{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:02:23Z","timestamp":1785391343380,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":209,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Tropical Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Trachoma is a leading infectious cause of preventable blindness and remains a major public health problem in rural Ethiopia, where inadequate water, sanitation, and hygiene (WASH) conditions sustain transmission. This study assessed the prevalence of active trachoma and associated WASH and hygiene\u2010related factors among children aged 1\u20139\u2009years in rural communities of North Gondar Zone, Ethiopia. A community\u2010based cross\u2010sectional study was conducted among 456 children selected using a multistage sampling technique. Data on sociodemographic characteristics, household WASH conditions, and hygiene practices were collected using structured caregiver interviews and direct observation. Active trachoma was diagnosed using the WHO simplified trachoma grading system (trachomatous inflammation\u2013follicular and\/or trachomatous inflammation\u2013intense). Poor face\u2010washing practice was defined as washing the child\u2019s face less than twice per day or the presence of ocular or nasal discharge, while good practice was defined as washing the child\u2019s face at least twice per day and the absence of ocular or nasal discharge. High fly density was defined as the observation of three or more eye\u2010seeking flies on or around the child\u2019s face during household assessment. Binary and multivariable logistic regression analyses were performed, with statistical significance set at\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05. The overall prevalence of active trachoma was 20.6% (95% CI: 16.9%\u201324.3%). In multivariable analysis, higher odds of active trachoma were observed among children from households using unimproved water sources (AOR = 1.76; 95% CI: 1.01\u20133.05), households without latrines (AOR = 1.94; 95% CI: 1.15\u20133.28), children with poor face\u2010washing practices (\n                    <jats:italic>A<\/jats:italic>\n                    <jats:italic>O<\/jats:italic>\n                    <jats:italic>R<\/jats:italic>\n                    = 2.63; 95% CI: 1.52\u20134.55), and children exposed to high fly density (AOR = 2.71; 95% CI: 1.60\u20134.58). These findings indicate significant associations rather than causal relationships due to the cross\u2010sectional design. The study highlights the continued burden of trachoma in the area and supports strengthening integrated WASH and facial cleanliness interventions under the WHO SAFE strategy.\n                  <\/jats:p>","DOI":"10.1155\/jotm\/8924826","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:46:40Z","timestamp":1785390400000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trachoma Prevalence and Associated WASH and Behavioral Risk Among Rural Communities of North Gondar Zone, Ethiopia: A Community\u2010Based Cross\u2010Sectional Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4439-6279","authenticated-orcid":false,"given":"Gebre Ayanaw","family":"Alula","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40123-025-01102-5"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joco.2016.08.011"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12081544"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(21)00409-5"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-039529"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2024.48.93.43242"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009644"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11100-4"},{"key":"e_1_2_14_9_2","article-title":"Prevalence and Risk Factors of Active Trachoma Among Children in Gondar Zuria District North Gondar, Ethiopia","volume":"1","author":"Asres M.","year":"2016","journal-title":"Preventive Medicine"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-017-0358-3"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-021-01064-x"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.1101\/2022.02.07.22270570"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0011573"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012399"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009962"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007784"},{"key":"e_1_2_14_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/09286586.2016.1243717"},{"key":"e_1_2_14_18_2","volume-title":"Sampling Techniques","author":"Cochran W. G.","year":"1977"},{"key":"e_1_2_14_19_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001605"},{"key":"e_1_2_14_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(25)00551-3"},{"key":"e_1_2_14_21_2","first-page":"363","article-title":"WHO Alliance for the Global Elimination of Trachoma: Progress Report on Elimination of Trachoma, 2023=Alliance De L\u2019Oms Pour L\u2019\u00c9limination Mondiale Du Trachome: Rapport De Situation, 2023","volume":"99","author":"Mondiale De La Sant\u00e9 O.","year":"2024","journal-title":"Weekly Epidemiological Record= Relev\u00e9 \u00e9pid\u00e9miologique Hebdomadaire"},{"key":"e_1_2_14_22_2","article-title":"Trachoma Elimination: Approaches, Experiences and Performance of Interventions in Amhara Regional State, Ethiopia","volume":"3","author":"Worku A.","year":"2018","journal-title":"Journal of Eye Diseases and Disorders"},{"key":"e_1_2_14_23_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1478001"},{"key":"e_1_2_14_24_2","volume-title":"Developing Strategies to Address Persistence and Recrudescence of Trachoma in Southern Ethiopia","author":"Buda D. S.","year":"2025"},{"key":"e_1_2_14_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/09286586.2016.1242757"},{"key":"e_1_2_14_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000583"},{"key":"e_1_2_14_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001585"},{"key":"e_1_2_14_28_2","doi-asserted-by":"crossref","DOI":"10.1080\/09286586.2018.1550205","article-title":"Impact of the Global Trachoma Mapping Project","author":"Cama A.","year":"2018","journal-title":"Ophthalmic Epidemiology"},{"key":"e_1_2_14_29_2","volume-title":"World Health Organization Alliance for the Global Elimination of Trachoma by 2020: Second Global Scientific Meeting on Trachomatous Trichiasis: Cape Town, 4\u20136 November 2015","author":"Organization W. H.","year":"2016"},{"key":"e_1_2_14_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006178"},{"key":"e_1_2_14_31_2","volume-title":"The Impact of Latrine Construction on Densities and Pathogen Infection Rates of Synanthropic Flies and Culex quinquefasciatus Mosquitoes in Odisha, India","author":"Bell M. J.","year":"2020"},{"key":"e_1_2_14_32_2","doi-asserted-by":"publisher","DOI":"10.18203\/2394-6040.ijcmph20200939"},{"key":"e_1_2_14_33_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312024"},{"key":"e_1_2_14_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-024-02966-w"},{"key":"e_1_2_14_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1991.01080060119038"},{"key":"e_1_2_14_36_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010272"}],"container-title":["Journal of Tropical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jotm\/8924826","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jotm\/8924826","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jotm\/8924826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:46:43Z","timestamp":1785390403000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jotm\/8924826"}},"subtitle":[],"editor":[{"given":"Priya","family":"Gusain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jotm\/8924826"],"URL":"https:\/\/doi.org\/10.1155\/jotm\/8924826","archive":["Portico"],"relation":{},"ISSN":["1687-9686","1687-9694"],"issn-type":[{"value":"1687-9686","type":"print"},{"value":"1687-9694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8924826"}}