ArticleParasites & vectors2019
Associations between Water, Sanitation and Hygiene (WASH) and trachoma clustering at aggregate spatial scales, Amhara, Ethiopia.
Article in Parasites & vectors, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Community-level trachoma ecological associations and the use of geospatial analysis methods: A systematic review.PLoS neglected tropical diseases · 2022Pooled it
- The impact of access to water supply and sanitation on the prevalence of active trachoma in Ethiopia: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Prevalence of Ocular Chlamydia trachomatis Infection in Amhara Region, Ethiopia, after 8 Years of Trachoma Control Interventions.The American journal of tropical medicine and hygiene · 2023Trial
- The linkages between water supply, sanitation and hygiene and small-scale irrigation: insights from rural Ethiopia.Journal of water and health · 2025Article
- Hygiene and sanitation-related socio-ecological contexts and constraints of communities in districts with persistent trachoma, Southern Ethiopia.BMC infectious diseases · 2025Article
- Prevalence and spatial distributions of trachomatous inflammation-follicular among children aged 1-9 years in rural areas of Yilmana Densa and Gonji Kolela districts, Northwestern Ethiopia.BMC public health · 2025Article
- Prevalence of ocular Chlamydia trachomatis infection and antibodies within districts persistently endemic for trachoma, Amhara, Ethiopia.PLoS neglected tropical diseases · 2025Article
- Correlates of Trachoma Recrudescence: Results from 51 District-Level Trachoma Surveillance Surveys in Amhara, Ethiopia.Tropical medicine and infectious disease · 2024Article
- Severity of Trachomatous Scarring among Adults in Trachoma-Endemic Amhara Region of Ethiopia.The American journal of tropical medicine and hygiene · 2024Article
- The Epidemiology of Ocular Chlamydia trachomatis Infection within Districts Persistently Endemic for Trachoma in Amhara, Ethiopia.The American journal of tropical medicine and hygiene · 2024Article
- Impact of a School Trachoma Program Emphasizing Facial Cleanliness and Environmental Improvement in Amhara, Ethiopia.The American journal of tropical medicine and hygiene · 2024Article
- Field- and laboratory-based studies on correlates of Chlamydia trachomatis transmission by Musca sorbens: Determinants of fly-eye contact and investigations into fly carriage of elementary bodies.PLoS neglected tropical diseases · 2024Article
- Unravelling Chlamydia trachomatis diversity in Amhara, Ethiopia: MLVA-ompA sequencing as a molecular typing tool for trachoma.PLoS neglected tropical diseases · 2024Article
- Review
- Motivating school communities towards behavior change and local ownership: a gamification intervention to prevent trachoma at primary schools in southern Ethiopia.International health · 2023Article
- Trachoma risk factors in Oromia Region, Ethiopia.PLoS neglected tropical diseases · 2023Article
- Predicting future community-level ocular Chlamydia trachomatis infection prevalence using serological, clinical, molecular, and geospatial data.PLoS neglected tropical diseases · 2022Article
- Concordance of ompA types in children re-infected with ocular Chlamydia trachomatis following mass azithromycin treatment for trachoma.PLoS neglected tropical diseases · 2022Article
- Knowledge, Attitudes, and Practices about Trachoma in Rural Communities of Tigray Region, Northern Ethiopia: Implications for Prevention and Control.Journal of environmental and public health · 2020Article
Corrections and comments
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Authors and funding
15 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrachoma 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.
methodsData 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
resultsThe 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.
conclusionsWater 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.
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