Facial cleanliness and risk of trachoma in families
S. K. West, N. Congdon, S. Katala and L. Mele
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Md 21205.
Trachoma is the leading infectious cause of blindness worldwide, and
epidemiologic studies of factors that may increase the transmission of
ocular Chlamydia trachomatis are needed. In two villages in a hyperendemic
area of Central Tanzania, 472 (90%) of 527 preschool-aged children were
examined for specific signs of unclean faces and presence of trachoma. The
odds of trachoma were 70% higher in children with flies and nasal discharge
on their faces. Other facial signs were not important. In large families,
the odds of trachoma increased 4.8-fold if a sibling had trachoma and
6.8-fold if a sibling had trachoma and an unclean face. Health education
strategies aimed at improving face washing need to target cleaning nasal
discharge and keeping flies off children's faces.
