Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries.
Facial cleanliness and sanitation are postulated to reduce trachoma transmission, but there are no previous data on community-level herd protection thresholds. We characterize associations between active trachoma, access to improved sanitation facilities, and access to improved water sources for the...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2018-01-01
|
| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC5800679?pdf=render |
| _version_ | 1818992730071629824 |
|---|---|
| author | Joshua V Garn Sophie Boisson Rebecca Willis Ana Bakhtiari Tawfik Al-Khatib Khaled Amer Wilfrid Batcho Paul Courtright Michael Dejene Andre Goepogui Khumbo Kalua Biruck Kebede Colin K Macleod Kouakou IIunga Marie Madeleine Mariamo Saide Abdala Mbofana Caleb Mpyet Jean Ndjemba Nicholas Olobio Alexandre L Pavluck Oliver Sokana Khamphoua Southisombath Fasihah Taleo Anthony W Solomon Matthew C Freeman |
| author_facet | Joshua V Garn Sophie Boisson Rebecca Willis Ana Bakhtiari Tawfik Al-Khatib Khaled Amer Wilfrid Batcho Paul Courtright Michael Dejene Andre Goepogui Khumbo Kalua Biruck Kebede Colin K Macleod Kouakou IIunga Marie Madeleine Mariamo Saide Abdala Mbofana Caleb Mpyet Jean Ndjemba Nicholas Olobio Alexandre L Pavluck Oliver Sokana Khamphoua Southisombath Fasihah Taleo Anthony W Solomon Matthew C Freeman |
| author_sort | Joshua V Garn |
| collection | DOAJ |
| description | Facial cleanliness and sanitation are postulated to reduce trachoma transmission, but there are no previous data on community-level herd protection thresholds. We characterize associations between active trachoma, access to improved sanitation facilities, and access to improved water sources for the purpose of face washing, with the aim of estimating community-level or herd protection thresholds.We used cluster-sampled Global Trachoma Mapping Project data on 884,850 children aged 1-9 years from 354,990 households in 13 countries. We employed multivariable mixed-effects modified Poisson regression models to assess the relationships between water and sanitation coverage and trachomatous inflammation-follicular (TF). We observed lower TF prevalence among those with household-level access to improved sanitation (prevalence ratio, PR = 0.87; 95%CI: 0.83-0.91), and household-level access to an improved washing water source in the residence/yard (PR = 0.81; 95%CI: 0.75-0.88). Controlling for household-level water and latrine access, we found evidence of community-level protection against TF for children living in communities with high sanitation coverage (PR80-90% = 0.87; 95%CI: 0.73-1.02; PR90-100% = 0.76; 95%CI: 0.67-0.85). Community sanitation coverage levels greater than 80% were associated with herd protection against TF (PR = 0.77; 95%CI: 0.62-0.97)-that is, lower TF in individuals whose households lacked individual sanitation but who lived in communities with high sanitation coverage. For community-level water coverage, there was no apparent threshold, although we observed lower TF among several of the higher deciles of community-level water coverage.Our study provides insights into the community water and sanitation coverage levels that might be required to best control trachoma. Our results suggest access to adequate water and sanitation can be important components in working towards the 2020 target of eliminating trachoma as a public health problem. |
| first_indexed | 2024-12-20T20:30:48Z |
| format | Article |
| id | doaj.art-f5f2620ce4864abbbc9931c1669bcc64 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-20T20:30:48Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-f5f2620ce4864abbbc9931c1669bcc642022-12-21T19:27:22ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352018-01-01121e000611010.1371/journal.pntd.0006110Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries.Joshua V GarnSophie BoissonRebecca WillisAna BakhtiariTawfik Al-KhatibKhaled AmerWilfrid BatchoPaul CourtrightMichael DejeneAndre GoepoguiKhumbo KaluaBiruck KebedeColin K MacleodKouakou IIunga Marie MadeleineMariamo Saide Abdala MbofanaCaleb MpyetJean NdjembaNicholas OlobioAlexandre L PavluckOliver SokanaKhamphoua SouthisombathFasihah TaleoAnthony W SolomonMatthew C FreemanFacial cleanliness and sanitation are postulated to reduce trachoma transmission, but there are no previous data on community-level herd protection thresholds. We characterize associations between active trachoma, access to improved sanitation facilities, and access to improved water sources for the purpose of face washing, with the aim of estimating community-level or herd protection thresholds.We used cluster-sampled Global Trachoma Mapping Project data on 884,850 children aged 1-9 years from 354,990 households in 13 countries. We employed multivariable mixed-effects modified Poisson regression models to assess the relationships between water and sanitation coverage and trachomatous inflammation-follicular (TF). We observed lower TF prevalence among those with household-level access to improved sanitation (prevalence ratio, PR = 0.87; 95%CI: 0.83-0.91), and household-level access to an improved washing water source in the residence/yard (PR = 0.81; 95%CI: 0.75-0.88). Controlling for household-level water and latrine access, we found evidence of community-level protection against TF for children living in communities with high sanitation coverage (PR80-90% = 0.87; 95%CI: 0.73-1.02; PR90-100% = 0.76; 95%CI: 0.67-0.85). Community sanitation coverage levels greater than 80% were associated with herd protection against TF (PR = 0.77; 95%CI: 0.62-0.97)-that is, lower TF in individuals whose households lacked individual sanitation but who lived in communities with high sanitation coverage. For community-level water coverage, there was no apparent threshold, although we observed lower TF among several of the higher deciles of community-level water coverage.Our study provides insights into the community water and sanitation coverage levels that might be required to best control trachoma. Our results suggest access to adequate water and sanitation can be important components in working towards the 2020 target of eliminating trachoma as a public health problem.http://europepmc.org/articles/PMC5800679?pdf=render |
| spellingShingle | Joshua V Garn Sophie Boisson Rebecca Willis Ana Bakhtiari Tawfik Al-Khatib Khaled Amer Wilfrid Batcho Paul Courtright Michael Dejene Andre Goepogui Khumbo Kalua Biruck Kebede Colin K Macleod Kouakou IIunga Marie Madeleine Mariamo Saide Abdala Mbofana Caleb Mpyet Jean Ndjemba Nicholas Olobio Alexandre L Pavluck Oliver Sokana Khamphoua Southisombath Fasihah Taleo Anthony W Solomon Matthew C Freeman Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. PLoS Neglected Tropical Diseases |
| title | Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. |
| title_full | Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. |
| title_fullStr | Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. |
| title_full_unstemmed | Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. |
| title_short | Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. |
| title_sort | sanitation and water supply coverage thresholds associated with active trachoma modeling cross sectional data from 13 countries |
| url | http://europepmc.org/articles/PMC5800679?pdf=render |
| work_keys_str_mv | AT joshuavgarn sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT sophieboisson sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT rebeccawillis sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT anabakhtiari sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT tawfikalkhatib sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT khaledamer sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT wilfridbatcho sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT paulcourtright sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT michaeldejene sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT andregoepogui sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT khumbokalua sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT biruckkebede sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT colinkmacleod sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT kouakouiiungamariemadeleine sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT mariamosaideabdalambofana sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT calebmpyet sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT jeanndjemba sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT nicholasolobio sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT alexandrelpavluck sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT oliversokana sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT khamphouasouthisombath sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT fasihahtaleo sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT anthonywsolomon sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries AT matthewcfreeman sanitationandwatersupplycoveragethresholdsassociatedwithactivetrachomamodelingcrosssectionaldatafrom13countries |