Prevalence of active trachoma among children aged 1–9 years in Ethiopia: umbrella review

Abstract

Trachoma ranks as the third leading cause of avoidable blindness, behind cataracts and glaucoma. While numerous studies have estimated its prevalence and identified potential risk factors, the reported findings remain inconsistent. This umbrella review synthesizes existing systematic reviews and meta-analyses to provide a consolidated, comprehensive overview of active trachoma prevalence and its associated factors to inform targeted public health interventions. The databases searched include Web of Science, Scopus, PubMed Central, CINAHL, EMBASE, and Google Scholar for relevant systematic reviews and meta-analyses. This study synthesized data from five systematic reviews and Meta analyses published from beginning through November 27, 2025. Five authors independently extracted data for analysis in STATA 17.0. The Joanna Briggs Institute rating technique for prevalence data was used to evaluate the methodological quality. In accordance with standard Cochrane and PRISMA guidance, publication bias was not formally evaluated using funnel plots or egger’s test, as a total number of included systematic reviews was less than 10 ( n < 10). A random-effects model was employed to pool the prevalence of active trachoma, and the results were displayed using a forest plot. Out of 876 articles retrieved, five met the inclusion criteria, representing a total sample of 745,994 children. As broad summary of the currently available evidence rather than an absolute national figure, the overall pooled national prevalence of active trachoma among children aged 1–9 years was 22.28% (95% CI: 19.51, 25.06). Non-latrine utilization [AOR = 3.79; 95% CI: 2.29, 5.29] and lack of soap usage for face washing [AOR = 2.92; 95% CI: 1.43, 4.40] were significantly associated with an increased risk of active trachoma. Active trachoma remains a major public health concern among children aged 1–9 years in Ethiopia, with pooled estimates exceeding WHO elimination targets. Synthesized evidence demonstrated significant statistical associations between active trachoma and key individual and environmental factors, including non-utilization of latrines and face washing without soap. To accelerate progress towards elimination targets, comprehensive interventions should focus on expanding sanitation infrastructure and promoting facial hygiene within the multi-component WHO SAFE framework.