Socio-ecological factors influencing vulnerability to trachoma disease: a new tool applied in five pre-saharan provinces, Morocco

This study intentions to appraise the rela- tive vulnerability of the trachoma disease in some provinces of the pre-Sahara of Morocco. In this region, numerous socio-ecological risk factors of this illness yield the appropriate conditions to its preva- lence. A multivariate method is needed to estimate and compare the vulnerability to this disease in the endemic zones. To reach this objective, a compos- ite indicator (the integrated trachoma vulnerability index) was conceived and applied in five provinces. This tool uses 28 standardized indicators classified nto seven vulnerability components. To visual- ize the associations between variables, the principal component analysis was applied through the Clustvis tool. The outcomes reveal in relation to the terms of the anthropogenic vulnerability, Errachidia, Ting- hir, Ouarzazate, and Zagora rank the higher score. Geographically and climatically, Tata scored a very high score. Otherwise, Tinghir, Zagora, Ouarzazate, and Errachidia recorded very high scores concerning socioeconomic component, while Tinghir and Zagora are the most vulnerable for the public services cate- gory. However, in terms of health aspects, Ouarzaz- ate has a relatively very high vulnerability compared to the rest of the sites. Lastly, the hygiene component vulnerability shows a very high vulnerability in Erra- chidia followed by Ouarzazate. Overall, Errachidia, followed by Ouarzazate scored very high vulnerabil- ity, whereas, Zagora, Tata, and Tinghir ranked high vulnerability to the disease. The results depict also that all the studied sites are very highly exposed to the disease and Ouarzazate is at the top of this aspect. However, Zagora is the most susceptible, and Ting- hir, Tata, and Zagora are relatively the most resilient. The proposed index may be considered as part of the National proactive plan to fight against the disease.