ArticlePLoS neglected tropical diseases2023
Exploring water, sanitation, and hygiene coverage targets for reaching and sustaining trachoma elimination: G-computation analysis.
Article in PLoS neglected tropical diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Does persistent active trachoma mandate antibiotic mass drug administration? A comparison of prevalence of trachomatous inflammation-follicular with that of conjunctival infection and anti-chlamydial antibodies, Western Province, Zambia.International health · 2026Article
- Hygiene and sanitation-related socio-ecological contexts and constraints of communities in districts with persistent trachoma, Southern Ethiopia.BMC infectious diseases · 2025Article
- Trachoma.Lancet (London, England) · 2025Review
- Assessing the prevalence of trachoma in the East, North, Far North and Adamaoua regions of Cameroon, 2016-2022.International health · 2025Article
- Prevalence of ocular Chlamydia trachomatis infection and antibodies within districts persistently endemic for trachoma, Amhara, Ethiopia.PLoS neglected tropical diseases · 2025Article
- Severity of Trachomatous Scarring among Adults in Trachoma-Endemic Amhara Region of Ethiopia.The American journal of tropical medicine and hygiene · 2024Article
- High prevalence of trachomatous inflammation-follicular with no trachomatous trichiasis: can alternative indicators explain the epidemiology of trachoma in Côte d'Ivoire?International health · 2023Article
- Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys.Ophthalmic epidemiology · 2023Article
- Potential mitigating role of ivermectin on the spread of Chlamydia trachomatis by Musca sorbens.PLoS neglected tropical diseases · 2023Article
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34 authors at 20 institutions in 18 countries.
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Abstract
backgroundTrachoma is the leading infectious cause of blindness. To reduce transmission, water, sanitation, and hygiene (WaSH) improvements are promoted through a comprehensive public health strategy. Evidence supporting the role of WaSH in trachoma elimination is mixed and it remains unknown what WaSH coverages are needed to effectively reduce transmission. METHODS/
findingsWe used g-computation to estimate the impact on the prevalence of trachomatous inflammation-follicular among children aged 1-9 years (TF1-9) when hypothetical WaSH interventions raised the minimum coverages from 5% to 100% for "nearby" face-washing water (<30 minutes roundtrip collection time) and adult latrine use in an evaluation unit (EU). For each scenario, we estimated the generalized prevalence difference as the TF1-9 prevalence under the intervention scenarios minus the observed prevalence. Data from 574 cross-sectional surveys conducted in 16 African and Eastern Mediterranean countries were included. Surveys were conducted from 2015-2019 with support from the Global Trachoma Mapping Project and Tropical Data. When modeling interventions among EUs that had not yet met the TF1-9 elimination target, increasing nearby face-washing water and latrine use coverages above 30% was generally associated with consistent decreases in TF1-9. For nearby face-washing water, we estimated a ≥25% decrease in TF1-9 at 65% coverage, with a plateau upon reaching 85% coverage. For latrine use, the estimated decrease in TF1-9 accelerated from 80% coverage upward, with a ≥25% decrease in TF1-9 by 85% coverage. Among EUs that had previously met the elimination target, results were inconclusive.
conclusionsOur results support Sustainable Development Goal 6 and provide insight into potential WaSH-related coverage targets for trachoma elimination. Targets can be tested in future trials to improve evidence-based WaSH guidance for trachoma.
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