No abstract

Trachoma is prevalent in many arid areas but data assessing the relationship between water use and trachoma are very scarce. This study compared 18 families having one or more active trachoma cases among the children with 16 trachoma-free families in the same village with respect to water use. Potential confounders such as family size, distance to water source, socio-economic indicators, and hygiene behaviour were assessed in the 2 groups. The families with trachoma were found to use significantly less water per person per day for washing children than did the control group (P = 0.033) with no evidence of confounding by the other measured variables. Low amounts of water for washing were also associated with unclean faces and impetigo in the children. If such a relationship can be substantiated it might provide the basis for effective and cheap interventions against trachoma.

No abstract

Although infection with any of the three types of Mansonella species that affect humans is often asymptomatic, a large portion of the world's population is at risk of this vectorborne filarial nematode infection. No previous global review of the epidemiology of mansonelliasis has been conducted. A systematic review of the literature was conducted. Original research articles that provided population-based mansonelliasis prevalence rates were identified by searching the PubMed database using pre-defined eligibility criteria. Data from each of the forty-six included studies were extracted and compared. Mansonelliasis is a common infection in some parts of west and central Africa and Latin America, with significant variation in prevalence rates over small geographic spaces. The risk of infection increases with age and may be higher in males than females. Despite many similarities, the three agents that cause mansonelliasis have distinct biological, clinical, and epidemiological characteristics. Knowledge about mansonelliasis is important for making differential diagnoses, identifying the possible risks of co-infection with multiple filariases, and addressing the concerns of at-risk populations.

We have measured the prevalence of active trachoma in children aged less than 15 years in the Gambian village of Keneba, which has had excellent free medical care and a continuous supply of antibiotics since 1974. The prevalence was 13%, with the peak prevalence (20%) occurring in the 2 to 3-year age group. Of 71 cases diagnosed, only 23 (33%) had complained of ocular symptoms in the previous 3 months, in spite of the fact that 66 (94%) had attended the clinic. Only five had been diagnosed as having trachoma by the duty paediatrician (7%). Compliance with treatment was poor, with only 29 subjects returning for continued treatment (41%), and at follow-up 16 months later 22 of 64 subjects still had active disease (34%). We conclude that the widespread use of antimicrobial agents does not preclude the persistence of endemic disease. Socio-economic improvement or behavioural changes appear necessary for the control of trachoma in endemic areas. In the meantime there is a need for greater awareness of the disease both among clinicians in endemic areas and among the communities afflicted.