Trachoma Prevalence and Associated WASH and Behavioral Risk Among Rural Communities of North Gondar Zone, Ethiopia: A Community-Based Cross-Sectional Study.

Trachoma is a leading infectious cause of preventable blindness and remains a major public health problem in rural Ethiopia, where inadequate water, sanitation, and hygiene (WASH) conditions sustain transmission. This study assessed the prevalence of active trachoma and associated WASH and hygiene-related factors among children aged 1-9 years in rural communities of North Gondar Zone, Ethiopia. A community-based cross-sectional study was conducted among 456 children selected using a multistage sampling technique. Data on sociodemographic characteristics, household WASH conditions, and hygiene practices were collected using structured caregiver interviews and direct observation. Active trachoma was diagnosed using the WHO simplified trachoma grading system (trachomatous inflammation-follicular and/or trachomatous inflammation-intense). Poor face-washing practice was defined as washing the child's face less than twice per day or the presence of ocular or nasal discharge, while good practice was defined as washing the child's face at least twice per day and the absence of ocular or nasal discharge. High fly density was defined as the observation of three or more eye-seeking flies on or around the child's face during household assessment. Binary and multivariable logistic regression analyses were performed, with statistical significance set at