02535nas a2200457   4500000000100000008004100001653001600042653001300058653001600071653001100087653001200098653001100110653002100121653001300142653001600155653002100171653002600192653002100218653001000239653002600249653002200275653000900297653001000306653001500316100001300331700001200344700001500356700001200371700001700383700001300400700001400413700001200427700001500439700001100454700001400465245020200479300001200681490000800693520136200701022001402063       2009                            d10aYoung Adult10aTrachoma10aMiddle Aged10aInfant10aHygiene10aHumans10aHealth Education10aEthiopia10aEnvironment10aCluster Analysis10aChlamydia trachomatis10aChild, Preschool10aChild10aAnti-Bacterial Agents10aAged, 80 and over10aAged10aAdult10aAdolescent1 aNgondi J1 aGebre T1 aShargie EB1 aAdamu L1 aEjigsemahu Y1 aTeferi T1 aZerihun M1 aAyele B1 aCevallos V1 aKing J1 aEmerson P00aEvaluation 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.  a1001-100 v1033 a<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>
  a1878-3503