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Environmental sanitation measures to reduce trachoma transmission

Trachoma is the commonest cause of preventable vision loss and is common in poor communities. Repeated bouts of conjunctivitis caused by chlamydia infection lead to scarring and turning in of the eyelid. The lashes rub the cornea causing opacification and blindness. Environmental sanitation is a package of measures aimed at eliminating factors that encourage proliferation of flies and the spread of the disease. Some of these interventions include provision of water and latrines as well insecticide spray to control flies and health education programmes to improve the personal and environmental hygienic practices of the people. We included six studies involving 12,294 participants of different ages and both sexes in this review. The trials were conducted in The Gambia, Mali, Tanzania, Niger and Ethiopia. Two studies looked at insecticide spray, one looked at insecticide spray and provision of latrines, one study looked at provision of latrines, and two studies looked at health education with one of them having health education combined with water supply. Prevalence of active trachoma, prevalence of Chlamydia trachomatis and fly count measures were the main outcomes assessed. Two studies conducted in the same area found insecticide spray effective in reducing active trachoma but one study in a different setting found the spray ineffective. A separate study found health education on personal and environmental hygiene to be effective in reducing active trachoma, however, another study found that a modest health education programme combined with a modest water supply was not effective in reducing active trachoma. One study on latrine provision found no impact on trachoma. However, more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antibiotics reduce the prevalence of ocular infection with trachoma

Trachoma is common in people living in poor communities and is the most common infectious cause of vision loss. Repeated bouts of conjunctivitis (inflammation of the membranes of the eyes) caused by Chlamydia infection eventually lead to scarring and inward turning of the eyelid. The lashes rub on the cornea causing opacification and blindness. Antibiotics can be used to treat the Chlamydia infection and may be given as an ointment or by mouth. This review included 14 trials in 3587 people with ocular trachoma and eight community‐based trials (67 communities). Antibiotic treatment reduce conjunctivitis caused by trachoma ('active trachoma') and ocular infection in individuals. Community‐based trials provided evidence that azithromycin treatment reduces the prevalence of active trachoma and ocular Chlamydia infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Face washing promotion for preventing active trachoma

We investigated whether face washing prevents active trachoma in endemic communities.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

The added value of water, sanitation, and hygiene interventions to mass drug administration for reducing the prevalence of trachoma: a systematic review examining

Trachoma is the leading cause of infectious blindness worldwide. The SAFE strategy, the World Health Organization-recommended method to eliminate blinding trachoma, combines developments in water, sanitation, surgery, and antibiotic treatment. Current literature does not focus on the comprehensive effect these components have on one another. The present systematic review analyzes the added benefit of water, sanitation, and hygiene education interventions to preventive mass drug administration of azithromycin for trachoma. Trials were identified from the PubMed database using a series of search terms. Three studies met the complete criteria for inclusion. Though all studies found a significant change in reduction of active trachoma prevalence, the research is still too limited to suggest the impact of the "F" and "E" components on trachoma prevalence and ultimately its effects on blindness.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Interventions for trachomatous trichiasis

Trachoma is the commonest infectious cause of blindness in the world. It is caused by a bacterium called Chlamydia trachomatis. This infection causes inflammation and scarring of the surface of the eye, which results in the eyelid turning in (entropion) so that the eyelashes touch the eyeball. This is known as trachomatous trichiasis. The lashes can scratch the corneal surface, leading directly or indirectly (from secondary infections) to corneal opacity. Surgery to correct the eyelid deformity is the main treatment for the late stages of the disease. Most cases of trachomatous trichiasis occur in sub‐Saharan Africa. They are generally treated by nurses with limited surgical training. Unfortunately the results of the surgery can be quite variable, with frequent post‐operative trichiasis reported. Therefore, we wanted to find out what types of surgery and other interventions give the best results in treating this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Community based interventions for the prevention and control of Non-Helmintic NTD

In this paper, we aim to systematically analyze the effectiveness of community based interventions (CBI) for the prevention and control of non-helminthic diseases including dengue, trypanosomiasis, chagas, leishmaniasis, buruli ulcer, leprosy and trachoma. We systematically reviewed literature published up to May 2013 and included 62 studies in this review. Findings from our review suggest that CBI including insecticide spraying; insecticide treated bednets and curtains; community education and cleanliness campaigns; chemoprophylaxis through mass drug administration; and treatment have the potential to reduce the incidence and burden of non-helminthic diseases. Lack of data limited the subgroup analysis for integrated and non-integrated delivery strategies however, qualitative synthesis suggest that integrated delivery is more effective when compared to vertical interventions; however, such integration was possible only because of the existing vertical vector control programs. Community delivered interventions have the potential to achieve wider coverage and sustained community acceptance. Eradicating these diseases will require a multipronged approach including drug administration, health education, vector control and clean water and sanitation facilities. This would require high level governmental commitment along with strong partnerships among major stakeholders.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Assessing the Impact of Economic Evidence on Policymakers in Health Care—A Systematic Review [Internet]

Many health care experts are demanding greater use of economic evidence in the assessment of new and existing health technologies.

Methods Research Reports - Agency for Healthcare Research and Quality (US).

Version: October 2012
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Allergen-Specific Immunotherapy for the Treatment of Allergic Rhinoconjunctivitis and/or Asthma: Comparative Effectiveness Review [Internet]

Allergic rhinitis is highly prevalent in North America, affecting 20 to 40 percent of the population. Nearly 9 percent of Americans suffer from asthma, with more than half having evidence of atopy. This comparative effectiveness review describes the effectiveness and safety of subcutaneous immunotherapy and sublingual immunotherapy (off-label use of subcutaneous-aqueous allergens for sublingual desensitization) compared with other therapies for treatment of allergic rhinoconjunctivitis and asthma.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: March 2013
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Shared sanitation versus individual household latrines: a systematic review of health outcomes

BACKGROUND: More than 761 million people rely on shared sanitation facilities. These have historically been excluded from international sanitation targets, regardless of the service level, due to concerns about acceptability, hygiene and access. In connection with a proposed change in such policy, we undertook this review to identify and summarize existing evidence that compares health outcomes associated with shared sanitation versus individual household latrines.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Diagnostic impact of signs and symptoms in acute infectious conjunctivitis: systematic literature search

This review attempted to assess the diagnostic utility of signs, symptoms or both for the differential diagnosis of bacterial and viral conjunctivitis. The authors' conclusion that the use of signs and symptoms were not based on evidence accurately reflected the fact that no eligible studies were located, and appeared likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

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