Impact of face washing and environmental improvement on reduction of active trachoma in Vietnam-a public health intervention study.

PURPOSE: A public health intervention study in Vietnam was conducted between 2002 and 2005 to assess the impact of improved water and sanitation facilities and increased awareness about active trachoma in the community.
METHODS: In My Thon village (MT), all four components of the SAFE strategy were implemented. In Xom Ngoai village (XN), only the S & A components of the trachoma control strategy were implemented. The villagers improved water and sanitation facilities in MT. Women's Union and school authorities assisted in increasing awareness in the community. Ophthalmologists examined the residents for trachoma. The decline in active trachoma and other water-related diseases was determined by pre- and post-intervention assessments. The impact of the differential F & E strategy on two villages was evaluated.
RESULTS: The active trachoma prevalence in MT (SAFE) and XN (SA) at baseline was 13.3% and 10.2%, respectively. In two years, the masons constructed or improved 281 double-vault and three septic tank latrines, 241 bathrooms, 273 dug wells and 252 water tanks in MT. The prevalence in MT (SAFE) & XN (SA) after two years was 1.4% and 6.7%, respectively. The additional decline of active trachoma due to the differential F & E strategy among children under the age of 15 was 6.8%. The F & E strategy was responsible for 58.7% of the decline at all ages and 37.4% in children under the age of 15. Knowledge of the prevention of trachoma had improved in two years. However, the attitude towards and practice of trachoma control were not different in the two villages.
CONCLUSIONS: 'F' & 'E' implementation made a significant contribution to the reduction of active trachoma. Community participation and collaborative efforts of partners are crucial. The indicators used to monitor F & E strategies are interrelated and therefore should be evaluated together.