TY - JOUR KW - Sanitation KW - Trachoma KW - Neglected tropical diseases (NTDs) KW - WASH KW - Ethiopia KW - Communities KW - Children AU - King D AU - Emerson P AU - Callahan EK AU - Flanders D AU - Moe C AU - Clasen T AB -

Objective
To investigate, in Amhara, Ethiopia, the association between prevalence of active trachoma among children aged 1–9 years and community sanitation usage.
Methods
Between 2011 and 2014, prevalence of trachoma and household pit latrine usage were measured in five population-based crosssectional surveys. Data on observed indicators of latrine use were aggregated into a measure of community sanitation usage calculated as the proportion of households with a latrine in use. All household members were examined for clinical signs, i.e. trachomatous inflammation, follicular and/or intense, indicative of active trachoma. Multilevel logistic regression was used to estimate prevalence odds ratios (OR) and 95% confidence intervals (CI), adjusting for community, household and individual factors, and to evaluate modification by household latrine use and water access.
Findings
In surveyed areas, prevalence of active trachoma among children was estimated to be 29% (95% CI: 28–30) and mean community sanitation usage was 47% (95% CI: 45–48). Despite significant modification (p < 0.0001), no pattern in stratified ORs was detected. Summarizing across strata, community sanitation usage values of 60 to < 80% and ≥ 80% were associated with lower prevalence odds of active trachoma, compared with community sanitation usage of < 20% (OR: 0.76; 95% CI: 0.57–1.03 and OR: 0.67; 95% CI: 0.48–0.95, respectively).
Conclusion
In Amhara, Ethiopia, a negative correlation was observed between community sanitation usage and prevalence of active trachoma among children, highlighting the need for continued efforts to encourage higher levels of sanitation usage and to support sustained use throughout the community, not simply at the household level.

BT - WHO Bulletin DO - 10.2471/BLT.16.177758 LA - eng N2 -

Objective
To investigate, in Amhara, Ethiopia, the association between prevalence of active trachoma among children aged 1–9 years and community sanitation usage.
Methods
Between 2011 and 2014, prevalence of trachoma and household pit latrine usage were measured in five population-based crosssectional surveys. Data on observed indicators of latrine use were aggregated into a measure of community sanitation usage calculated as the proportion of households with a latrine in use. All household members were examined for clinical signs, i.e. trachomatous inflammation, follicular and/or intense, indicative of active trachoma. Multilevel logistic regression was used to estimate prevalence odds ratios (OR) and 95% confidence intervals (CI), adjusting for community, household and individual factors, and to evaluate modification by household latrine use and water access.
Findings
In surveyed areas, prevalence of active trachoma among children was estimated to be 29% (95% CI: 28–30) and mean community sanitation usage was 47% (95% CI: 45–48). Despite significant modification (p < 0.0001), no pattern in stratified ORs was detected. Summarizing across strata, community sanitation usage values of 60 to < 80% and ≥ 80% were associated with lower prevalence odds of active trachoma, compared with community sanitation usage of < 20% (OR: 0.76; 95% CI: 0.57–1.03 and OR: 0.67; 95% CI: 0.48–0.95, respectively).
Conclusion
In Amhara, Ethiopia, a negative correlation was observed between community sanitation usage and prevalence of active trachoma among children, highlighting the need for continued efforts to encourage higher levels of sanitation usage and to support sustained use throughout the community, not simply at the household level.

PY - 2017 SP - 250 EP - 260 T2 - WHO Bulletin TI - Active trachoma and community use of sanitation, Ethiopia. UR - http://www.who.int/bulletin/volumes/95/4/16-177758.pdf VL - 95 ER -