Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis
Trachoma is the world's leading cause of infectious blindness. The World Health Organization (WHO) has endorsed the SAFE strategy in order to eliminate blindness due to trachoma by 2020 through "surgery," "antibiotics," "facial cleanliness," and "environmental...
Gespeichert in:
| Veröffentlicht in: | PLoS medicine 2014-02, Vol.11 (2), p.e1001605 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 2 |
| container_start_page | e1001605 |
| container_title | PLoS medicine |
| container_volume | 11 |
| creator | Stocks, Meredith E Ogden, Stephanie Haddad, Danny Addiss, David G McGuire, Courtney Freeman, Matthew C |
| description | Trachoma is the world's leading cause of infectious blindness. The World Health Organization (WHO) has endorsed the SAFE strategy in order to eliminate blindness due to trachoma by 2020 through "surgery," "antibiotics," "facial cleanliness," and "environmental improvement." While the S and A components have been widely implemented, evidence and specific targets are lacking for the F and E components, of which water, sanitation, and hygiene (WASH) are critical elements. Data on the impact of WASH on trachoma are needed to support policy and program recommendations. Our objective was to systematically review the literature and conduct meta-analyses where possible to report the effects of WASH conditions on trachoma and identify research gaps.
We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through October 27, 2013 with no restrictions on language or year of publication. Studies were eligible for inclusion if they reported a measure of the effect of WASH on trachoma, either active disease indicated by observed signs of trachomatous inflammation or Chlamydia trachomatis infection diagnosed using PCR. We identified 86 studies that reported a measure of the effect of WASH on trachoma. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. If three or more studies reported measures of effect for a comparable WASH exposure and trachoma outcome, we conducted a random-effects meta-analysis. We conducted 15 meta-analyses for specific exposure-outcome pairs. Access to sanitation was associated with lower trachoma as measured by the presence of trachomatous inflammation-follicular or trachomatous inflammation-intense (TF/TI) (odds ratio [OR] 0.85, 95% CI 0.75-0.95) and C. trachomatis infection (OR 0.67, 95% CI 0.55-0.78). Having a clean face was significantly associated with reduced odds of TF/TI (OR 0.42, 95% CI 0.32-0.52), as were facial cleanliness indicators lack of ocular discharge (OR 0.42, 95% CI 0.23-0.61) and lack of nasal discharge (OR 0.62, 95% CI 0.52-0.72). Facial cleanliness indicators were also associated with reduced odds of C. trachomatis infection: lack of ocular discharge (OR 0.40, 95% CI 0.31-0.49) and lack of nasal discharge (OR 0.56, 95% CI 0.37-0.76). Other hygiene factors found to be significantly associated with reduced TF/TI included face washing at least once dail |
| doi_str_mv | 10.1371/journal.pmed.1001605 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_plos_</sourceid><recordid>TN_cdi_plos_journals_1507814936</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_79f4ca0181b5430d8347fc92d9b96d84</doaj_id><sourcerecordid>1520375311</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4465-a59cd2ee25e89a31093ca3a0fd08e25dc5f49057af643d0fbc7fd1184ffbd7b83</originalsourceid><addsrcrecordid>eNpVUk1v1DAQjRCIfsA_QOAjh2axYzuJOVRCVYFKlbjA2ZrY492sEnuxs63239fpplV78mjmvTcffkXxidEV4w37tg376GFY7Ua0K0Ypq6l8U5wyKVTJ6qZ--yI-Kc5S2lJaKaro--KkErKtWUVPi_HaOTQTCY7cw4TxgiTw_QRTH_wFAW_J5rDu0SMJnkwbJLuId-jn8syZIphNGOE7AZIOacIxMw3JmB7vH-kjTlBCHvSQ-vSheOdgSPhxec-Lfz-v_179Lm___Lq5-nFbGiFqWYJUxlaIlcRWAWdUcQMcqLO0zUlrpBOKygZcLbilrjONs4y1wrnONl3Lz4svR93dEJJeLpU0k7RpmVC8zoibI8IG2Opd7EeIBx2g14-JENcaYl5lQN0oJwxQ1rJOCk5ty0XjjKqs6lRtW5G1Lpdu-y5_hsnniTC8En1d8f1Gr8Od5ooLpWaBr4tADP_3mCY99sngMIDHsJ_nrihvJGcsQ8URamJIKaJ7bsOonn3xtK2efaEXX2Ta55cjPpOejMAfALsKuFE</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1520375311</pqid></control><display><type>article</type><title>Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Public Library of Science (PLoS)</source><creator>Stocks, Meredith E ; Ogden, Stephanie ; Haddad, Danny ; Addiss, David G ; McGuire, Courtney ; Freeman, Matthew C</creator><creatorcontrib>Stocks, Meredith E ; Ogden, Stephanie ; Haddad, Danny ; Addiss, David G ; McGuire, Courtney ; Freeman, Matthew C</creatorcontrib><description>Trachoma is the world's leading cause of infectious blindness. The World Health Organization (WHO) has endorsed the SAFE strategy in order to eliminate blindness due to trachoma by 2020 through "surgery," "antibiotics," "facial cleanliness," and "environmental improvement." While the S and A components have been widely implemented, evidence and specific targets are lacking for the F and E components, of which water, sanitation, and hygiene (WASH) are critical elements. Data on the impact of WASH on trachoma are needed to support policy and program recommendations. Our objective was to systematically review the literature and conduct meta-analyses where possible to report the effects of WASH conditions on trachoma and identify research gaps.
We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through October 27, 2013 with no restrictions on language or year of publication. Studies were eligible for inclusion if they reported a measure of the effect of WASH on trachoma, either active disease indicated by observed signs of trachomatous inflammation or Chlamydia trachomatis infection diagnosed using PCR. We identified 86 studies that reported a measure of the effect of WASH on trachoma. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. If three or more studies reported measures of effect for a comparable WASH exposure and trachoma outcome, we conducted a random-effects meta-analysis. We conducted 15 meta-analyses for specific exposure-outcome pairs. Access to sanitation was associated with lower trachoma as measured by the presence of trachomatous inflammation-follicular or trachomatous inflammation-intense (TF/TI) (odds ratio [OR] 0.85, 95% CI 0.75-0.95) and C. trachomatis infection (OR 0.67, 95% CI 0.55-0.78). Having a clean face was significantly associated with reduced odds of TF/TI (OR 0.42, 95% CI 0.32-0.52), as were facial cleanliness indicators lack of ocular discharge (OR 0.42, 95% CI 0.23-0.61) and lack of nasal discharge (OR 0.62, 95% CI 0.52-0.72). Facial cleanliness indicators were also associated with reduced odds of C. trachomatis infection: lack of ocular discharge (OR 0.40, 95% CI 0.31-0.49) and lack of nasal discharge (OR 0.56, 95% CI 0.37-0.76). Other hygiene factors found to be significantly associated with reduced TF/TI included face washing at least once daily (OR 0.76, 95% CI 0.57-0.96), face washing at least twice daily (OR 0.85, 95% CI 0.80-0.90), soap use (OR 0.76, 95% CI 0.59-0.93), towel use (OR 0.65, 95% CI 0.53-0.78), and daily bathing practices (OR 0.76, 95% CI 0.53-0.99). Living within 1 km of a water source was not found to be significantly associated with TF/TI or C. trachomatis infection, and the use of sanitation facilities was not found to be significantly associated with TF/TI.
We found strong evidence to support F and E components of the SAFE strategy. Though limitations included moderate to high heterogenity, low study quality, and the lack of standard definitions, these findings support the importance of WASH in trachoma elimination strategies and the need for the development of standardized approaches to measuring WASH in trachoma control programs.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1001605</identifier><identifier>PMID: 24586120</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Antibiotics ; Chlamydia trachomatis ; Chlamydia trachomatis - isolation & purification ; Disease prevention ; Face ; Households ; Humans ; Hygiene ; Medicine ; Meta-analysis ; Odds Ratio ; Risk Factors ; Sanitation - methods ; Skin - microbiology ; Skin Care ; Soaps ; Studies ; Trachoma - diagnosis ; Trachoma - epidemiology ; Trachoma - microbiology ; Trachoma - prevention & control ; Water Microbiology ; Water Supply - analysis</subject><ispartof>PLoS medicine, 2014-02, Vol.11 (2), p.e1001605</ispartof><rights>2014 Stocks et al 2014 Stocks et al</rights><rights>2014 Stocks et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Stocks ME, Ogden S, Haddad D, Addiss DG, McGuire C, et al. (2014) Effect of Water, Sanitation, and Hygiene on the Prevention of Trachoma: A Systematic Review and Meta-Analysis. PLoS Med 11(2): e1001605. doi:10.1371/journal.pmed.1001605</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4465-a59cd2ee25e89a31093ca3a0fd08e25dc5f49057af643d0fbc7fd1184ffbd7b83</citedby><cites>FETCH-LOGICAL-c4465-a59cd2ee25e89a31093ca3a0fd08e25dc5f49057af643d0fbc7fd1184ffbd7b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934994/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934994/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24586120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stocks, Meredith E</creatorcontrib><creatorcontrib>Ogden, Stephanie</creatorcontrib><creatorcontrib>Haddad, Danny</creatorcontrib><creatorcontrib>Addiss, David G</creatorcontrib><creatorcontrib>McGuire, Courtney</creatorcontrib><creatorcontrib>Freeman, Matthew C</creatorcontrib><title>Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Trachoma is the world's leading cause of infectious blindness. The World Health Organization (WHO) has endorsed the SAFE strategy in order to eliminate blindness due to trachoma by 2020 through "surgery," "antibiotics," "facial cleanliness," and "environmental improvement." While the S and A components have been widely implemented, evidence and specific targets are lacking for the F and E components, of which water, sanitation, and hygiene (WASH) are critical elements. Data on the impact of WASH on trachoma are needed to support policy and program recommendations. Our objective was to systematically review the literature and conduct meta-analyses where possible to report the effects of WASH conditions on trachoma and identify research gaps.
We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through October 27, 2013 with no restrictions on language or year of publication. Studies were eligible for inclusion if they reported a measure of the effect of WASH on trachoma, either active disease indicated by observed signs of trachomatous inflammation or Chlamydia trachomatis infection diagnosed using PCR. We identified 86 studies that reported a measure of the effect of WASH on trachoma. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. If three or more studies reported measures of effect for a comparable WASH exposure and trachoma outcome, we conducted a random-effects meta-analysis. We conducted 15 meta-analyses for specific exposure-outcome pairs. Access to sanitation was associated with lower trachoma as measured by the presence of trachomatous inflammation-follicular or trachomatous inflammation-intense (TF/TI) (odds ratio [OR] 0.85, 95% CI 0.75-0.95) and C. trachomatis infection (OR 0.67, 95% CI 0.55-0.78). Having a clean face was significantly associated with reduced odds of TF/TI (OR 0.42, 95% CI 0.32-0.52), as were facial cleanliness indicators lack of ocular discharge (OR 0.42, 95% CI 0.23-0.61) and lack of nasal discharge (OR 0.62, 95% CI 0.52-0.72). Facial cleanliness indicators were also associated with reduced odds of C. trachomatis infection: lack of ocular discharge (OR 0.40, 95% CI 0.31-0.49) and lack of nasal discharge (OR 0.56, 95% CI 0.37-0.76). Other hygiene factors found to be significantly associated with reduced TF/TI included face washing at least once daily (OR 0.76, 95% CI 0.57-0.96), face washing at least twice daily (OR 0.85, 95% CI 0.80-0.90), soap use (OR 0.76, 95% CI 0.59-0.93), towel use (OR 0.65, 95% CI 0.53-0.78), and daily bathing practices (OR 0.76, 95% CI 0.53-0.99). Living within 1 km of a water source was not found to be significantly associated with TF/TI or C. trachomatis infection, and the use of sanitation facilities was not found to be significantly associated with TF/TI.
We found strong evidence to support F and E components of the SAFE strategy. Though limitations included moderate to high heterogenity, low study quality, and the lack of standard definitions, these findings support the importance of WASH in trachoma elimination strategies and the need for the development of standardized approaches to measuring WASH in trachoma control programs.</description><subject>Antibiotics</subject><subject>Chlamydia trachomatis</subject><subject>Chlamydia trachomatis - isolation & purification</subject><subject>Disease prevention</subject><subject>Face</subject><subject>Households</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Medicine</subject><subject>Meta-analysis</subject><subject>Odds Ratio</subject><subject>Risk Factors</subject><subject>Sanitation - methods</subject><subject>Skin - microbiology</subject><subject>Skin Care</subject><subject>Soaps</subject><subject>Studies</subject><subject>Trachoma - diagnosis</subject><subject>Trachoma - epidemiology</subject><subject>Trachoma - microbiology</subject><subject>Trachoma - prevention & control</subject><subject>Water Microbiology</subject><subject>Water Supply - analysis</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpVUk1v1DAQjRCIfsA_QOAjh2axYzuJOVRCVYFKlbjA2ZrY492sEnuxs63239fpplV78mjmvTcffkXxidEV4w37tg376GFY7Ua0K0Ypq6l8U5wyKVTJ6qZ--yI-Kc5S2lJaKaro--KkErKtWUVPi_HaOTQTCY7cw4TxgiTw_QRTH_wFAW_J5rDu0SMJnkwbJLuId-jn8syZIphNGOE7AZIOacIxMw3JmB7vH-kjTlBCHvSQ-vSheOdgSPhxec-Lfz-v_179Lm___Lq5-nFbGiFqWYJUxlaIlcRWAWdUcQMcqLO0zUlrpBOKygZcLbilrjONs4y1wrnONl3Lz4svR93dEJJeLpU0k7RpmVC8zoibI8IG2Opd7EeIBx2g14-JENcaYl5lQN0oJwxQ1rJOCk5ty0XjjKqs6lRtW5G1Lpdu-y5_hsnniTC8En1d8f1Gr8Od5ooLpWaBr4tADP_3mCY99sngMIDHsJ_nrihvJGcsQ8URamJIKaJ7bsOonn3xtK2efaEXX2Ta55cjPpOejMAfALsKuFE</recordid><startdate>201402</startdate><enddate>201402</enddate><creator>Stocks, Meredith E</creator><creator>Ogden, Stephanie</creator><creator>Haddad, Danny</creator><creator>Addiss, David G</creator><creator>McGuire, Courtney</creator><creator>Freeman, Matthew C</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>C1K</scope><scope>F1W</scope><scope>H95</scope><scope>H97</scope><scope>L.G</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope></search><sort><creationdate>201402</creationdate><title>Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis</title><author>Stocks, Meredith E ; Ogden, Stephanie ; Haddad, Danny ; Addiss, David G ; McGuire, Courtney ; Freeman, Matthew C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4465-a59cd2ee25e89a31093ca3a0fd08e25dc5f49057af643d0fbc7fd1184ffbd7b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Antibiotics</topic><topic>Chlamydia trachomatis</topic><topic>Chlamydia trachomatis - isolation & purification</topic><topic>Disease prevention</topic><topic>Face</topic><topic>Households</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Medicine</topic><topic>Meta-analysis</topic><topic>Odds Ratio</topic><topic>Risk Factors</topic><topic>Sanitation - methods</topic><topic>Skin - microbiology</topic><topic>Skin Care</topic><topic>Soaps</topic><topic>Studies</topic><topic>Trachoma - diagnosis</topic><topic>Trachoma - epidemiology</topic><topic>Trachoma - microbiology</topic><topic>Trachoma - prevention & control</topic><topic>Water Microbiology</topic><topic>Water Supply - analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stocks, Meredith E</creatorcontrib><creatorcontrib>Ogden, Stephanie</creatorcontrib><creatorcontrib>Haddad, Danny</creatorcontrib><creatorcontrib>Addiss, David G</creatorcontrib><creatorcontrib>McGuire, Courtney</creatorcontrib><creatorcontrib>Freeman, Matthew C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stocks, Meredith E</au><au>Ogden, Stephanie</au><au>Haddad, Danny</au><au>Addiss, David G</au><au>McGuire, Courtney</au><au>Freeman, Matthew C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2014-02</date><risdate>2014</risdate><volume>11</volume><issue>2</issue><spage>e1001605</spage><pages>e1001605-</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Trachoma is the world's leading cause of infectious blindness. The World Health Organization (WHO) has endorsed the SAFE strategy in order to eliminate blindness due to trachoma by 2020 through "surgery," "antibiotics," "facial cleanliness," and "environmental improvement." While the S and A components have been widely implemented, evidence and specific targets are lacking for the F and E components, of which water, sanitation, and hygiene (WASH) are critical elements. Data on the impact of WASH on trachoma are needed to support policy and program recommendations. Our objective was to systematically review the literature and conduct meta-analyses where possible to report the effects of WASH conditions on trachoma and identify research gaps.
We systematically searched PubMed, Embase, ISI Web of Knowledge, MedCarib, Lilacs, REPIDISCA, DESASTRES, and African Index Medicus databases through October 27, 2013 with no restrictions on language or year of publication. Studies were eligible for inclusion if they reported a measure of the effect of WASH on trachoma, either active disease indicated by observed signs of trachomatous inflammation or Chlamydia trachomatis infection diagnosed using PCR. We identified 86 studies that reported a measure of the effect of WASH on trachoma. To evaluate study quality, we developed a set of criteria derived from the GRADE methodology. Publication bias was assessed using funnel plots. If three or more studies reported measures of effect for a comparable WASH exposure and trachoma outcome, we conducted a random-effects meta-analysis. We conducted 15 meta-analyses for specific exposure-outcome pairs. Access to sanitation was associated with lower trachoma as measured by the presence of trachomatous inflammation-follicular or trachomatous inflammation-intense (TF/TI) (odds ratio [OR] 0.85, 95% CI 0.75-0.95) and C. trachomatis infection (OR 0.67, 95% CI 0.55-0.78). Having a clean face was significantly associated with reduced odds of TF/TI (OR 0.42, 95% CI 0.32-0.52), as were facial cleanliness indicators lack of ocular discharge (OR 0.42, 95% CI 0.23-0.61) and lack of nasal discharge (OR 0.62, 95% CI 0.52-0.72). Facial cleanliness indicators were also associated with reduced odds of C. trachomatis infection: lack of ocular discharge (OR 0.40, 95% CI 0.31-0.49) and lack of nasal discharge (OR 0.56, 95% CI 0.37-0.76). Other hygiene factors found to be significantly associated with reduced TF/TI included face washing at least once daily (OR 0.76, 95% CI 0.57-0.96), face washing at least twice daily (OR 0.85, 95% CI 0.80-0.90), soap use (OR 0.76, 95% CI 0.59-0.93), towel use (OR 0.65, 95% CI 0.53-0.78), and daily bathing practices (OR 0.76, 95% CI 0.53-0.99). Living within 1 km of a water source was not found to be significantly associated with TF/TI or C. trachomatis infection, and the use of sanitation facilities was not found to be significantly associated with TF/TI.
We found strong evidence to support F and E components of the SAFE strategy. Though limitations included moderate to high heterogenity, low study quality, and the lack of standard definitions, these findings support the importance of WASH in trachoma elimination strategies and the need for the development of standardized approaches to measuring WASH in trachoma control programs.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24586120</pmid><doi>10.1371/journal.pmed.1001605</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2014-02, Vol.11 (2), p.e1001605 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_1507814936 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Public Library of Science (PLoS) |
| subjects | Antibiotics Chlamydia trachomatis Chlamydia trachomatis - isolation & purification Disease prevention Face Households Humans Hygiene Medicine Meta-analysis Odds Ratio Risk Factors Sanitation - methods Skin - microbiology Skin Care Soaps Studies Trachoma - diagnosis Trachoma - epidemiology Trachoma - microbiology Trachoma - prevention & control Water Microbiology Water Supply - analysis |
| title | Effect of water, sanitation, and hygiene on the prevention of trachoma: a systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T10%3A19%3A44IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20water,%20sanitation,%20and%20hygiene%20on%20the%20prevention%20of%20trachoma:%20a%20systematic%20review%20and%20meta-analysis&rft.jtitle=PLoS%20medicine&rft.au=Stocks,%20Meredith%20E&rft.date=2014-02&rft.volume=11&rft.issue=2&rft.spage=e1001605&rft.pages=e1001605-&rft.issn=1549-1676&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1001605&rft_dat=%3Cproquest_plos_%3E1520375311%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1520375311&rft_id=info:pmid/24586120&rft_doaj_id=oai_doaj_org_article_79f4ca0181b5430d8347fc92d9b96d84&rfr_iscdi=true |