Water availability and trachoma

As part of an epidemiological survey of risk factors for trachoma in 20 villages in the United Republic of Tanzania, we investigated the relationship of village water pumps, distance to water source, and quantity of household water to the risk of inflammatory trachoma. We also evaluated whether there was an association between the cleanliness of children's faces and these water variables. No association was found between the presence of a village water supply and the prevalence of trachoma. However, the risk of trachoma in the household increased with the distance to a water source--although there was no association with the estimated daily amount of water brought into the house. Likewise, children were more likely to have unclean faces if they lived more than 30 minutes from a water source, but whether they had clean faces was not associated with the daily quantity of water brought into the household. The effect of the distance to water supply on trachoma may well reflect the value placed on water within the family, and this determines the priority for its use for hygiene purposes. The results of the study suggest that changing the access to water per se may be insufficient to alter the prevalence of trachoma without also a concomitant effort to change the perception of how water should be utilized in the home.