Evaluation of community intervention with pit latrines for trachoma control in Ghana, Mali, Niger and Nigeria.

Trachoma is the leading cause of preventable blindness worldwide and is controlled with an integrated strategy of treatment and prevention which includes latrine provision and promotion. We aimed to evaluate the latrine uptake, construction, and usage in villages participating in latrine promotion programmes supported by The Carter Center in Ghana, Mali, Niger and Nigeria where 113 457 new latrines have been reported from 2002 to 2008. In each country a two stage cluster random sampling design was used to select villages and households for evaluation. Household heads were interviewed using a standardised structured questionnaire and latrines were inspected. The sample included 1154 households (Ghana: 326; Mali: 293; Niger: 300; and Nigeria: 235). Overall, 813 (70.5%, 95% confidence interval [CI] 65.7-74.8) had pit latrines, ranging from 30.3% of households in Niger to over 92.0% of households in Ghana and Mali. Of those with latrines 762 (93.7%) were found to be usable and 659 (86.5%) were in use. Overall 659/1154 (57.1%) of households in the targeted communities were using latrines at least 12 months after latrine promotion was initiated. Latrine promotion had been successful increasing access to sanitation in different country contexts and demonstrates the target population are willing to construct, use and maintain household latrines.