Sanitation, Water, and Instruction in Face-washing for Trachoma I/II (SWIFT I/II)
Trachoma
About this trial
This is an interventional treatment trial for Trachoma focused on measuring trachoma, soil transmitted helminths, sanitation, face washing, antibiotics
Eligibility Criteria
Community Level
Inclusion Criteria
- Community in a school district that is within the study area of WagHimra
- Area within each school district with a site identified for water point construction
- At least 5 rounds of mass azithromycin distributions had been performed within community
Exclusion Criteria:
- School districts that are too difficult to reach (more than a 1-day of travel to access)
- School districts in the 2 urban regions of the study area, since urban communities have better access to water and sanitation and have less trachoma
- Refusal of village chief
Individual Level
Inclusion Criteria:
- All residents residing within a 1.5km radius from the most promising potential water point the water point sites within the school district that were identified for the study
Exclusion criteria
- Refusal of participant [or parent/guardian]
Sites / Locations
- The Carter Center EthiopiaRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Experimental
Other
Experimental
Other
Active Comparator
WASH arm (WUHA)
Standard of care WASH arm (WUHA)
Targeted antibiotics arm (TAITU)
Delayed mass antibiotics arm (TAITU)
Mass antibiotics arm (TAITU)
WUHA I, Behavioral: Water, sanitation, and hygiene (WASH) intervention: Communities will receive the water, sanitation, and hygiene (WASH) intervention including community water point construction, hygiene and sanitation education and promotion, community-based hygiene promotion workers, household wash stations, household WASH education books, household soap distribution, and a hygiene curriculum for primary schools. WUHA II, Behavioral and Treatment: WASH intervention communities will continue to receive the water, sanitation, and hygiene (WASH) intervention. A single mass azithromycin distribution will be given in all 40 WUHA I communities (both intervention and control) after the final study visit (i.e., month 36). Children 6 months and up will be offered azithromycin 20mg/kg; those under 6 months will be offered tetracycline.
WUHA I: Standard of care WASH intervention: Communities will continue to receive the standard of care WASH programming offered by the Ethiopian government. WUHA II: Standard of care WASH intervention and treatment: Communities will continue to receive the standard of care WASH programming offered by the Ethiopian government. A single mass azithromycin distribution will be given in all 40 WUHA I communities (both intervention and control) after the final study visit (i.e., month 36). Children 6 months and up will be offered azithromycin 20mg/kg; those under 6 months will be offered tetracycline. These communities will receive a WASH package at the conclusion of the SWIFT II study, including water point construction, hygiene and sanitation promotion, and educational materials.
Targeted antibiotic treatment: Communities will receive targeted antibiotic treatments for children testing positive for ocular chlamydia at 3, 6, 9, and 12 months after baseline testing. After testing for ocular chlamydia at 12 months, any children testing positive at this time point will receive antibiotic treatments at 15, 18, 21, and 24 months. Children 6 months and up will be offered azithromycin 20mg/kg; those under 6 months will be offered tetracycline.
Delayed mass antibiotic treatment: Communities will receive no mass azithromycin treatment during the study period. Communities in this treatment group have previously received at least 8 rounds of mass azithromycin treatment. These clusters will be enrolled in an antibiotics treatment program (azithromycin or tetracycline) after the completion of the study.
Mass antibiotic treatment: Communities will receive mass azithromycin treatment of all individuals aged 6 months and up (20mg/kg for children; 1 g for adults); those younger than 6 months, pregnant, or allergic to macrolide antibiotics will be offered a 2-week course of tetracycline.