Impact of a School Trachoma Program Emphasizing Facial Cleanliness and Environmental Improvement in Amhara, Ethiopia

Am J Trop Med Hyg. 2024 May 28;111(3_Suppl):114-120. doi: 10.4269/ajtmh.23-0665. Print 2024 Sep 3.

Abstract

The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is the WHO's endorsed approach for eliminating trachoma as a public health problem; however, not all components have been treated equally. Historically, the F and E components have not been prioritized owing to their perceived complexity. With school enrollment increasing in Ethiopia, development of a national school health program that is focused on the F and E components represents an opportunity to strengthen the SAFE strategy in the country. In 2016, the Trachoma Control Program in Amhara, Ethiopia, along with its partners, developed a School Trachoma Program (STP) that offers grade-specific lessons to improve sanitation and hygiene knowledge and practices among primary school-aged children. To assess its impact, schools were sampled before implementation and then up to 1 year after STP rollout. The aim of this report is to detail STP outcomes and the associations between outcomes and school-level variables. By 2018, adoption of an STP was strong within Amhara, with 85% of the 137 surveyed schools completing their quarterly reports and nearly 80% having at least one teacher trained in the STP. By the end of the third quarter, nearly all schools (86%) had access to a latrine, and 89% of students had a clean face. A schoolwide orientation was associated with increased STP lessons and activities (P = 0.01). Development of an STP, with buy-in from principals and teachers, represents a promising approach for the adoption of a new F- and E-specific curriculum and may help advance efforts to eliminate trachoma.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Ethiopia / epidemiology
  • Face
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hygiene* / standards
  • Male
  • Sanitation / standards
  • School Health Services
  • Schools*
  • Trachoma* / epidemiology
  • Trachoma* / prevention & control

Substances

  • Anti-Bacterial Agents