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The Association between Latrine Use and Trachoma: A Secondary Cohort Analysis from a Randomized Clinical Trial

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  • Francis I. Proctor Foundation, University of California, San Francisco, California; The Carter Center, Addis Ababa, Ethiopia; Departments of Ophthalmology and Epidemiology and Biostatistics, University of California, San Francisco, California; The Carter Center, Atlanta, Georgia; Institute for Global Health, University of California, San Francisco, California

Latrine use has been promoted as a component of an integrated strategy for trachoma control. As part of a randomized trial in Ethiopia, 12 communities received a mass azithromycin distribution followed by a latrine promotion intervention. A random sample of children ages 0–9 years in each community was monitored longitudinally for ocular chlamydia. After latrine construction ended, those communities with a higher proportion of households using latrines were more likely to experience a reduction in the prevalence of ocular chlamydia. Specifically, for each 10% increase in latrine use, there was a 2.0% decrease (95% confidence interval = 0.2–3.9% decrease) in the community prevalence of ocular chlamydia over the subsequent year (P = 0.04).

Author Notes

* Address correspondence to Jeremy D. Keenan, 513 Parnassus Avenue, Box 0412, MedSci S309, University of California, San Francisco, CA 94143-0412. E-mail: jeremy.keenan@ucsf.edu

Financial support: The main support for this study was National Institutes of Health Grants NEI U10 EY016214 and NEI K23 EY019071. Support was also provided by the International Trachoma Initiative (donation of azithromycin) as well as the Bernard Osher Foundation, That Man May See, the Bodri Foundation, the Harper Inglis Trust, the South Asia Research Fund, and Research to Prevent Blindness.

Authors' addresses: Meron Haile, Sun N. Yu, Nicole E. Stoller, Bruce D. Gaynor, and Travis C. Porco, Francis I. Proctor Foundation, University of California, San Francisco, CA, E-mails: Meron.Haile@ucsf.edu, sun.yu@ucsf.edu, Nicole.Stoller@ucsf.edu, Bruce.Gaynor@ucsf.edu, and Travis.Porco@ucsf.edu. Zerihun Tadesse, Sintayehu Gebreselassie, Berhan Ayele, and Teshome Gebre, The Carter Center–Ethiopia, Addis Ababa, Ethiopia, E-mails: zerihtad@yahoo.co.uk, sint_selam@yahoo.com, berhanayele@yahoo.com, and teshumanga2002@yahoo.com. Paul M. Emerson, The Carter Center, Atlanta, GA, E-mail: pemerso@emory.edu. Thomas M. Lietman and Jeremy D. Keenan, Francis I. Proctor Foundation, and Department of Ophthalmology, University of California, San Francisco, CA, E-mails: tom.lietman@ucsf.edu and jeremy.keenan@ucsf.edu.

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