Facial hygiene, water access ‘could prevent trachoma’

Bonsa-Lalenda, a 10yr old boy suffering from trachoma
Copyright: Flickr/Orbis UK

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  • Trachoma is an eye disease that affects more than 21.4 million people globally
  • Evidence from 86 articles show that facial cleaning could help control it
  • An expert adds that surgery and poverty reduction could also help tackle it

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[NAIROBI] Facial cleanliness and environmental improvement could prevent trachoma, an eye disease which is common among the rural poor in regions such as Africa, Asia, Latin America and the Middle East, says a new study.

According to WHO, the disease affects more than 21.4 million people worldwide with 2.2 million becoming visually impaired and causing blindness in 1.2 million people.

The researchers analysed different studies on the effect of water, sanitation and hygiene (WASH) on trachoma.

“So parents especially, should be sure to wash their children's faces with water and soap at least once daily and use a towel to dry them.”

Matthew Freeman, Emory University, United States.

They searched studies conducted worldwide and published by 27 October 2013 from eight databases, including Embase, Web of Science, PubMed and Africa Index Medicus.

Most of the articles were from studies conducted in Sub-Saharan Africa countries, including Ethiopia, Malawi, Mali, Mozambique, Niger, Nigeria, Senegal, South Sudan and Tanzania.

According to the study published in PLOS Medicine on 25 February, the findings based on 86 articles suggested that whereas all components of WASH could reduce the risk of trachoma infection, improved personal hygiene had the greatest impact.

The WHO says that the bacterium which causes trachoma — Chlamydia trachomatis — could be transmitted through contact with infected eye discharges, especially by touching handkerchiefs and through its spread by eye-seeking flies.

Matthew Freeman, a co-author of the study and an assistant professor of environmental health at the US-based Emory University, says that they identified specific hygiene measures that are effective for trachoma prevention, including facial cleaning, soap and towel use and daily bathing.

“So parents especially, should be sure to wash their children's faces with water and soap at least once daily and use a towel to dry them,” he tells SciDev.Net.

The researchers note in the journal: “Current advice tends to focus on washing faces with clean water, but use of soap appears to be more effective”. Freeman adds that organisations promoting hand washing with soap to prevent diarrhoea in children, could also campaign for face washing with soap to reduce trachoma transmission.

The study also identified a strong association between access to proper sanitation facilities, such as pit latrines and lower levels of trachoma.

“But for people to actually make use of them, these [sanitation] facilities need to feel safe, clean and comfortable,” Freeman explains.

According to Freeman, access to water should not be ignored because when its supply is plenty, it increases facial washing and proper hygiene.

Francis Dikir, the project manager for trachoma control at the Kenya-headquartered African Medical Research Foundation, says that trachoma is the second leading cause of blindness globally, but it is 100 per cent preventable.

He adds that if detected early enough, surgery can be done to correct blindness caused by trachoma and that other interventions not directly related to WASH could also help control the disease.

“Antibiotics are also used to treat the disease, minimising the number of infected people thus cutting transmission,” says Dikir. “Increased awareness on trachoma and poverty eradication is central in fighting this disease which is common in arid and semi-arid areas.”

Link to full paper in PLOS Medicine

This article has been produced by Sub-Saharan Africa desk.


PLOS Medicine doi 10.1371/journal.pmed.1001605 (2014)