Effectiveness of community interventions to eliminate trachomatous inflammation – follicular in Kongwa And Mpwapwa Districts, Dodoma Region

Abstract

ABSTRACT Background: Blinding trachoma is targeted for elimination by 2020 using the SAFE (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements) strategy. Annual mass drug administration (MDA) with azithromycin for three years, is recommended by WHO, in combination with other elements (Facial cleanliness and Environmental sanitation) of the SAFE strategy to eliminate infection, in all endemic communities where the prevalence of Follicular Trachoma in children aged 1–9 years is between 5% to 10% TF, determined using trachoma population–based surveys. Objectives: To evaluate the effectiveness of community interventions; its success and challenges in eliminating Follicular Trachoma in Kongwa and Mpwapwa districts in Dodoma Region. Methodology: A cross sectional study design employing a mixed method approach was used to assess the effectiveness of community interventions in Kongwa District which has been declared Trachoma free and Mpwapwa district where there has been a recurrence of Trachoma in year 2017 after being TF free in 2014. Data about the population and implementation of the community interventions were obtained at the district levels through interview and document review while the information about environment and human cleanliness behavior were gathered at the household level through observation and semi-structured interviews. Quantitative data were analyzed using descriptive statistics to obtain the frequencies and proportions, and independent paired sample t-test to determine the statistical significance difference in proportion between the two districts. Results: It was found that the proportional difference between household members who were not offered drugs in Kongwa as compared to Mpwapwa was statistically significant (t868=-14.048, p=0.000), whereby only few people in Kongwa were not offered the drugs. Moreover, the study found an association between children unclean faces and the distance to water source in Mpwapwa district (12.963, d.f 1, p 0.000). Qualitative findings revealed that the communities were full involved in intervention through educational campaigns on personal hygiene and environment cleanliness, and also reporting trachoma cases. Conclusion: Community interventions are effective for elimination of follicular trachoma. This has been observed in the study when Mpwapwa adopted the community approach after the recurrence of the trachoma; the prevalence started to go down as in Kongwa district.