Are Children Least Engaged with Health Care More Likely to Have Trachoma?

Distribution of azithromycin to children ages 0-9 years old is an established strategy for treating and preventing trachoma. Our study aimed to determine whether the order in which children show up for trachoma screening is correlated with their infection status. We used baseline visit data from the study Kebele Elimination of Trachoma for Ocular Health in Ethiopia. All children ages 0-9 years old in 20 randomly selected villages were tested for ocular Chlamydia trachomatis with polymerase chain reaction. We used mixed effects logistic regression to estimate the odds ratio (OR) of trachoma positivity on presentation day 1 versus later, with village as a random effect. There was no statistical difference between infection prevalence among children measured on day 1 versus those measured during the following days (OR = 0.89-fold, 95% CI: 0.65- to 1.21-fold, P = 0.44), indicating that presentation order is not a considerable factor in highly prevalent regions.