IMPACT OF FACE-WASHING ON TRACHOMA IN KONGWA, TANZANIA
IMPACT OF FACE-WASHING ON TRACHOMA IN KONGWA, TANZANIA
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DOI：
10.1016/s0140-6736(95)90167-1
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发表时间：
1995-01-21
期刊：
影响因子：
168.9
通讯作者：
TAYLOR, HR
中科院分区：
文献类型：
--
作者：
WEST, S;MUNOZ, B;TAYLOR, HR
观察性研究表明，与眼分泌物、鼻分泌物或脸上有苍蝇的儿童相比，面部清洁儿童的沙眼患病率较低。我们在三对村庄开展了一项基于社区的随机试验，以评估大规模局部抗生素治疗运动后洗脸干预方案对沙眼的影响。坦桑尼亚Kongwa的6个村庄被随机分配了大规模治疗加上洗脸项目或仅进行治疗。在这些村庄随机选取1417名1-7岁的儿童，随访沙眼状况，并在基线、2个月、6个月和12个月时观察面部清洁度。在12个月时，干预村的儿童在两次或更多次随访中面部不干净的可能性比对照村的儿童高60%。与对照村相比，干预村发生严重沙眼的几率为0.62 （95% CI 0.40-0.97）。两次或两次以上随访时面部清洁对任何沙眼（优势比0.58[0.47-0.72]）和严重沙眼（优势比0.35[0.21-0.59]）均有保护作用。这种以社区为基础的参与式洗脸干预方法在村庄的渗透率各不相同，而且是劳动密集型的。然而，我们发现，结合局部治疗，以社区为基础的改善沙眼流行村庄儿童卫生的策略可以降低沙眼的患病率。
Observational studies have suggested that the prevalence of trachoma is lower in children with clean faces than in those with ocular or nasal discharge or flies on the face. We carried out a community-based randomised trial in three pairs of villages to assess the impact on trachoma of a face-washing intervention programme following a mass topical antibiotic treatment campaign.Six villages in Kongwa, Tanzania, were randomly assigned mass treatment plus the face-washing programme or treatment only. 1417 children aged 1-7 years in these villages were randomly selected and followed up for trachoma status and observations of facial cleanliness at baseline and 2, 6, and 12 months. At 12 months, children in the intervention villages were 60% more likely to have bad clean faces at two or more follow-up visits than children in the control villages. The odds of having severe trachoma in the intervention villages were 0.62 (95% CI 0.40-0.97) compared with control villages. A clean face at two or more follow-up visits was protective for any trachoma (odds ratio 0.58 [0.47-0.72]) and severe trachoma (0.35 [0.21-0.59]).This community-based participatory approach to face-washing intervention had variable penetration rates in the villages and was labour intensive. However, we found that, combined with topical treatment, community-based strategies for improving hygiene in children in trachoma-endemic villages can reduce the prevalence of trachoma.