{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:59:36Z","timestamp":1788267576339,"version":"build-2803163510"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\nBackground<\/jats:title>\nTrachoma is the leading infectious cause of blindness worldwide, primarily affecting populations in low-income countries with poor sanitation and hygiene conditions. The World Health Organization has set a goal to eliminate trachoma as a public health problem. However, progress towards this goal has been uneven across different regions. This systematic review and meta-analysis aimed to synthesize the available evidence on the association between the presence of latrine facilities and unclean child faces with the prevalence of active trachoma among children aged 1 to 9 years in low-income country settings. The findings from this study can help guide the design of more targeted interventions to reduce the burden of trachoma in vulnerable populations.<\/jats:p>\n<\/jats:sec>\n\nMaterials and methods<\/jats:title>\nA total of 2695 articles were searched from PubMed, Hinari, African Online Journals, Google, Google Scholar, Science Direct, and Semantic Scholar and exported to STATA version 17 for analysis. The levels of heterogeneity among studies were assessed using I2 and p-values. The findings of the meta-analysis were presented using a table, graph, and forest plot with a 95% confidence interval. A P-value of less than 0.05 was considered statistically significant.<\/jats:p>\n<\/jats:sec>\n\nResult<\/jats:title>\nAmong 2695 articles searched, 16 of them were selected for meta-analysis. The pooled prevalence of active trachoma was 21.10 (95% CI; 14.18, 28.02). The finding indicated high heterogeneity among the included studies (I2<\/jats:sup> =99.3%, p<0.0001). There was a statistically significant association between the presence of a latrine (POR=0.10, 95% CI: 0.00, 0.19) and unclean child face (POR=1.30, 95% CI: 1.08, 1.53) and the pooled prevalence of active trachoma among children aged 1 to 9 years in low-income countries.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nThe present study revealed that the pooled prevalence of active trachoma was high as compared to the WHO trachoma eradication goal. The presence of latrine facility and unclean child face were significantly associated with the prevalence of active trachoma among children aged 1 to 9 years in low-income countries. Hence it is recommended to improve access to latrines, promote child facial hygiene, and intensify overall trachoma control in low-income countries.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330077","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T17:33:10Z","timestamp":1754587990000},"page":"e0330077","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between presence of latrine and unclean child face on the prevalence of active trachoma among children aged 1 to 9 years in low-income setting: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2998-0917","authenticated-orcid":true,"given":"Leykun","family":"Berhanu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4906-9610","authenticated-orcid":true,"given":"Chala","family":"Daba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belay","family":"Desye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2663-2204","authenticated-orcid":true,"given":"Abebe Kassa","family":"Geto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gete","family":"Berihun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"issue":"8","key":"pone.0330077.ref001","doi-asserted-by":"crossref","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"},{"key":"pone.0330077.ref002","article-title":"A simple system for the assessment of trachoma and its complications","author":"B Thylefors","journal-title":"Bull World Health Organ"},{"issue":"10","key":"pone.0330077.ref003","doi-asserted-by":"crossref","first-page":"698","DOI":"10.2471\/BLT.19.248708","article-title":"The simplified trachoma grading system, amended","volume":"98","author":"AW Solomon","year":"2020","journal-title":"Bull World Health Organ"},{"issue":"8","key":"pone.0330077.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0002359","article-title":"The geographical distribution and burden of trachoma in Africa","volume":"7","author":"JL Smith","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"pone.0330077.ref005","first-page":"844","volume-title":"Global data on visual impairment in the year 2002","author":"S Resnikoff"},{"issue":"144","key":"pone.0330077.ref006","first-page":"9","article-title":"Prevalence and associated factors of active trachoma among 1\u20139 years old children in Deguatemben, Tigray, Ethiopia, 2018: community cross-sectional study","volume":"20","author":"G Reda","year":"2018","journal-title":"BMC Ophthalmol"},{"key":"pone.0330077.ref007","volume-title":"Ending the neglect to attain the Sustainable Development Goals A road map for neglected tropical diseases 2021\u20132030","author":"WHO"},{"issue":"2005","key":"pone.0330077.ref008","first-page":"8","article-title":"Active trachoma in children aged three to nine years in rural communities in Ethiopia: prevalence, indicators, and risk factors","volume":"99","author":"P Cumberland","year":"2005","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"2","key":"pone.0330077.ref009","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001605","article-title":"Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis","volume":"11","author":"ME Stocks","year":"2014","journal-title":"PLoS Med"},{"key":"pone.0330077.ref010","volume-title":"Weekly epidemiological record","author":"WHO","year":"2013"},{"key":"pone.0330077.ref011","volume-title":"The End of sight: The Carter Center","author":"ICTC","year":"2020"},{"key":"pone.0330077.ref012","doi-asserted-by":"crossref","first-page":"648106","DOI":"10.1155\/2013\/648106","article-title":"Will the SAFE strategy be sufficient to eliminate trachoma by 2020? 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