Prevalence and risk factors for trachoma infection among children aged 1-9 years old in Oldonyonyokie Location, Magadi Division, Kajiado County, Kenya
Nyamwaro, Christine Moraa
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Trachoma is one of the water-related infectious diseases that affects the eyes and manifests itself in impoverished, rural areas with little access to clean safe water and proper sanitation that disproportionately afflicts women and children in poor communities. It is a bacterial disease caused by Chlamydia trachomatis that is highly infectious and can spread through an infected person’s hands or clothing or transmitted by flies that have been in contact with discharge or nose of an infected person. The disease remains the principal cause of preventable blindness and the second leading cause of blindness globally. The current recommended surgery for trichiasis, antibiotics for active disease, facial cleanliness, and environmental change to reduce transmission (SAFE) strategy targets all key elements believed to be necessary for a short- and long-term intervention program. Even with the interventions on the ground, the prevalence of trachoma is still high. The study investigated the prevalence and risk factors for trachoma infections among children aged 1-9 years old in Oldonyonyokie Location, Magadi Division, Kajiado County. Specifically the study sought to examine the prevalence of trachoma, assess socio-demographic factors influencing trachoma prevalence, identify water, sanitation and hygiene related factors influencing prevalence of trachoma, determine whether the practice of keeping of animals affect trachoma prevalence and assess the health seeking behaviors of care givers of children affected by trachoma. The study was a cross-sectional descriptive survey that employed both quantitative and qualitative approaches. Kajiado County was purposively sampled using multi stage cluster sampling methods in the first stage; secondly Oldonyonyokie location was randomly selected. Thirdly snow ball sampling was used to select households with children aged 1-9 years old, guided by Community Health Workers (CHWs). Data was collected using interviewer administered structured questionnaires, focus group discussions (FGDs) and In-Depth Interviews (IDIs). Quantitative data was entered and analyzed using SPSS version 20, which was triangulated using qualitative data. Qualitative data was transcribed and analyzed by content analysis and presented verbatim. The results indicated that prevalence of trachoma is high (18.6%) in Oldonyonyokie, Magadi. Although this was lower than the greater Kajiado County, the prevalence was still an issue of public health concern. The main socio-demographic characteristic found to influence the prevalence of trachoma were the levels of formal education. Majority of the respondents had poor hygiene practices mainly manifested by poor latrine coverage of 11.6%, and hand washing (28.1%) after toilet use. Majority of the households kept cattle (50.9%), goats (82.6%) and sheep (57.4%) in the households, hence increasing the risk of transmission of trachoma The results further indicated that majority of households’ health seeking behaviors was poor – with only 23.1% of respondents visiting health centers after having watery eyes. The study recommends that the Ministry of Health, at County and National levels, should come up with effective, tailor-made and sustainable ways of curbing the trachoma infections. There should be concerted efforts to promote the understanding of Trachoma prevention and management in affected communities. This could be undertaken through localized Behavior Change Communication (BCC) using Information, Education and communication (IEC) materials. There should also be special programmes aimed at improving the negative hygiene practices in the communities. Traditional practices such keeping animals in the houses should be addressed so that the community is trained on behavior change.