Abstract
Purpose:
Trachoma is the leading infectious cause of blindness world-wide. The World Health Organization (WHO) has the goal of eliminating blinding trachoma by 2020. The identification risk factors for active disease, that are amenable to intervention, is important for designing successful control programs. Previous studies have linked sleeping by a cooking fire to trachoma, however other risk factors were not accounted for and the assessment of exposure was simple. Our aim is to determine risk factors for active trachoma in children, including exposure to indoor cooking fires.
Methods:
A cross sectional study of active trachoma in 5610 randomly selected children ages 1-9 was carried out in 52 communities in the Kongwa district of Tanzania. Putative risk factors for trachoma including exposure to indoor cooking fires were collected from the children’s families. Active trachoma was defined as having either follicular (TF) or intense inflammation (TI) using the WHO grading standards. The cross sectional relationships of these factors and the presence of trachoma in children were examined.
Results:
5240 (93%) of the 5610 children selected participated in the study. Six percent of the children had active disease (TF and/or TI), and 2.5% had TI. Lack of education of the head of household, more than 30 minutes to the source of water, and younger age, were associated with significant higher odds of both active disease and TI. After controlling for the above factors children sleeping in a room with a cooking fire were more likely to have active trachoma (odds ratio(95% confidence interval)) 1.8 (1.0 - 3.2), and intense inflammation 3.1 (1.6 - 6.1).
Conclusions:
In addition to the known risk factors for trachoma, exposure to indoor cooking fire was not only associated with active disease but appears to increase the risk of intense inflammation.
Keywords: 464 clinical (human) or epidemiologic studies: risk factor assessment •
736 trachoma •
461 clinical (human) or epidemiologic studies: natural history