Face washing promotion for preventing active trachoma.

Area of Science:

• Ophthalmology
• Infectious Disease Prevention
• Public Health

Background:

• Trachoma causes avoidable blindness, affecting 146 million people with active infection and nearly six million blind from repeat infections.
• It disproportionately impacts underprivileged populations in developing countries.

Purpose of the Study:

• To evaluate the impact of promoting face washing on preventing active trachoma in communities where the disease is endemic.
• To assess the effectiveness of face washing interventions in trachoma prevention strategies.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) and quasi-RCTs comparing face washing interventions with control groups.
• Searched multiple electronic databases (CENTRAL, MEDLINE, EMBASE, PubMed, LILACS, mRCT, ClinicalTrials.gov, WHO ICTRP) up to January 2015.
• Included trials involving residents of trachoma-endemic communities; data extraction and quality assessment were performed independently by two reviewers.

Main Results:

• Two cluster-RCTs involving 2447 participants from Australia and Tanzania were included.
• One trial showed that face washing combined with topical tetracycline reduced severe active trachoma (OR 0.62) and increased facial cleanliness at 12 months.
• The second trial found no significant benefit of eye washing alone or with tetracycline in reducing follicular trachoma at three months.

Conclusions:

• Face washing combined with topical tetracycline appears effective in reducing severe active trachoma and improving facial cleanliness.
• Current evidence is insufficient to conclude on the effectiveness of face washing alone or with topical tetracycline for active trachoma prevention.