Matched study links three factors with trachomatous trichiasis in Ethiopian women

Women who could not read and write, washed their faces irregularly or lacked access to a latrine had higher adjusted odds of trachomatous trichiasis in a community-based matched case-control study conducted in Bora district, East Shoa zone, Oromia, Ethiopia. The study, conducted from February 27 to April 12, 2023, found adjusted odds ratios of 5.98 for inability to read and write, 5.03 for irregular face washing and 5.80 for lack of an available latrine. The corresponding 95% confidence intervals were 1.82–19.65, 1.97–12.88 and 2.49–13.52, respectively.

Trachomatous trichiasis is an eye disease caused by repeated infection with the bacterium Chlamydia trachomatis . The researchers investigated determinants of the condition among women because evidence on this topic was limited. The research analyzed associations in this defined population rather than testing whether any of the identified factors directly caused the disease.

The study included 380 women: 76 cases and 304 controls. Investigators identified cases and controls through community-based screening during a trachomatous trichiasis screening campaign and enrolled participants consecutively until the desired sample size was reached. Each case was matched with four controls by age and by the kebele in which the participant lived.

This observational design examined the odds of trachomatous trichiasis in the selected sample; it did not follow new cases over time or measure changes in incidence or prevalence. Researchers entered the collected data into Epi Info version 7.2 and exported them to STATA version 17 for analysis. They used bi-variable and multivariable binary conditional logistic regression to evaluate the matched case-control data.

The final analysis treated variables with adjusted odds ratios, 95% confidence intervals and P values below 0.05 as statistically significant determinants. Specifically, irregular face washing was associated with an adjusted odds ratio of 5.03, with a 95% confidence interval of 1.97 to 12.88. Women without access to a latrine had an adjusted odds ratio of 5.80, with a 95% confidence interval of 2.49 to 13.52.

For women who could not read and write, the adjusted odds ratio was 5.98 and the 95% confidence interval extended from 1.82 to 19.65. These wide confidence intervals, particularly for educational status, indicate substantial uncertainty around the estimated magnitudes even though each reported association met the study’s statistical threshold. The authors concluded that improved educational status, regular face washing and construction of latrines may decrease the likelihood of trachomatous trichiasis.

The findings identify these characteristics as potentially important considerations for prevention strategies in Bora district, but the matched case-control evidence does not demonstrate that changing them will prevent the condition. The analysis also cannot establish whether the associations reflect causal relationships, and it did not evaluate a prevention intervention. Because the sample comprised women aged 15 years and older in selected kebeles of one district, the results should not automatically be extended to men, younger people, other regions or communities with different living conditions.

Subject of Research: Determinants of trachomatous trichiasis among women in Bora district, Ethiopia

Article Title: Determinants of trachomatous trichiasis among women in Bora district, East Shoa zone, Oromia, Ethiopia: community-based matched case-control study

Article References: Alemu, T. N., Charkos, T. G., & Girsha, W. D. (2026). Determinants of trachomatous trichiasis among women in Bora district, East Shoa zone, Oromia, Ethiopia: community-based matched case-control study. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14409-w

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14409-w

Keywords: trachomatous trichiasis, Ethiopia, women's health, case-control study, facial hygiene, sanitation, latrine access, education, public health, Determinants, trachomatous, trichiasis