@article{28552,
  keywords = {Young Adult, Trachoma, Middle Aged, Infant, Hygiene, Humans, Health Education, Ethiopia, Environment, Cluster Analysis, Chlamydia trachomatis, Child, Preschool, Child, Anti-Bacterial Agents, Aged, 80 and over, Aged, Adult, Adolescent},
  author = {Ngondi J and Gebre T and Shargie EB and Adamu L and Ejigsemahu Y and Teferi T and Zerihun M and Ayele B and Cevallos V and King J and Emerson P},
  title = {Evaluation of three years of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement) for trachoma control in five districts of Ethiopia hyperendemic for trachoma.},
  abstract = {<p>Trachoma surveys were conducted at baseline in five districts of Amhara National Regional State, Ethiopia (7478 participants in 1096 households) and at 3-year evaluation (5762 participants in 1117 households). Uptake of SAFE was assessed with programme monitoring data and interviews, and children (1-6 years) were swabbed for detection of ocular Chlamydia. At evaluation, 23,933 people had received trichiasis surgery; 93% of participants reported taking azithromycin at least once; 67% of household respondents (range 46-93) reported participation in trachoma health education; and household latrine coverage increased from 2% to 34%. In children aged 1-9 years percentage decline, by district, for outcomes was: 32% (95% CI 19-48) to 88% (95% CI 83-91) for trachomatous inflammation-follicular (TF); 87% (95% CI 83-91) to 99% (95% CI 97-100) for trachomatous inflammation-intense (TI); and 31% increase (95% CI -42 to -19) to 89% decrease (95% CI 85-93) for unclean face; and in adults percentage decline in trichiasis was 45% (95% CI -13 to 78) to 92% (95% CI 78-96). Overall prevalence of swabs positive for ocular Chlamydia was 3.1%. Although there were substantial reductions in outcomes in children and adults, the presence of ocular Chlamydia and TF in children suggests ongoing transmission. Continued implementation of SAFE is warranted.</p>
},
  year = {2009},
  journal = {Transactions of the Royal Society of Tropical Medicine and Hygiene},
  volume = {103},
  pages = {1001-10},
  issn = {1878-3503},
  doi = {10.1016/j.trstmh.2008.11.023},
  language = {eng},
}