Factors associated with trachoma in persistently endemic setting in Southern Ethiopia: a community-based cross-sectional study.

Introduction: in Ethiopia, despite implementing decades-long surgery, antibiotics, facial cleanliness, and environmental improvement interventions, commonly known as the SAFE strategies, persistence and recrudescence of trachoma are common. There is limited evidence that explained the reasons. This study assesses factors associated with trachoma in persistently endemic settings. Methods: using a World Health Organization (WHO)-endorsed Global Trachoma Mapping Methodology, a two-stage cluster sampling technique was applied to select 1538 study respondents from 52 clusters. Data was collected using ODK and analysed using SPSS 28. A total of 1522 respondents were enrolled. Results: the mean age of the respondents was 33.4 and 50.5% of the respondents were females. About 32.3% (CI 30%, 34%) of the households reported the presence of at least one member of the family having one or more symptoms of trachoma. Being from poorer household (AOR=1.36, 95% CI: 1.0,1.75), presence of a household member who did not receive optimum treatment (AOR=2.8, 95% CI: 1.5, 5.2), and less than 3 doses of treatment (AOR=1.94, 95% CI: 1.32, 2.86) and presence of children ever not treated (AOR= 2.5, 95% CI: 1.5, 4.2) are associated with increased risk of manifesting symptoms of trachoma. In contrast, having optimally treated members of household (AOR=11.2,95% CI: 6.5, 19.3) and face washing with soap (AOR=0.59, 95% CI 36, 0.97) were preventive. Conclusion: trachoma is a persistent problem in the study districts. Generally, persistent, and recrudescent districts are characterised by segments of population missing optimum treatment as well as poor sanitation and hygiene practices. Our evidence supports the importance of adhering to optimal treatment guidelines, leaving no one behind, and the need for adequate treatment coverage.