Abstract
BackgroundElimination of blinding trachoma by 2020 can only be achieved if affected areas have effective control programs in place before the target date. Identifying risk factors for active disease that are amenable to intervention is important to successfully design such programs. Previous studies have linked sleeping by a cooking fire to trachoma in children, but not fully explored the mechanism and risks. We propose to determine the risk for active trachoma in children with exposure to cooking fires by severity of trachoma, adjusting for other known risk factors.MethodsComplete census of 52 communities in Kongwa, Tanzania, was conducted to collect basic household characteristics and demographic information on each family member. Information on exposure to indoor cooking fires while the mother was cooking and while sleeping for each child was collected. 6656 randomly selected children ages 1-9yrs were invited to a survey where both eyelids were graded for follicular (TF) and intense trachoma (TI) using the WHO simplified grading scheme. Ocular swab were taken to assess the presence of Chlamydia trachomatis.Findings5240 (79%) of the invited children participated in the study. Overall prevalence for trachoma was 6·1%. Odds for trachoma and increased severity were higher in children sleeping without ventilation and a cooking fire in their room (TF OR = 1·81, 1·00–3·27 and TI OR 4·06, 1·96–8·42). Children with TF or TI who were exposed were more likely to have infection than children with TF or TI who were not exposed. There was no increased risk with exposure to a cooking fire while the mother was cooking.ConclusionsIn addition to known risk factors for trachoma, sleeping by an indoor cooking fire in a room without ventilation was associated with active trachoma and appears to substantially increase the risk of intense inflammation.
Highlights
Trachoma remains the leading infectious cause of preventable blindness in the world, and a significant public health problem in endemic areas.[1]
We propose to determine the risk for active trachoma in children with exposure to cooking fires by severity of trachoma, adjusting for other known risk factors
In addition to known risk factors for trachoma, sleeping by an indoor cooking fire in a room without ventilation was associated with active trachoma and appears to substantially increase the risk of intense inflammation
Summary
Trachoma remains the leading infectious cause of preventable blindness in the world, and a significant public health problem in endemic areas.[1] Elimination of trachoma by 2020 can only be achieved if all affected areas have effective control programs in place at a prudential period before the target date. [5,6,7,8,9,10,11,12,13,14] no detailed study of the risk of trachoma or infection with Chlamydia trachomatis in children, associated with a broader exposure to sleeping rooms and rooms with a cooking fire has been carried out. We propose to determine the risk in children ages 1 to 9 years of active trachoma, both follicular diseases and intense trachoma, with a detailed assessment of exposure to indoor cooking fire. We propose to determine the risk for active trachoma in children with exposure to cooking fires by severity of trachoma, adjusting for other known risk factors
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