这篇博客文章是系列的一部分，其中包含在lcntdrCollection: Advances in scientific research for NTD control,led by the伦敦被忽视的热带疾病研究中心(LCNTDR). Stay tuned for updates on Twitter@bugbittentweetsand@NTDResearch. You can find other posts in the serieshere.
Trachoma and the SAFE strategy
Trachoma这是世界领先的失明感染原因，影响了全球1.369亿人，并导致了190万人的视力障碍或失明。它是由细菌的眼部感染引起的Chlamydia trachomatis. Transmission is thought to occur directly from contact with hands and faces, or indirectly via clothing and potentially through the putative vector, the eye-seeking flyMusca sorbens. Access to clean water, sanitation and hygiene (WASH) is considered key to limiting transmission of ocularC. trachomatis感染。
The World Health Organization (WHO)-endorsed strategy for trachoma elimination as a public health problem is known by the acronym“SAFE”, where “S” stands for surgery for trichiasis (inturned eyelashes from the upper eyelid), “A” stands for antibiotics, “F” stands for facial cleanliness and “E” stands for environmental improvements, such as increased access to clean water and sanitation. Surgery and antibiotics are important treatments. Facial cleanliness and environmental improvements are essential to reducing the transmission of ocularC. trachomatis感染。
Measuring facial cleanliness
Having an unclean face is commonly associated with having active trachoma. The presence of active trachoma is measured directly in trachoma population-based prevalence surveys to determine whether, and for how long, “AFE” interventions are needed for.
因此，测量面部清洁度的主要目的是确定洗脸运动的成功。但是，评估面部清洁度的指标的准确性和可靠性是值得怀疑的，并且它们与面对洗涤实践的关系得到了很差的描述。
确定英蒂常用的可靠性cators of facial cleanliness (dirt on the face, nasal discharge, ocular discharge, and flies on the face), London School of Hygiene & Tropical Medicine, the Institut de Recherche pour le Développement (IRD) researchers and the Senegalese Programme National de Lutte Contre la Cécité, conducted一项研究, embedded within another study aimed at evaluating a prototype ocularC. trachomatisinfection point-of-care test.
一个考试小组位于塞内加尔班比区的一个村庄的一个中心点，在监护人提供知情同意后，它检查了所有年龄在0-9岁的儿童。单个毕业生使用2.5倍放大镜和手电筒检查了每个参与者，记录脸部是否有污垢，眼部排出，鼻腔排出或脸上的苍蝇。
They then examined each participant’s eyes for clinical signs of trachoma, according to the WHO simplified grading system. The heads of all village compounds were asked questions about WASH access and use through a risk factor questionnaire.
Results of the studyshow that participants had high levels of WASH access and use. Face washing on awakening was reported for all but three children, however, over three-quarters of children had at least one dirty face indicator (an “unclean face”) at the first examination timeslot. A large proportion of children continued to have indicators of an unclean face throughout the day, with the proportion of children examined with specific unclean face indicators varying by time of day.
使用外部水龙头作为主要水源的化合物中的儿童，收集水的时间增加，更可能有一个不洁的脸，年轻的孩子是男性，并且有活跃的沙丘瘤。眼睛儿童C. trachomatisinfection were more likely to have ocular discharge.
鉴于据报道，洗涤途径和使用量很高，因此在一天开始时，患有不洁的面部指示器的儿童比例应该很低。没有观察到这一点，也可以通过以下方式解释：面部指标不是可靠的面部洗涤措施；野外工作时，该人群的儿童面对面洗脸后，眼睛排出，鼻子排出或污垢迅速重新累积；和/或对风险因素问卷的响应者偏见。
Facial cleanliness and trachoma elimination
In order to achieve global elimination of trachoma as a public health problem, as targeted in theWHO road map for neglected tropical diseases 2021-2030and theSustainable Development Goals, reliable, standardised, practical measures of face washing are needed.
One key, albeit ambitious, target for further research is to determine a universally agreed upon measure of clean faces, which includes indicators that have high intra- and inter-grader reliability and consistency, that can be employed in a methodology without being confounded by place of assessment, time of day, environmental conditions, or cultural practices. This would enable national programmes to standardise training and data collection, enabling within- and between-country comparisons of face washing campaign effectiveness.
面部清洁度是沙眼消除策略的关键组成部分，WASH被认为对NTD控制和预防至关重要。但是，作为被忽视的热带疾病/WHO工具包洗涤和健康一起工作：NTD计划的“操作方法”指南notes, the clean face indicator is: “…investigational, requiring further research to confirm its programmatic relevance, repeatability, utility and/or safety.”
This research contributes to this need for further research and demonstrates that using these indicators within a prevalence survey context does not provide a reliable marker of face washing practices.
此博客文章中的研究刚刚在lcntdrCollection: Advances in scientific research for NTD control,led by the伦敦被忽视的热带疾病研究中心(LCNTDR). The collection has beenpublishing inParasites & Vectorssince 2016, and releasing new articles periodically. This series features recent advances in scientific research for NTDs executed by LCNTDR member institutions and their collaborators. It aims to highlight the wide range of work being undertaken by the LCNTDR towards achieving the United Nations Sustainable Development Goals as well as supporting the objectives of the World Health Organization road map for neglected tropical disease 2021-2030.
LCNTDR于2013年启动，目的是为NTD提供重点的运营和研究支持。LCNTDR，联合计划自然界al History Museum,伦敦卫生与热带医学学院,皇家兽医学院,Partnership for Child Development,SCI基金会(formerly known as the Schistosomiasis Control Initiative) and伦敦帝国学院, undertakes interdisciplinary research to build the evidence base around the design, implementation, monitoring and evaluation of NTD programmes.
You can find other posts in the serieshere.
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