Associations between Water, Sanitation and Hygiene (WASH) and trachoma clustering at aggregate spatial scales, Amhara, Ethiopia.
Chlamydia trachomatis
Facial cleanliness
Spatial analysis
Trachoma
Journal
Parasites & vectors
ISSN: 1756-3305
Titre abrégé: Parasit Vectors
Pays: England
ID NLM: 101462774
Informations de publication
Date de publication:
14 Nov 2019
14 Nov 2019
Historique:
received:
14
05
2019
accepted:
04
11
2019
entrez:
16
11
2019
pubmed:
16
11
2019
medline:
26
3
2020
Statut:
epublish
Résumé
Trachoma is the leading infectious cause of blindness globally. The WHO has recommended the SAFE (Surgery, Antibiotics, Facial cleanliness and Environmental improvements) strategy to eliminate trachoma as a public health problem. The F and E arms of the strategy will likely be important for sustained disease reductions, yet more evidence is needed detailing relationships between hygiene, sanitation and trachoma in areas with differing endemicity. This study addressed whether the regional differences in water, sanitation, and hygiene (WASH) variables were associated with the spatial distribution of trachomatous inflammation-follicular (TF) among children aged 1 to 9 years in the Amhara National Regional State of Ethiopia. Data from 152 multi-stage cluster random trachoma surveys were used to understand the degree of clustering of trachoma on two spatial scales (district and village) in Amhara using a geographical information system and the Getis-Ord G The mean district prevalence of TF among children aged 1 to 9 years in Amhara was 25.1% (standard deviation = 16.2%). The spatial distribution of TF was found to exhibit global spatial dependency with neighboring evaluation units at both district and village level. Specific clusters of high TF were identified at both the district and the village scale of analysis using weighted estimates of the prevalence of the disease. Increased prevalence of children without nasal and ocular discharge as well as increased prevalence of households with access to a water source within 30 minutes were statistically significantly negatively associated with clusters of high TF prevalence. Water access and facial cleanliness were important factors in the clustering of trachoma within this hyperendemic region. Intensified promotion of structural and behavioral interventions to increase WASH coverage may be necessary to eliminate trachoma as a public health problem in Amhara and perhaps other hyper-endemic settings.
Sections du résumé
BACKGROUND
BACKGROUND
Trachoma is the leading infectious cause of blindness globally. The WHO has recommended the SAFE (Surgery, Antibiotics, Facial cleanliness and Environmental improvements) strategy to eliminate trachoma as a public health problem. The F and E arms of the strategy will likely be important for sustained disease reductions, yet more evidence is needed detailing relationships between hygiene, sanitation and trachoma in areas with differing endemicity. This study addressed whether the regional differences in water, sanitation, and hygiene (WASH) variables were associated with the spatial distribution of trachomatous inflammation-follicular (TF) among children aged 1 to 9 years in the Amhara National Regional State of Ethiopia.
METHODS
METHODS
Data from 152 multi-stage cluster random trachoma surveys were used to understand the degree of clustering of trachoma on two spatial scales (district and village) in Amhara using a geographical information system and the Getis-Ord G
RESULTS
RESULTS
The mean district prevalence of TF among children aged 1 to 9 years in Amhara was 25.1% (standard deviation = 16.2%). The spatial distribution of TF was found to exhibit global spatial dependency with neighboring evaluation units at both district and village level. Specific clusters of high TF were identified at both the district and the village scale of analysis using weighted estimates of the prevalence of the disease. Increased prevalence of children without nasal and ocular discharge as well as increased prevalence of households with access to a water source within 30 minutes were statistically significantly negatively associated with clusters of high TF prevalence.
CONCLUSIONS
CONCLUSIONS
Water access and facial cleanliness were important factors in the clustering of trachoma within this hyperendemic region. Intensified promotion of structural and behavioral interventions to increase WASH coverage may be necessary to eliminate trachoma as a public health problem in Amhara and perhaps other hyper-endemic settings.
Identifiants
pubmed: 31727155
doi: 10.1186/s13071-019-3790-3
pii: 10.1186/s13071-019-3790-3
pmc: PMC6857222
doi:
Substances chimiques
Water
059QF0KO0R
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
540Références
Trans R Soc Trop Med Hyg. 2009 Oct;103(10):1001-10
pubmed: 19178920
Am J Epidemiol. 2000 Aug 1;152(3):204-11
pubmed: 10933266
Cochrane Database Syst Rev. 2015 Feb 20;(2):CD003659
pubmed: 25697765
Clin Infect Dis. 2018 Nov 28;67(12):1840-1846
pubmed: 29741592
PLoS Negl Trop Dis. 2009 Jun 16;3(6):e462
pubmed: 19529762
Trans R Soc Trop Med Hyg. 2006 Nov;100(11):1075-83
pubmed: 16546229
PLoS One. 2013 Sep 16;8(9):e74570
pubmed: 24066147
PLoS Med. 2014 Feb 25;11(2):e1001605
pubmed: 24586120
Lancet. 1995 Jan 21;345(8943):155-8
pubmed: 7823670
Am J Trop Med Hyg. 2019 Dec;101(6):1286-1295
pubmed: 31549612
PLoS Negl Trop Dis. 2016 Oct 26;10(10):e0005080
pubmed: 27783678
Invest Ophthalmol Vis Sci. 2006 Nov;47(11):4767-71
pubmed: 17065486
PLoS Negl Trop Dis. 2018 Jan 22;12(1):e0006110
pubmed: 29357365
Arch Ophthalmol. 1991 Jun;109(6):855-7
pubmed: 2043075
Int J Epidemiol. 1996 Feb;25(1):198-203
pubmed: 8666490
Parasit Vectors. 2017 Feb 17;10(1):91
pubmed: 28212668
BMC Public Health. 2015 May 02;15:451
pubmed: 25933607
Am J Trop Med Hyg. 2018 Apr;98(4):1013-1020
pubmed: 29488457
Br J Ophthalmol. 2014 Apr;98(4):432-7
pubmed: 24344228
Bull World Health Organ. 2017 Apr 1;95(4):250-260
pubmed: 28479620
Ophthalmic Epidemiol. 2016 Dec;23(6):392-405
pubmed: 27820657
Trans R Soc Trop Med Hyg. 2011 Jan;105(1):7-16
pubmed: 21036378
Trans R Soc Trop Med Hyg. 2000 Jan-Feb;94(1):28-32
pubmed: 10748893
Epidemics. 2015 Jun;11:85-91
pubmed: 25979286
Lancet. 2014 Dec 13;384(9960):2142-52
pubmed: 25043452
PLoS Negl Trop Dis. 2014 Mar 13;8(3):e2732
pubmed: 24625539
PLoS Negl Trop Dis. 2015 Mar 23;9(3):e0003610
pubmed: 25799168
PLoS Negl Trop Dis. 2017 Nov 30;11(11):e0006019
pubmed: 29190298
Bull World Health Organ. 2018 Oct 1;96(10):723-725
pubmed: 30455520
PLoS Negl Trop Dis. 2008 Mar 19;2(3):e197
pubmed: 18350115
PLoS Negl Trop Dis. 2018 Jan 25;12(1):e0006178
pubmed: 29370169
Br J Ophthalmol. 2010 Mar;94(3):278-81
pubmed: 19897474
Bull World Health Organ. 1987;65(4):477-83
pubmed: 3500800
Int J Environ Res Public Health. 2015 May 28;12(6):5954-74
pubmed: 26030467
Br J Ophthalmol. 2009 May;93(5):563-8
pubmed: 19098034