Who Knows How to Prevent Trachoma? Caregiver Preventive Knowledge and Associated Factors in Moroto District, Uganda.

Abstract

Background: Trachoma remains the leading infectious cause of blindness globally. In Moroto District, Uganda, the prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years remained at 10-29.9% in 2023, at least twice the elimination threshold. Caregivers directly influence children's hygiene, yet evidence on their preventive knowledge is limited. This study assessed trachoma preventive knowledge and associated factors among caregivers of children aged 1-9 years in Moroto District.

Methods: This was a community-based cross-sectional study conducted among 620 randomly selected caregivers of children aged 1-9 years in selected communities in Moroto District. Data were collected using a pretested structured questionnaire in Kobo Collect, with knowledge items adapted from published trachoma knowledge tools. Knowledge was measured with 12 items (score 0-12), and caregivers scoring above the mean were classified as having good knowledge. Bivariate and multivariable logistic regression were used to determine the factors associated with trachoma preventive knowledge at the 95% confidence level.

Results: Overall, 75.3% (467/620) of caregivers demonstrated good knowledge of trachoma prevention. In multivariable analysis, factors positively associated with trachoma preventive knowledge were being a male caregiver (AOR=4.21, 95% CI: 1.63-10.86, p=0.003), washing the child's face twice a day (AOR=2.46, 95% CI: 1.20-5.04, p=0.014), and more than twice a day (AOR=2.51, 95% CI: 1.04-6.06, p=0.040). Caregivers with no formal education (AOR=0.56, 95% CI: 0.34-0.91, p=0.019), those who dumped waste in open fields/bushes (AOR=0.38, 95% CI: 0.22-0.66, p<0.001), and those who did not receive trachoma prevention messages (AOR=0.25, 95% CI: 0.10-0.61, p=0.002) were negatively associated with trachoma preventive knowledge.

Conclusion: Most caregivers had good trachoma-preventive knowledge, but knowledge was lower among female caregivers, those with no formal education, those who disposed of waste in open fields and those not reached by prevention messages. Health education in Moroto should prioritise these groups and be delivered alongside sanitation and hygiene interventions.