Knowing the target for neglected tropical disease programs: identifying systematic differences between school-attending and non-school-attending children in Amhara region, Ethiopia Open Access

Stewart, Aisha Elizabeth Pomfret (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/h989r3823?locale=en
Published

Abstract

Background: School-age children are often targeted by neglected tropical disease (NTD) programs. In areas where school attendance is low, the population of school-age children may not be homogeneous, with differences between school-attending and non-school-attending children. We aimed to identify whether systematic differences between school-attending and non-school-attending children exist in Amhara National Regional State in Ethiopia, where school attendance is approximately 60%.

Methods: We conducted a cross-sectional, cluster random survey of school-age children aged 6-15 years. Potential differences between school and non-school children recorded were: demographics, trachoma clinical signs and intestinal parasitic infections, anthropometric measurements, knowledge and behaviors regarding trachoma control and hygiene activities and household characteristics. Stool specimens were collected.

Principal Findings: 2,711 school-age children were recruited of whom 2,468 (91.0%) from 106 communities in 20 districts provided assent and all data. Reported school attendance was 58.5% (95% confidence interval (CI): 54.5-62.4). School-attending children were older (odds ratio (OR)=1.42, 95% CI: 1.33-1.51), more likely to be female (OR=1.42, 95% CI: 1.15-1.76), live with their birth parents (OR=2.49, 95% CI: 1.30-4.77), present with less trachomatous inflammation-follicular (TF; OR=0.55, 95% CI: 0.37-0.81), have lower body-mass-index-for age (OR=1.86, 95% CI: 1.36-2.55), reside in households with higher socio-economic status (OR=1.94, 95% CI: 1.46-2.56), have heard about trachoma (OR=3.87, 95% CI: 2.70-5.54), report more frequent face washing (OR=2.74, 95% CI: 1.76-4.25), hand washing after defecation (OR=3.49, 95% CI: 2.16-5.64) and latrine use (OR=2.29, 95% CI: 1.80-2.92). Adjusting for age and sex, there were no significant differences in presentation of TF or intestinal parasitic infections between school-attending and non-school-attending children.

Conclusions : Systematic differences exist between school-attending and non-school-attending children. Control strategies for NTDs should include interventions specifically targeted to school-attending and non-school-attending children, as they are different populations and consequently require unique approaches to maximize coverage to each group.

Table of Contents

TABLE OF CONTENTS

LIST OF TABLES....................................................................... viii

LIST OF FIGURES...................................................................... viii

CHAPTER 1: INTRODUCTION....................................................... 1

Problem statement..................................................................... 4

Purpose statement..................................................................... 5

Research questions.............................................................. ..... 6

Statement of study significance.................................................... 6

List of acronyms and terms.......................................................... 7

CHAPTER 2: LITERATURE REVIEW............................................... 8

Trachoma burden, prevalence and control strategies......................... 8

Trachoma risk factors.................................................................. 12

School-attending and non-school-attending children......................... 18

CHAPTER 3: MANUSCRIPT ........................................................... 23

Contribution of student................................................................ 24

Abstract....................................................................................25

Introduction...............................................................................26

Methods....................................................................................28

Results......................................................................................34

Discussion..................................................................................39

References.................................................................................46

Tables and figures........................................................................ 48

CHAPTER 4: CONCLUSIONS AND RECOMMENDATIONS .................... .55

CHAPTER 5: LESSONS LEARNED....................................................60

APPENDICES..............................................................................63

Appendix A. Map of study area....................................................... 63

Appendix B. Study tools................................................................64

Appendix C. Institutional Review Board exemption letter...................... 71

REFERENCES ............................................................................. 72

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Department
Degree
Submission
Language
  • English
Research Field
Keyword
Committee Chair / Thesis Advisor
Committee Members
Partnering Agencies
Last modified

Primary PDF

Thumbnail Title Date Uploaded Actions
Knowing the target for neglected tropical disease programs: identifying systematic differences between school-attending and non-school-attending children in Amhara region, Ethiopia () 2018-08-28 13:17:49 -0400

Supplemental Files

Thumbnail Title Date Uploaded Actions