Baseline trachoma survey in ELCK-Arsim integrated development project area of Samburu North, Kenya

Abstract

Objectives: To establish the prevalence of active trachoma (TF) in children aged 1-9 years; potentially blinding trachoma (TT) in adults >15 years and to document the magnitude of selected known trachoma risk factors. Design: Baseline community based survey conducted in March 2008 using the standardized WHO protocol. Setting: Evangelical Lutheran Church of Kenya (ELCK)-Arsim Integrated Development Project area, Samburu District, Lift Valley Province, Kenya. Subjects: A total of 47 villages and 71 households were visited. 862 children aged 1-9 years and 1,044 adults aged ≥15 yrs were examined. 427 (49.5%) of the children were boys and 435 (50.5%) were girls. 330 (31.6%) of the adults were males and 714 (68.4%) were females. 97.6% of adults and 90.0% of children over 5 years had never gone to school. Results: The prevalence of active trachoma (TF) in children was 31.3% (95% CI: 28.2 – 34.4). Boys and girls were equally affected. Children 1-5 years of age were most affected. The prevalence of potentially blinding trachoma (TT) in adults >15 years was 2.2% (95% CI: 1.5–2.9). Of those with TT, 5 (22%) were males and 18 (78%) females. The prevalence of TT increased with age. Eight (34.8%) of those with TT had coexisting corneal opacity meaning that they were either blind or going blind. Of he 1044 adults examined during the survey, 371 (35.5%) had TS giving a TT to TS ratio of 1:16. This implies that it will take time before potentially blinding trachoma (TT) is eliminated. Known trachoma risk factors were documented. During the dry season, most households take about 3 hours to fetch water. During the wet season, they take about 1 hour. A total of 460 (53.4%) children examined had dirty faces. No household had a leaky tin. o household has a leaky tin. Ten of the 47 villages visited did not have any communal water point. In most households (97.4%) animals were kept no more than 20 meters of the house. Most (57.4%) households had animals kept inside the house at times. Only 7 (11%) of the 155 households had latrines (built as part of a demonstration project). 58 households (37.4%) had uncovered human faeces in/around the compound. In 125 (80.6%) of the households, garbage was scattered all over the compound. Conclusions: It was concluded that both, active and potentially blinding trachoma are a public health problem in the ELCK-Arisim integrated development project area. Recommendations: The whole population (23,607 people) living in the project area need mass antibiotic treatment. About 312 adults living in the project area have potentially blinding TT and need of immediate surgery.