Prevalence and Determinants of Trachomatous Trichiasis towards Elimination of Trachoma in Ethiopia: A Systematic Review and Meta- Analysis

Abstract Background: Trachomatous Trichiasis is a preventable and treatable late stage of trachoma infection, mainly exacerbating the condition of poor and marginalized people. Given the hurtful nature of the infection, many countries, including Ethiopia, lack coherent data on the status of the problem toward its targeted time of elimination. Hence, this systematic review and meta-analysis aimed to provide a comprehensive overview of the prevalence and determinants of trachomatous trichiasis towards the elimination of trachoma in Ethiopia.Methods: Based on the predefined criteria, electronic database searches on the peer-reviewed journal papers of an English version were reviewed on the prevalence and determinants of trachomatous trichiasis among the adult population in Ethiopia from January 2015 to December 2020. After reviewing the quality of the individual sources of evidence by three reviewers, the data items were extracted using a locally devised charting form. Data were synthesized qualitatively and quantitatively in terms of publication year, design, study participants, and outcome of interest. Finally, quantitative results were pooled, explored for sources of variation, tested for a potential source of influence of prevalence estimates and publication bias in the statistical meta-analysis using STATA version-16 software.Result: After the exclusion of 121 duplicates, 108 extraneous titles & abstracts, and removal of three articles for the reasons detected on full-text screening, ten eligible studies were included for analysis. All the included studies were cross-sectional studies that took prevalence as the main outcome of interest. Accordingly, the overall pooled prevalence of Trachomatous trichiasis was 1.80 % (95%CI=1.15, 2.44) while an individual prevalence estimate of the studies ranged from 0.5% (95%CI= 0.42, 0.60) to 3.9 % (95%CI=3.82, 3.98). On subgroup analysis, the highest [3.76% (95% CI = 3.20, 4.41)] and the lowest [0.5% (95%CI= 0.42, 0.60)] prevalence were respectively reported in Gambella and Somalia. The trend of the prevalence has demonstrated unstable pattern, while there were no published studies on the determinants of trachoma trichiasis among adult over the specified period of the review.Conclusion: The prevalence of TT was significantly higher than the elimination threshold in all regions of Ethiopia, needing further implementation to facilitate roads toward the elimination.Trail registration: CRD42021260802