Hygiene factors and increased risk of trachoma in central Tanzania
H. R. Taylor, S. K. West, B. B. Mmbaga, S. J. Katala, V. Turner, M. Lynch, B. Munoz and P. A. Rapoza
Dana Center of Preventive Ophthalmology, Wilmer Institute, Johns Hopkins Hospital, Baltimore, MD 21205.
Trachoma remains the major infectious cause of blindness in many developing
areas, especially where hygiene is poor. The practices and behaviors
associated with an increased risk of trachoma were studied in central
Tanzania, where a stratified random cluster sample of 8409 people was
examined. Data were collected on family and individual characteristics and
behaviors and on trachoma status. Overall, 60% of the children aged 1 to 7
years had active inflammatory trachoma, and 10% of those aged 60 years or
older had trichiasis. Regression analysis showed that active inflammatory
trachoma in children was associated with the characteristics of the more
traditional families and several measures of poor personal hygiene. Two
important risk factors for severe inflammatory trachoma were poor facial
cleanliness in children (odds ratio of 1.7 [1.17, 2.50]) and household fly
density (odds ratio of 1.63 [1.17, 2.29]). Both factors are potentially
amenable to intervention. These data suggest that an intervention strategy
aimed at these hygiene measures would provide an effective method of
controlling trachoma in this region, and a similar approach may be useful
in other areas.
