Abstract
Viral conjunctivitis, a highly contagious ocular inflammation caused by adenoviruses and enteroviruses, ac counts for 80% of all conjunctivitis cases, presenting with redness, itching, tearing, and discharge, leading to discomfort and visual disturbances. Accurate diagnosis and management are essential for patient care and preventing transmission. Between February and April 2024, Zambia reported 6,684 suspected viral conjunc tivitis cases across Eastern (Chadiza, Mambwe) and Northern (Mpulungu) Provinces. This study aimed to identify factors contributing to the outbreak and recommend control measures. A mixed-methods approach, combining case-control and exploratory designs, was employed. Quantitative data collection involved health facility record reviews. Qualitative data was collected via interviews with healthcare workers, affected indi viduals (cases), and unaffected household members (controls). Controls were selected from households with reported cases, following a 4:1 ratio. Household environmental and sanitation conditions were assessed using a checklist. Data analysis included descriptive, qualitative, and logistic regression to identify associations. A total of 221 cases and 46 controls were recruited. Females accounted for 151 (68%) of cases, while 67 (30%) were children under 17 (median age: 25, IQR: 17-40). Factors associated with higher odds of conjunctivitis included residing in Northern Province (aOR: 3.66, 95% CI: 1.59-9.96) and household exposure (aOR: 1.49, 95% CI: 1.24-1.84). Elderly individuals (> 65 years) had lower odds of infection (aOR: 0.04, 95% CI: 0.00 0.35). Qualitative findings highlighted use of alternative and harmful remedies in the community, absence of an incident management system at district level, unclear case definitions, and underreporting. Household transmission and regional factors were associated with higher odds of infection. Strengthening surveillance, implementing incident management systems, and increasing community awareness on the disease and its transmissibility are essential for prevention.
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