Effect of Water, Sanitation, and Hygiene on the Prevention of Trachoma: A Systematic Review and Meta-Analysis

Stocks, Meredith; Ogden, Stephanie; Haddad, Danny; Addiss, David G.; McGuire, Courtney; Freeman, Matthew C.

doi:10.1371/journal.pmed.1001605

Cited by 189 publications

(171 citation statements)

References 94 publications

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“…These results are in contrast with systematic reviews that have reported significant health gains from rural household sanitation interventions (Esrey et al 1991;Wolf et al 2014;Clasen et al 2010;Engell & Lim 2013;Ziegelbauer et al 2012;Stocks et al 2014;Strunz et al 2014). They are consistent, however, with another trial of a sanitation project implemented within the context of the TSC in the state of Madhya Pradesh (Patil et al 2014).…”

Section: Discussioncontrasting

confidence: 52%

Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and malnutrition in India

Clasen¹,

Boisson²,

Routray³

et al. 2016

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The International Initiative for Impact Evaluation (3ie) is an international grant-making NGO promoting evidence-informed development policies and programmes. We are the global leader in funding, producing and synthesising high-quality evidence of what works, how, why and at what cost. We believe that better and policy-relevant evidence will make development more effective and improve people's lives. 3ie impact evaluations3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design, use the most appropriate mix of methods to capture outcomes and are useful in complex development contexts. About this report3ie accepted the final version of this report, Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and child malnutrition in India, as partial fulfilment of requirements under grant OW2.063 issued under Open Window 2. The content has been copy-edited and formatted for publication by 3ie. Due to unavoidable constraints at the time of publication, some figures and tables are not optimal. All of the content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors or its board of commissioners. Any errors and omissions are the sole responsibility of the authors. Any comments or queries should be directed to the corresponding author, Thomas Clasen, thomas.f.clasen@emory.edu Summary BackgroundA third of the 2.5 billion people worldwide without access to improved sanitation live in India, as do two-thirds of the 1.1 billion practising open defecation and a quarter of the 1.5 million who die annually from diarrhoeal diseases. We aimed to assess the effectiveness of a rural sanitation intervention, within the context of the Government of India's Total Sanitation Campaign, to prevent diarrhoea, soil-transmitted helminth infection and child malnutrition. MethodsWe did a cluster-randomised controlled trial between 20 May 2010 and 22 December 2013, in 100 rural villages in Odisha, India. Households within villages were eligible if they had a child younger than four years or a pregnant woman. Villages were randomly assigned (1:1), with a computer-generated sequence, to undergo latrine promotion and construction or to receive no intervention (control). Randomisation was stratified by administrative block to ensure an equal number of intervention and control villages in each block. Masking of participants was not possible because of the nature of the intervention. However, households were not told explicitly that the purpose of enrolment was to study the effect of a trial intervention, and the surveillance team was different from the intervention team. The primary endpoint was seven-day prevalence of reported diarrhoea in children younger than five years. We did intention-to-treat and per-protocol analyses. This trial is registered with ClinicalTrials.gov, no. NCT01214785. FindingsWe randomly assig...

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Section: Discussioncontrasting

confidence: 52%

Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and malnutrition in India

Clasen¹,

Boisson²,

Routray³

et al. 2016

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“…Trachoma has been linked with low levels of sanitation 31 and we noted very low levels of sanitation in all EUs other than NCD. Less than 0.1% of households in the Southern Highlands had improved sanitation.…”

Section: Discussionmentioning

confidence: 54%

Population-Based Trachoma Mapping in Six Evaluation Units of Papua New Guinea

Macleod

Pahau

et al. 2016

Ophthalmic Epidemiology

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Purpose: We sought to determine the prevalence of trachomatous inflammation – follicular (TF) in children aged 1–9 years, and trachomatous trichiasis (TT) in those aged ≥15 years, in suspected trachoma-endemic areas of Papua New Guinea (PNG). Methods: We carried out six population-based prevalence surveys using the protocol developed as part of the Global Trachoma Mapping Project. Results: A total of 19,013 individuals were sampled for inclusion, with 15,641 (82.3%) consenting to participate. Four evaluation units had prevalences of TF in children ≥10%, above which threshold the World Health Organization (WHO) recommends mass drug administration (MDA) of azithromycin for at least three years; Western Province (South Fly/Daru) 11.2% (95% confidence interval, CI, 6.9–17.0%), Southern Highlands (East) 12.2% (95% CI 9.6–15.0%), Southern Highlands (West) 11.7% (95% CI 8.5–15.3%), and West New Britain 11.4% (95% CI 8.7–13.9%). TF prevalence was 5.0–9.9% in Madang (9.4%, 95% CI 6.1–13.0%) and National Capital District (6.0%. 95% CI 3.2–9.1%) where consideration of a single round of MDA is warranted. Cases of TT were not found outside West New Britain, in which four cases were seen, generating an estimated population-level prevalence of TT in adults of 0.10% (95% CI 0.00–0.40%) for West New Britain, below the WHO elimination threshold of 0.2% of those aged ≥15 years. Conclusion: Trachoma is a public health issue in PNG. However, other than in West New Britain, there are few data to support the idea that trachoma is a cause of blindness in PNG. Further research is needed to understand the stimulus for the active trachoma phenotype in these populations.

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“…ITI collaborates with governmental and nongovernmental organizations at the local, national and international levels to implement SAFE strategy for trachoma control 23, 24, 25, 26, 27…”

Section: Management and Preventionmentioning

confidence: 99%

Trachoma: Past, present and future

Mohammadpour

Abrishami

Masoumi

et al. 2016

Journal of Current Ophthalmology

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PurposeTo review the background, epidemiology and current management of trachoma in endemic areas and worldwide.MethodsReview of literature.ResultsTrachoma is one of the leading causes of preventable blindness in developing countries. It was reported as one of the seven most neglected tropical diseases that can be prevented via drug administration. Its infliction is primarily aimed at those living in areas deprived of clean water and proper sanitation. It is estimated that trachoma is the cause of visual impairment in about 2.2 million people worldwide of which about 1.2 million are completely blind. With implementation of the SAFE (surgery, antibiotics, facial cleanliness, and environmental control) strategy with support from the International Trachoma Initiative (ITI) the incidence of trachoma has decreased significantly in the Middle East and North Africa region.ConclusionWith the enhancement of socioeconomic and sanitary status of people, advent of new generations of antibiotics, training of expert ophthalmologists and eye care facilities the prevalence of trachoma is decreasing.

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Effect of Water, Sanitation, and Hygiene on the Prevention of Trachoma: A Systematic Review and Meta-Analysis

Abstract: Matthew Freeman and colleagues identified 86 individual studies that reported a measure of the effect of water, sanitation, and hygiene on trachoma and conducted 15 meta-analyses for specific exposure-outcome pairs. Please see later in the article for the Editors' Summary

Cited by 189 publications

References 94 publications

Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and malnutrition in India

Effectiveness of a rural sanitation programme on diarrhoea, soil-transmitted helminth infection and malnutrition in India

Population-Based Trachoma Mapping in Six Evaluation Units of Papua New Guinea

Trachoma: Past, present and future

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