Prevalence of Trachoma and Associated Factors among Children Aged 1–9 Years in Kombolcha District, East Hararge, Oromiya Regional State, Ethiopia, 2021

<i>Introduction:</i> Trachoma, caused by the bacterium Chlamydia trachomatis, remains a significant public health concern and the leading infectious cause of blindness worldwide. In 2021, trachoma was endemic in 42 countries, primarily located in Africa, and accounted for 80% of the global burden of blindness due to an infectious disease. Despite the availability of effective prevention strategies and treatment, trachoma continues to be a major issue in certain regions, including Ethiopia. <i>Objectives: </i>This study aimed to assess the prevalence and identify factors associated with trachoma among children aged 1-9 years in rural communities of the Kombolcha district, East Hararge zone, Oromia Regional State, Ethiopia.<i> Methods: </i>A cross-sectional study design was employed, involving children aged 1-9 years in rural communities. A multistage random sampling method was utilized to select 622 study participants. Data were collected through face-to-face interviews using a structured questionnaire, which was pretested on 5% of the sample size. After data cleaning and entry into Epi Info version 7.1, data were exported to SPSS version 23 for analysis. Variables with a p-value < 0.20 in bivariate binary logistic regression were included in a multivariate binary logistic regression model to identify factors associated with trachoma. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated to evaluate the strength of associations at a p-value < 0.05.<i> Results: </i>The overall prevalence of active trachoma among children aged 1-9 years was 7.55%. Of the affected children, 83% exhibited trachomatous inflammation follicular (TF), 11% had trachomatous inflammation intense (TI), and 6% had both TF and TI. The prevalence ranged from 2.7% in children aged 1-4 years to 10.4% in children aged 5-9 years. In the multivariate analysis, factors significantly associated with the presence of active trachoma in the study population included: * Households with unprotected water sources (AOR = 0.32, 95% CI: 0.15-0.67) * Regular towel usage (AOR = 8.03, 95% CI: 2.18-29.6) * Not using soap to wash the face (AOR = 4.53, 95% CI: 2.13-9.63) * Family history of eye problems (AOR = 4.76, 95% CI: 2.19-10.35) <i>Conclusion and Recommendation: </i>The overall prevalence of active trachoma in the study area was 7.55%. While this prevalence is below the WHO threshold for mass drug administration (MDA) (>10%), it remains a significant public health concern. The findings highlight the need to implement the WHO-endorsed SAFE strategy, which focuses on surgery, antibiotics, facial cleanliness, and environmental improvement, to effectively prevent and control trachoma. Additionally, improving the overall living conditions of the community through coordinated efforts is essential in addressing the factors associated with the disease.