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Research Article

Prevalence of Ocular Chlamydia trachomatis and Active Trachoma among Children in Merhabete District, Amhara, Ethiopia

Awraris Hailu Bilchut Debre Berhan University, Debre Berhan, Ethiopia;
Eyu-Ethiopia, Bahir Dar, Ethiopia;

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Esmael Habtamu Eyu-Ethiopia, Bahir Dar, Ethiopia;
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom;
College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;

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Yeshigeta Gelaw College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;

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Aemero Abateneh College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;

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Belay Beyene Amhara Public Health Institute, Bahir Dar, Ethiopia;

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Ambahun Chernet Amhara Public Health Institute, Bahir Dar, Ethiopia;
The Carter Center, Addis Ababa, Ethiopia;

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Tariku Wondie Eyu-Ethiopia, Bahir Dar, Ethiopia;

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Adisu Abebe Amhara Regional Health Bureau, Bahir Dar, Ethiopia;

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Huiyu Hu Francis I Proctor Foundation, University of California, San Francisco, California;

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Hadley Burroughs Francis I Proctor Foundation, University of California, San Francisco, California;

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Zhaoxia Zhao Francis I Proctor Foundation, University of California, San Francisco, California;

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Jessica Shantha Francis I Proctor Foundation, University of California, San Francisco, California;
Department of Ophthalmology, University of California, San Francisco, California;

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Scott D. Nash Rollins School of Public Health, Emory University, Atlanta, Georgia;
The Carter Center, Atlanta, Georgia;

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Benjamin F. Arnold Francis I Proctor Foundation, University of California, San Francisco, California;
Department of Ophthalmology, University of California, San Francisco, California;

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Thomas M. Lietman Francis I Proctor Foundation, University of California, San Francisco, California;
Department of Ophthalmology, University of California, San Francisco, California;
Department of Epidemiology & Biostatistics, University of California, San Francisco, California

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Catherine E. Oldenburg Francis I Proctor Foundation, University of California, San Francisco, California;
Department of Ophthalmology, University of California, San Francisco, California;
Department of Epidemiology & Biostatistics, University of California, San Francisco, California

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DOI:
https://doi.org/10.4269/ajtmh.24-0732
Volume/Issue:
Ahead of Print
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There have been significant reductions in the burden of trachoma worldwide. However, some districts have experienced persistently high trachoma prevalence despite many years of intervention. Here, we report the epidemiology of trachoma in Merhabete, Ethiopia, a district in the Amhara Region that has been receiving azithromycin mass drug administration (MDA) since 2009. Data were obtained from the baseline survey of a cluster randomized trial evaluating targeted treatment strategies for trachoma elimination. An enumerative census was conducted in February 2022 to generate lists of children aged 6 months to 9 years in 80 sentinel communities participating in the trial. All children in the sentinel communities who were included in the census were examined. Field grades and conjunctival swabs were collected to assess active trachoma (based on clinical assessment) and ocular chlamydia (based on polymerase chain reaction to identify Chlamydia trachomatis). A total of 5,935 children were examined in 80 communities. The prevalence of trachomatous inflammation—follicular (TF) was 46.6%, trachomatous inflammation—intense (TI) was 17.5%, and ocular chlamydia was 28.0%. The correlation between TF and ocular chlamydia (correlation coefficient 0.54, 95% CI 0.34–0.70) was similar to the correlation between TI and ocular chlamydia (correlation coefficient 0.49, 95% CI 0.30–0.65). The prevalence of ocular chlamydia remained high in this district, which had received more than 10 rounds of azithromycin MDA. Ocular chlamydia was moderately correlated with both TF and TI. Intensive interventions may be required to eliminate trachoma in settings with persistently high ocular chlamydia prevalence despite many years of intervention.

Author Notes

Financial support: The Kebele Elimination of Trachoma for Ocular Health trial is supported by the National Eye Institute (UG1EY028088; MPIs Lietman and Oldenburg). The funders played no role in the design, analysis, interpretation, or decision to publish.

Current contact information: Awraris Hailu Bilchut, Debre Berhan University, Debre Berhan, Ethiopia, and Eyu-Ethiopia, Bahir Dar, Ethiopia, E-mail: awrarishailu@gmail.com. Esmael Habtamu, Eyu-Ethiopia, Bahir Dar, Ethiopia, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, and College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia, E-mail: esmael.ali@lshtm.ac.uk. Yeshigeta Gelaw and Aemero Abateneh, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia, E-mails: yeshigetagelaw@gmail.com and alma.aem@gmail.com. Belay Beyene, Amhara Public Health Institute, Bahir Dar, Ethiopia, E-mail: fiametaye@gmail.com. Ambahun Chernet, Amhara Public Health Institute, Bahir Dar, Ethiopia, and The Carter Center, Addis Ababa, Ethiopia, E-mail: ambahun.chernet@cartercenter.org. Tariku Wondie, Eyu-Ethiopia, Bahir Dar, Ethiopia, E-mail: twondie@ymail.com. Adisu Abebe, Amhara Regional Health Bureau, Bahir Dar, Ethiopia, E-mail: adisua0@gmail.com. Huiyu Hu, Hadley Burroughs, Zhaoxia Zhao, Jessica Shantha, Benjamin F. Arnold, Thomas M. Lietman, and Catherine E. Oldenburg, University of California, San Francisco, San Francisco, CA, E-mails: huiyu.hu@ucsf.edu, hadley.burroughs@ucsf.edu, zhaoxia.zhao@ucsf.edu, jessica.shantha@ucsf.edu, ben.arnold@ucsf.edu, tom.lietman@ucsf.edu, and catherine.oldenburg@ucsf.edu. Scott D. Nash, The Carter Center, Atlanta, GA, E-mail: scott.nash@cartercenter.org.

Address correspondence to Catherine E. Oldenburg, Francis I Proctor Foundation, University of California, San Francisco, 490 Illinois St., Floor 2, San Francisco, CA 94158. E-mail: catherine.oldenburg@ucsf.edu
Copyright:
© American Society of Tropical Medicine and Hygiene 2025
Received:
30 Oct 2024
|
Accepted:
18 Nov 2024
|
Published Online:
04 Mar 2025
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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