International Ophthalmology

, Volume 33, Issue 1, pp 53–59 | Cite as

Risk of trachoma in a SAFE intervention area

  • Assegid Aga Roba
  • Daksha Patel
  • Marcia Zondervan
Original Paper


To determine prevalence and risk factors of trachoma in communities receiving intervention with the SAFE strategy (surgery, antibiotic, face washing, environmental hygiene), a cross-sectional trachoma survey was undertaken in 2006 in the Enemor district of southern Ethiopia where the SAFE program has been implemented for over five years. A sample of 374 household heads and 2,080 individuals were interviewed and examined for trachoma using an established trachoma grading system of the World Health Organization. The most prominent risk factors were identified with logistic regression analysis. Among individuals >14 years of age, the prevalence of trichiasis was 9.04 % [confidence interval (CI) 7.4–10.6]. People >40 years of age [odds ratio (OR) 1.7; CI 1.2–2.7), women (OR 2.2; CI 1.1–4.3), and illiterates (OR 3; CI 1.4–6.8) had increased risk of trichiasis. Coverage of surgical and antibiotic services was 46 and 85.5 %, respectively. Prevalence of active follicular trachoma (TF) in children aged 1–9 years was 33.1 % (CI 29.4–37.1). Unclean faces (OR 5.9; CI 4.3–8.3) and not being in school (OR 2.1; CI 1.3–3.3) were significantly associated with TF. Clean faces were observed in 56.1 % of children and improved with age and schooling (P < 0.001, Chi-squared test). Household latrine use (74.4 %) was associated with knowledge about SAFE and economic level (P ≤ 0.004, Chi-squared tests). Elderly illiterate women remain at risk of becoming blind from trachoma even in intervention areas. Trachoma particularly affects children without clean faces or opportunity for schooling. Provision of SAFE services with high coverage should be sustained in trachoma-hyperendemic areas.


Active trachoma Blinding trachoma Ethiopia Risk factors SAFE strategy Trachoma trichiasis 



This work was financially supported by the Association of Physicians of Great Britain and Ireland, and Thomas Spence Dunn Trust. We acknowledge the cooperation of the Enemor and Ener District Health Office, Gurage Zone Health Desk and ORBIS International-Ethiopia Office for facilitating the study.

Conflict of interest

None of the authors has financial conflict of interest in this study. Sponsors had no role in the design, implementation or publication of the research work.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Assegid Aga Roba
    • 1
  • Daksha Patel
    • 2
  • Marcia Zondervan
    • 2
  1. 1.Sector de Oftalmologia, Hospital Central Da BeiraLight for the WorldBeiraMozambique
  2. 2.International Centre for Eye HealthLondon School of Hygiene and Tropical MedicineLondonUK

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