Predictors of trachoma among children aged 1–9 years in Ethiopia: a comprehensive systematic review and meta-analysis

Trachoma is one of the leading chronic diseases in children 1–9 years old and a cause of death primary in resources limited countries. Even though unlimited efforts have been undertaken to control the disease, it remains a major public health challenge in developing nations. In this comprehensive meta-analysis, we aimed to evaluate the pooled estimate and the factors associated with trachoma among 1–9 years old children. Potential research articles were retrieved from PubMed/Medline, SCOPUS, EMBASE, and electronic databases. Following PRISMA guidelines, a total of 38 observational studies were included in this study. The pooled single estimate of prevalence and odds ratio (OR) was calculated for each predictor. The data was analyzed using STATA version 14. A random effect model was used if the heterogeneity (I2) was greater than 50% and a p value less than 0.05 was considered a significance level. In this meta-analysis, we evaluated a total of 218,002 children aged 1–9 years and found estimate of trachoma prevalence of 20.49% (95% CI: 17.49, 23.49%). We identified several predictors associated with trachoma infection. These include: lack of access to piped drinking water (OR = 3.36, 95%Cl 2.42, 4.65), absence of household latrine (OR = 3.3, 95%Cl 2.35, 4.64), failure to wash face with soap (OR = 2.66, 95%Cl 2.0, 3.54), absence of waste disposal (OR = 2.57, 95%Cl 1.74, 3.79), and taking more than 30 min to fetch water (OR = 3.24, 95%Cl 1.85, 5.67). Furthermore, the presence of animal pens in the living area (OR = 3.28, 95%Cl 2.4, 4.47), inadequate knowledge of caregivers/mothers (OR = 3.56, 95%Cl 2.36, 5.36), family size greater than five (OR = 2.86, 95%Cl 1.39, 5.89), face washing < two times per day (OR = 3.09, 95%Cl 2.05, 4.67), presence of flies on the face (OR = 3.31, 95%Cl 2.09, 5.24) were also identified as significant predictors of trachoma. In overall, the present study revealed that the burden of trachoma among children was aged 1-9 years in Ethiopia 20.49%. The predictors associated with trachoma among children includes absence of household latrines, lack of access to piped drinking water, failure to wash face with soap, taking more than 30 min to fetch water, presence of animal pens in the living compound, inadequate knowledge of caregivers/mothers, family size exceeding five, infrequent face washing, the presence of flies on children’s faces, and insufficient waste disposal. Our findings suggest that, in addition to existing preventative strategies, there is an urgent need for improved personal and environmental hygiene practices, as well as addressing these factors.