Strategies for the control of trachoma.

Trachoma is still a major cause of blindness in many developing areas. Trachoma can be viewed as a community-based disease, and treatment or intervening strategies must be aimed at the community level. The more conventional approaches of treatment using either topical or systemic antibiotics do not seem to offer an appropriate cost-benefit ratio for widespread use. A number of the recent advances in epidemiological field research offer new methods and techniques for studying trachoma. Carefully designed epidemiological field studies can evaluate the role of many different community, family and personal practices and behaviours that could be associated with trachoma. Two recent studies have now shown a clear association between trachoma and infrequent face washing in children. Further studies are in progress to identify ways to alter this behaviour and assess the impact of such an intervention on trachoma. An appropriately designed intervention strategy using a public health approach to alter hygiene practices should have a lasting impact on trachoma at the community level.