants to trachoma such as open defecation (33.9%), lack of hand and face washing facilities (41%), poor treatment seeking behavior (5.8%), self-medication (5.2%), and use of herbs (1.2%) while health facility factors included distance from the households (P>0.01). Inadequate ophthalmologists (85.5%) and inadequate equipment (3.6%), low coverage and visitation by community health volunteers to households (23.3%) were among the factors influencing trachoma spread reported by the informants. Association analyses revealed a relationship between level of education and the following trachoma risk factors, namely; level of income, religion, level of knowledge on trachoma transmission, prevention, and control, face washing behavior, latrine ownership, and water treatment behavior (P<0.05). This study also reports a significant association between religion and cultural factors (P<0.05), face washing behavior and distance to water sources during the dry season (P<0.05), knowledge on trachoma and water treatment behavior (P<0.05), occupation and waste disposal (P<0.05), knowledge on trachoma and water treatment behavior (P<0.05), and distance to healthcare facility and time taken to seek treatment when sick (P<0.05). These study findings could be used to inform, plan and initiate socio-culturally sensitive sustainable interventions to combat the identified high-risk factors and undesirable practices in favor of safe, effective and sustainable trachoma control methods among the pastoralist in Samburu County, Kenya.