Epidemiology of Trachoma among Children in a War Zone: Prevalence and Risk Factors for Trachoma in Rural Areas During the Siege and War in Yemen

Abstract

Background and Aims: Trachoma has historical and continuing significance as a major cause of vision loss, with an essentially disproportionate impact on the poorest individuals in the poorest communities as in Yemen now under siege and war especially in rural areas. There is no awareness among local and national governments of this disease as a public health problem of top priority in Yemen. However, there is no evidence or no survey/research data or document regarding the prevalence of trachoma in the distract of Bani Matter, in Sana’a Governorate, Yemen. Therefore, we conducted a study to assess the
prevalence of active trachoma and associated factors in this rural area.

Methods: A cross-sectional, cross-sectional study was used. A total of 762 children aged 6-12 years participated. We compiled a structured questionnaire from the relevant literature and pre-tested before use. A range of data was collected on social, demographic, and related and environmental factors, facilities and services. The outcome variable was measured using frequencies, cross tabulation, percentage and odds ratio of association.

Results: The gender distribution of study participants was 402 (52.8%) male and 360 (47.2%) female. The study participants were in the age group of 6-9 years (58.9%) while the proportion between 10-12 years was 41.1%. The results of the independent ORs analysis showed that the risk factors for trachoma were: no toilet in the child’s home (odds ratio = 2.3, p = 0.003), orphaned mother (odds ratio = 3.7, p < 0.001), scarce water available in the child’s home (OR = 2.4, p = 0.001), face flies (OR = 2.6, p < 0.001), unclean face (OR = 2.2, p = 0.004), keeping animals in a living house (2.1, p = 0.01), and overcrowding homes (OR = 2.3, P < 0.001).

Conclusion: We define the area in which, at the time of survey among 10–12 children, trachoma was a public health problem in the distract of Bani matter (10.5%) as defined by the World Health Organization (rate ≥ 10%). The implementation of the WHO-approved SAFE strategy for effective prevention and control of trachoma was recommended in the study area due to the prevalence of active trachoma, reaching 10.5% among a group of children above the thresholds recommended by WHO (prevalence >10%). Reducing most of the risk factors in this study depends on health education and provision of the basic things of life to the individual. As for the child losing his parents, especially the loss of the mother, it is a disaster for the child, so addressing causes such as war and poverty for this problem must be a priority in Yemen by the Yemenis themselves, with the help of international organizations such as the United Nations, the World Health Organization and UNICEF.