Fitsum Weldegebreal ^1,2 Mitiku Getachew ³ Getachew Kabew K. Mekonnen ¹ Assefa Desalew ⁴ Shambel Mekonnen ^1* Temam B. Raru ⁵ Ukash Umer ¹ KEDIR URGESA ¹

• ¹ School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia, Harar, Ethiopia
• ² Laboratory Bacteriology Research, Faculty of Medicine and Health Sciences, Ghent University, Corneel Haymanslaan10, Ghent, Belgium, Belgium, Belgium
• ³ Midega Tola Woreda Ibro Salama Health Center, east Hararghe Zone, Oromia reginal state, eastern Ethiopia, Ibro, Ethiopia
• ⁴ Department of Pediatrics and Child Health Nursing, School of Nursing, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia, Harar, Ethiopia
• ⁵ School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia, Harar, Ethiopia

Abstract Background: Trachoma is a neglected tropical disease, mainly affects impoverished and marginalized communities with inadequate shelter and sanitation. Nevertheless, prevalence of active trachoma and specific factors contributing to it among communities residing in former leprosy settlements and the control group in eastern Ethiopia are not well explored. Therefore, objective of this study was to compare the prevalence of active trachoma and its associated factors among children aged 1-9 years in the previous leprosarium and non-leprosarium areas of eastern Ethiopia. Methods: A community-based comparative cross-sectional study was conducted among 580 systematically selected households from January 1 to 30, 2024. Data were collected by interviewing children’s caregivers, observing the child and environment, and conducting a clinical examination of the eye. Data were entered in EpiData version 4.6 and exported to SPSS version 26 software for analysis. A chi-square test was done. Adjusted odds ratio with a 95% confidence interval was used, and variables having a p-value less than 0.05 were regarded statistically significant. Results: The overall prevalence of active trachoma was 12.9% (95% CI: 10.5%-15.3%). prevalence of active trachoma was 15.6%, 9.8%, 18.3%, and 7.5% among children in previous leprosy, non-leprosy settlements, rural and urban, respectively (x²=5.65, P-value = 0.017). Eye discharge (AOR = 10.7'; 95% CI: 4.32, 26.51), latrine distance from homeless than 10 meter (AOR=3.12; 95% CI: 1.16–8.34), rural resident (AOR=4.1; 95% CI: 1.69-10.18), solid waste around their home (AOR=6.5; 95% CI: 2.14-19.72) and monthly income less than 5000 Ethiopian birrs (AOR=2.9; 95%CI: 1.04-8.30) were statistically associated with active trachoma among previous leprosy settlements. In non-leprosy settlement children with eye discharge (AOR = 7.6; 95% CI: 5.37, 58.05), latrine distance from home less than10 meter (AOR=3.12; 95%CI: 1.11, 8.77), playing with soil (AOR=9.0; 95% CI: 2.92, 28.24) and presence of animal dung (AOR=6.98; 95% CI: 3.44, 48.47) were statistically associated with active trachoma. Conclusion: The prevalence of active trachoma among children aged from 1-9 years was higher than the WHO target for the elimination active trachoma (<5%) at every district. Therefore, it is better to provide targeted treatments, creating awareness on proper hygiene and sanitation to alleviate the problem.