{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:01:27Z","timestamp":1785423687395,"version":"3.56.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011573","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000}}],"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"Background<\/jats:title>Trachoma is the chief cause of preventable blindness worldwide and has been earmarked for elimination as a public health problem by 2030. Despite the five-year Surgery, Antibiotics, Facial cleanliness, and Environmental improvement (SAFE)-based interventions in the Andabet district, the prevalence of trachomatous follicular (TF) was 37%. With such a high prevalence of TF, the determinant factors were not revealed. Besides, there were no reports on the overall prevalence of active trachoma (i.e.TF and or trachomatous intense (TI)).<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine the prevalence and associated factors of active trachoma among 1\u20139 years of age children in the Andabet district.<\/jats:p><\/jats:sec>Method<\/jats:title>A community-based cross-sectional study was conducted among children aged under nine years from March 1\u201330, 2023 in Andabet district, Northwest Ethiopia. Multi-stage systematic random sampling was employed to reach 540 children. A multilevel mixed-effect logistic regression analysis was employed to assess factors associated with active trachoma. We fitted both random effect and fixed effect analysis. Finally, variables with p<0.05 in the multivariable multilevel analysis were claimed to be significantly associated with active trachoma.<\/jats:p><\/jats:sec>Result<\/jats:title>In this study, the overall prevalence of active trachoma was 35.37% (95% CI: 31.32%, 39.41%). The prevalence of TF and TI was 31.3% and 4.07% respectively. In the multilevel logistic regression analysis ocular discharge, fly-eye contact, latrine utilization, and source of water were significantly associated with the prevalence of active trachoma.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In this study, the prevalence of active trachoma was much higher than the World Health Organization (WHO) threshold prevalence. Ocular discharge, fly-eye contact, latrine utilization, and source of water were independent determinants of active trachoma among children (1\u20139 years). Therefore, paying special attention to these high-risk groups could decrease the prevalence of a neglected hyperendemic disease, active trachoma.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0011573","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T17:52:58Z","timestamp":1692294778000},"page":"e0011573","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence and associated factors of active trachoma among 1\u20139 years of age children in Andabet district, northwest Ethiopia, 2023: A multi-level mixed-effect analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4003-207X","authenticated-orcid":true,"given":"Zufan Alamrie","family":"Asmare","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beminate Lemma","family":"Seifu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kusse Urmale","family":"Mare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yordanos Sisay","family":"Asgedom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bizunesh Fantahun","family":"Kase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdu Hailu","family":"Shibeshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsion Mulat","family":"Tebeje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afework Alemu","family":"Lombebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kebede Gemeda","family":"Sabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bezawit Melak","family":"Fente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achamyeleh Birhanu","family":"Teshale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiwot Altaye","family":"Asebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"issue":"6","key":"pntd.0011573.ref001","doi-asserted-by":"crossref","first-page":"e0006585","DOI":"10.1371\/journal.pntd.0006585","article-title":"Baseline trachoma prevalence in Guinea: Results of national trachoma mapping in 31 health districts","volume":"12","author":"A G\u00e9opogui","year":"2018","journal-title":"PLoS neglected tropical diseases"},{"issue":"26","key":"pntd.0011573.ref002","first-page":"371","article-title":"WHO Alliance for the Global Elimination of Trachoma by 2020: progress report on elimination of trachoma, 2017\u2013Alliance OMS pour l\u2019\u00e9limination mondiale du trachome d\u2019ici 2020: Rapport de situation sur l\u2019\u00e9limination du trachoma, 2017","volume":"93","author":"Organization WH","year":"2018","journal-title":"Weekly Epidemiological Record = Relev\u00e9 \u00e9pid\u00e9miologique hebdomadaire"},{"issue":"5_suppl_1","key":"pntd.0011573.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4269\/ajtmh.2003.69.5_suppl_1.0690001","article-title":"Global burden of trachoma and economics of the disease","volume":"69","author":"KD Frick","year":"2003","journal-title":"The American journal of tropical medicine and hygiene"},{"issue":"2","key":"pntd.0011573.ref004","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.tmaid.2012.01.005","article-title":"Targeting trachoma: Strategies to reduce the leading infectious cause of blindness","volume":"10","author":"A. Baneke","year":"2012","journal-title":"Travel medicine and infectious disease"},{"issue":"11","key":"pntd.0011573.ref005","first-page":"844","article-title":"Global data on visual impairment in the year 2002","volume":"82","author":"S Resnikoff","year":"2004","journal-title":"Bulletin of the world health organization"},{"key":"pntd.0011573.ref006","unstructured":"Organization WH. Report of the 2nd Global scientific meeting on trachoma: Geneva, 25\u201327 August, 2003. World Health Organization, 2003."},{"issue":"3","key":"pntd.0011573.ref007","first-page":"185","article-title":"National survey on blindness, low vision and trachoma in Ethiopia: Methods and study clusters profile","volume":"21","author":"Y Berhane","year":"2007","journal-title":"Ethiopian Journal of Health Development"},{"issue":"6","key":"pntd.0011573.ref008","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.4269\/ajtmh.19-0450","article-title":"Progress to eliminate trachoma as a public health problem in Amhara National Regional State, Ethiopia: results of 152 population-based surveys","volume":"101","author":"AE Stewart","year":"2019","journal-title":"The American journal of tropical medicine and hygiene"},{"issue":"7","key":"pntd.0011573.ref009","doi-asserted-by":"crossref","first-page":"e734","DOI":"10.1371\/journal.pntd.0000734","article-title":"Where do we go from here? Prevalence of trachoma three years after stopping mass distribution of antibiotics in the regions of Kayes and Koulikoro, Mali","volume":"4","author":"S Bamani","year":"2010","journal-title":"PLoS neglected tropical diseases"},{"issue":"3","key":"pntd.0011573.ref010","first-page":"204","article-title":"Prevalence and causes of blindness and low vision in Ethiopia","volume":"21","author":"Y Berhane","year":"2007","journal-title":"Ethiopian Journal of Health Development"},{"key":"pntd.0011573.ref011","doi-asserted-by":"crossref","DOI":"10.1155\/2015\/570898","article-title":"Prevalence of active trachoma and its associated factors among rural and urban children in Dera Woreda, Northwest Ethiopia: a comparative cross-sectional study","volume":"2015","author":"M Alemayehu","year":"2015","journal-title":"Biomed research international"},{"issue":"1","key":"pntd.0011573.ref012","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4269\/ajtmh.20-0777","article-title":"Population-based prevalence of Chlamydia trachomatis infection and antibodies in four districts with varying levels of trachoma endemicity in Amhara, Ethiopia","volume":"104","author":"SD Nash","year":"2021","journal-title":"The American journal of tropical medicine and hygiene"},{"issue":"6","key":"pntd.0011573.ref013","doi-asserted-by":"crossref","first-page":"e0268441","DOI":"10.1371\/journal.pone.0268441","article-title":"Prevalence of active trachoma and its associated factors among 1\u20139 years of age children from model and non-model kebeles in Dangila district, northwest Ethiopia","volume":"17","author":"A Genet","year":"2022","journal-title":"Plos one"},{"issue":"1","key":"pntd.0011573.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13052-022-01258-x","article-title":"Prevalence of active trachoma and associated factors among school age children in Debre Tabor Town, Northwest Ethiopia, 2019: a community based cross-sectional study","volume":"48","author":"A Shimelash","year":"2022","journal-title":"Italian Journal of Pediatrics"},{"issue":"7","key":"pntd.0011573.ref015","doi-asserted-by":"crossref","first-page":"e0271433","DOI":"10.1371\/journal.pone.0271433","article-title":"Prevalence of visual impairment and associated factors among children in Ethiopia: Systematic review and meta-analysis","volume":"17","author":"DT Anley","year":"2022","journal-title":"PloS one"},{"issue":"6","key":"pntd.0011573.ref016","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1080\/09286586.2016.1243717","article-title":"Prevalence of and risk factors for trachoma in Oromia regional state of Ethiopia: results of 79 population-based prevalence surveys conducted with the global trachoma mapping project","volume":"23","author":"B Bero","year":"2016","journal-title":"Ophthalmic epidemiology"},{"key":"pntd.0011573.ref017","article-title":"Factors Associated with Active Trachoma among Children in Ebinat District, South Gondar Zone, North West Ethiopia: A community-based cross-sectional study","author":"GA Beyene","year":"2022","journal-title":"medRxiv"},{"issue":"2","key":"pntd.0011573.ref018","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD003659.pub4","article-title":"Face washing promotion for preventing active trachoma","author":"HO Ejere","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"3","key":"pntd.0011573.ref019","doi-asserted-by":"crossref","first-page":"e0247772","DOI":"10.1371\/journal.pone.0247772","article-title":"Spatial variations and associated factors of knowledge of ORS packet or pre-packaged liquids for the management of diarrhea among women of reproductive age in Ethiopia: A spatial and multilevel analysis","volume":"16","author":"AB Teshale","year":"2021","journal-title":"Plos one"},{"issue":"5","key":"pntd.0011573.ref020","doi-asserted-by":"crossref","first-page":"e0251427","DOI":"10.1371\/journal.pone.0251427","article-title":"Community-level women\u2019s education and undernutrition among Indian adolescents: A multilevel analysis of a national survey","volume":"16","author":"AR Shah","year":"2021","journal-title":"Plos one"},{"key":"pntd.0011573.ref021","unstructured":"Abraham D. Latrine Utilization and Associated Factors Among Rural Households in Dega Damot Woreda, West Gojjam Zone, Amhara Region, Ethiopia 2021."},{"issue":"1","key":"pntd.0011573.ref022","first-page":"123","article-title":"Trachoma Prevention Practice and Associated Factors in Rural Lemo District, Southern Ethiopia, 2021","volume":"33","author":"MG Shobiso","year":"2023","journal-title":"Ethiop J Health Sci"},{"key":"pntd.0011573.ref023","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/8635191","article-title":"Prevalence of active trachoma and associated factors in Areka Town, south Ethiopia, 2018","volume":"2020","author":"MM Alambo","year":"2020","journal-title":"Interdisciplinary Perspectives on Infectious Diseases"},{"issue":"2","key":"pntd.0011573.ref024","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1111\/j.1365-3156.2009.02436.x","article-title":"Personal and environmental risk factors for active trachoma in children in Yobe state, north-eastern Nigeria","volume":"15","author":"C Mpyet","year":"2010","journal-title":"Tropical Medicine & International Health"},{"issue":"5","key":"pntd.0011573.ref025","doi-asserted-by":"crossref","first-page":"e2240","DOI":"10.1371\/journal.pntd.0002240","article-title":"Prevalence of trachoma in the Far North region of Cameroon: results of a survey in 27 Health Districts","volume":"7","author":"B Noa Noatina","year":"2013","journal-title":"PLoS Neglected Tropical Diseases"},{"issue":"11","key":"pntd.0011573.ref026","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1111\/tmi.12182","article-title":"Follicular trachoma and trichiasis prevalence in an urban community in The Gambia, West Africa: is there a need to include urban areas in national trachoma surveillance?","volume":"18","author":"E Quicke","year":"2013","journal-title":"Tropical Medicine & International Health"},{"issue":"sup1","key":"pntd.0011573.ref027","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1080\/09286586.2018.1546878","article-title":"A population-based trachoma prevalence survey covering seven districts of Sangha and Likouala departments, Republic of the Congo","volume":"25","author":"F Missamou","year":"2018","journal-title":"Ophthalmic epidemiology"},{"key":"pntd.0011573.ref028","first-page":"1","article-title":"Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal","volume":"18","author":"EM Harding-Esch","year":"2018","journal-title":"BMC public health"},{"issue":"8","key":"pntd.0011573.ref029","doi-asserted-by":"crossref","first-page":"e6702","DOI":"10.1371\/journal.pone.0006702","article-title":"Access to water source, latrine facilities and other risk factors of active trachoma in Ankober, Ethiopia","volume":"4","author":"I Golovaty","year":"2009","journal-title":"PLoS One"},{"issue":"3","key":"pntd.0011573.ref030","doi-asserted-by":"crossref","DOI":"10.4314\/ejhd.v21i3.10051","article-title":"Prevalence of trachoma in Ethiopia","volume":"21","author":"Y Berhane","year":"2007","journal-title":"The Ethiopian Journal of Health Development"},{"issue":"sup1","key":"pntd.0011573.ref031","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1080\/09286586.2016.1247876","article-title":"Prevalence of and risk factors for trachoma in Southern Nations, Nationalities, and Peoples\u2019 Region, Ethiopia: results of 40 population-based prevalence surveys carried out with the Global Trachoma Mapping Project","volume":"23","author":"TH Adera","year":"2016","journal-title":"Ophthalmic epidemiology"},{"issue":"1","key":"pntd.0011573.ref032","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-12-1105","article-title":"Active trachoma and associated risk factors among children in Baso Liben District of East Gojjam, Ethiopia","volume":"12","author":"K Ketema","year":"2012","journal-title":"BMC public health"},{"issue":"1","key":"pntd.0011573.ref033","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-021-06515-z","article-title":"Access to water, sanitation and hygiene services in health facilities in sub-Saharan Africa 2013\u20132018: Results of health facility surveys and implications for COVID-19 transmission","volume":"21","author":"M Kanyangarara","year":"2021","journal-title":"BMC health services research"},{"issue":"1","key":"pntd.0011573.ref034","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-020-09895-9","article-title":"Assessment of water, sanitation and hygiene service availability in healthcare facilities in the greater Kampala metropolitan area, Uganda","volume":"20","author":"D Kayiwa","year":"2020","journal-title":"BMC Public Health"},{"issue":"11","key":"pntd.0011573.ref035","doi-asserted-by":"crossref","first-page":"e0006080","DOI":"10.1371\/journal.pntd.0006080","article-title":"Effect of water, sanitation and hygiene interventions on active trachoma in North and South Wollo zones of Amhara Region, Ethiopia: a quasi-experimental study","volume":"11","author":"B Tadesse","year":"2017","journal-title":"PLoS neglected tropical diseases"},{"issue":"11","key":"pntd.0011573.ref036","doi-asserted-by":"crossref","first-page":"e861","DOI":"10.1371\/journal.pntd.0000861","article-title":"Trachoma prevalence and associated risk factors in the gambia and Tanzania: baseline results of a cluster randomised controlled trial","volume":"4","author":"EM Harding-Esch","year":"2010","journal-title":"PLoS neglected tropical diseases"},{"issue":"4","key":"pntd.0011573.ref037","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/j.1365-3156.2008.02034.x","article-title":"Risk factors for active trachoma and Chlamydia trachomatis infection in rural Ethiopia after mass treatment with azithromycin","volume":"13","author":"T Edwards","year":"2008","journal-title":"Tropical medicine & international health"},{"issue":"5","key":"pntd.0011573.ref038","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.trstmh.2008.02.014","article-title":"Risk factors for active trachoma in children and trichiasis in adults: a household survey in Amhara Regional State, Ethiopia","volume":"102","author":"J Ngondi","year":"2008","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"},{"key":"pntd.0011573.ref039","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1590\/S0102-311X2007000700020","article-title":"Preliminary evidence that synanthropic flies contribute to the transmission of trachoma-causing Chlamydia trachomatis in Latin America","volume":"23","author":"LA Reilly","year":"2007","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"1","key":"pntd.0011573.ref040","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40794-016-0022-0","article-title":"Prevalence of active trachoma and associated risk factors among children in Gazegibela district of Wagehemra Zone, Amhara region, Ethiopia: community-based cross-sectional study","volume":"2","author":"ZA Anteneh","year":"2016","journal-title":"Tropical diseases, travel medicine and vaccines"},{"issue":"1","key":"pntd.0011573.ref041","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-019-3992-5","article-title":"Prevalence of active trachoma and associated risk factors among children of the pastoralist population in Madda Walabu rural district, Southeast Ethiopia: a community-based cross-sectional study","volume":"19","author":"K Kassim","year":"2019","journal-title":"BMC infectious diseases"},{"issue":"10","key":"pntd.0011573.ref042","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/trstmh\/trz042","article-title":"Unimproved water sources and open defecation are associated with active trachoma in children in internally displaced persons camps in the Darfur States of Sudan","volume":"113","author":"CK Macleod","year":"2019","journal-title":"Transactions of the Royal Society of Tropical Medicine and Hygiene"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0011573","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T00:00:00Z","timestamp":1693267200000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011573","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T06:36:30Z","timestamp":1702967790000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011573"}},"subtitle":[],"editor":[{"given":"Joseph M.","family":"Vinetz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,8,17]]},"references-count":42,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0011573","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0011573","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,17]]}}}