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Robinson A, Gomes LRDO, Abdurahman OS, Alemayehu W, Shuka G, Melese E, Guye M, Legesse D, Elias E, Temam K, Koro KH, Adugna D, Seife F, Aga MA, Sarah V, Lambert SM, Walker SL, Habtamu E, Solomon AW, Last A, Macleod D, Burton MJ, Logan JG. Evaluation of the efficacy of insecticide-treated scarves to protect children from the trachoma vector Musca sorbens (Diptera: Muscidae): A phase II randomised controlled trial in Oromia, Ethiopia. EClinicalMedicine 2022; 49:101487. [PMID: 35747196 PMCID: PMC9189873 DOI: 10.1016/j.eclinm.2022.101487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 05/05/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background The eye-seeking fly Musca sorbens can act as a vector for ocular Chlamydia trachomatis, causing trachoma, yet there has been very little research on control measures. We investigated whether insect repellent products, specifically insecticide-treated clothing, could provide personal protection to the user from eye-seeking flies. Methods We first conducted a series of phase I laboratory studies to inform our choice of field intervention. We then conducted a phase II randomised controlled trial testing the efficacy of permethrin-treated scarves (PTS) in reducing fly-face contact in Oromia, Ethiopia. Children aged 4-10 years in full health and with no known adverse reactions to permethrin or other insecticides were allocated to either arm using restricted randomisation. Intervention arm children wore Insect Shield® versatile wraps (as PTS) for 28 days. The primary outcomes, fly-eye, -nose and -mouth contact, were assessed on the first day (0/30/60/180 minutes), on day 7 and on day 28. All participants present per timepoint were included in analyses. This trial was registered with ClinicalTrials.gov (NCT03813069). Findings Participants were recruited to the field trial between 29/10/2019 and 01/11/2019, 58 were randomised to test or control arm. More fly (-eye, -nose and -mouth) contacts were observed in the PTS arm at baseline. After adjusting for baseline contact rates, across all timepoints there was a 35% decrease in fly-eye contacts in the PTS relative to control arm (rate ratio [RR] 0.65, 95% CI 0.52-0.83). Similar cross-timepoint reductions were seen for fly-nose and fly-mouth contacts (RR 0.69, 95% CI 0.51-0.92 and RR 0.79, 95% CI 0.62-1.01, respectively). All children were included on day 0. Two in the control arm were absent on day 7, one left the study and four were excluded from analysis at day 28. No adverse events occurred in the trial. Interpretation Musca sorbens flies are sufficiently repelled by PTS to reduce fly-eye contacts for the wearer, thus possibly reducing the risk of trachoma transmission. Permethrin-treated scarves may therefore an alternative to insecticide space spraying for protection from these flies. Funding Wellcome Trust.
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Affiliation(s)
- Ailie Robinson
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Laura Reis de Oliveira Gomes
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Oumer Shafi Abdurahman
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Wondu Alemayehu
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Gemeda Shuka
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Ewunetu Melese
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Meseret Guye
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Demitu Legesse
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Eden Elias
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Kedir Temam
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Korso Hirpo Koro
- The Fred Hollows Foundation, P.O. Box 6307, Addis Ababa, Ethiopia
| | - Dereje Adugna
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - Fikre Seife
- The Ethiopian Federal Ministry of Health, Disease Prevention and Control Directorate, Addis Ababa, Ethiopia
| | | | - Virginia Sarah
- Global Partnerships Executive, The Fred Hollows Foundation, 12-15 Crawford Mews, York Street, London W1H1LX
| | - Saba M. Lambert
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Stephen L. Walker
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Esmael Habtamu
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1202 Genève, Switzerland
| | - Anna Last
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - David Macleod
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Matthew J. Burton
- International Centre for Eye Health, Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - James G. Logan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Greenland K, Czerniewska A, Guye M, Legesse D, Ahmed Mume A, Shafi Abdurahman O, Abraham Aga M, Miecha H, Shumi Bejiga G, Sarah V, Burton M, Last A. Seasonal variation in water use for hygiene in Oromia, Ethiopia, and its implications for trachoma control: An intensive observational study. PLoS Negl Trop Dis 2022; 16:e0010424. [PMID: 35560031 PMCID: PMC9173637 DOI: 10.1371/journal.pntd.0010424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 06/07/2022] [Accepted: 04/18/2022] [Indexed: 11/18/2022] Open
Abstract
If facial hygiene practices vary seasonally this could have important implications for the design of interventions for trachoma control. This observational study was conducted to explore seasonal variation in hygiene behaviours in 9 households with at least one child aged 1-9 years-of-age in the West Arsi zone in rural Oromia, Ethiopia. Sixty-one household members were observed intensively over two days in the dry season (January), the rainy season (July) and during the harvest period (October) in 2018. Structured record forms were used to document household water availability and use. Daily water use per capita was very low in all seasons (3.1-4.2 litres). Around one third of water consumed in households in all seasons was associated with body washing. Soap was used during 44 of 677 (6%) of these observed occasions and half of all body washes (n = 340; 50%) included face washing. Overall, 95% of 58 individuals washed their faces at least once between 06:30h and 21:30h in the dry season (21% with soap), compared with 79% in the rainy season (2% with soap) (p = 0.013). Sixty-five percent of householders washed their faces during the harvest observation period (06:30h to 17:30h), none of whom used soap. Twenty-eight percent of 204 children aged 11 and under still had ocular or nasal discharge on their faces after washing. Seventy-three percent of those who washed their faces did so more than once in the dry season, compared with 33% in the rainy season (p<0.001). Face washing occurred throughout the day during the dry season, with a clear peak in the early morning and extra washes in the early evening. Face washing mainly took place in the early morning in the other two seasons. Genuine water scarcity in this area is likely to limit the impact of face washing interventions for trachoma control in the absence of water supply interventions. However, face washing was most common at the time of year when water is the hardest to come by, and seasonal differences in behaviour should be considered in any resulting intervention design.
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Affiliation(s)
- Katie Greenland
- Environmental Health Group, Department for Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Alexandra Czerniewska
- Environmental Health Group, Department for Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Meseret Guye
- The Fred Hollows Foundation, Addis Ababa, Ethiopia
| | | | | | - Oumer Shafi Abdurahman
- The Fred Hollows Foundation, Addis Ababa, Ethiopia
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Hirpha Miecha
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | | | | | - Matthew Burton
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anna Last
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Ismail S, H/Giorgis F, Legesse D, Alemu E, Regassa K, Abdella M, Shibeshi M. Knowledge, attitude and practice on high risk factors pertaining to HIV/AIDS in a rural community. Ethiop Med J 1995; 33:1-6. [PMID: 7895741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A cross-sectional study on knowledge, attitude and practice on high risk factors for human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) was carried out among rural males of Dembia district, north Gonder Administrative Zone in January 1993. A random sample of 89(92.8%) males were interviewed by six senior medical students. A total of 66(74.2%) people reported to have heard something about AIDS. Eighty (89.9%) males did not know anything about condoms. The most common sources of information on AIDS were close friends, health workers, school teachers and the radio. Favourable attitude was observed. Fifty-four (60.7%) were afraid of getting AIDS; 7.5% had practised extramarital sex in the past three months. Higher knowledge was not associated with high risk behaviour (p > 0.05). Higher knowledge and favourable attitude were strongly correlated, (r = 0.83, 95% CI = 0.76-0.89). Strengthening risk perception, condom promotion and larger or detailed studies were recommended.
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Affiliation(s)
- S Ismail
- Department of Community Health, Gonder College of Medical Sciences
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