The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61222

Anne Paxton, Dr PH, Mailman School of Public Health, Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Avenue B-3, New York, NY 10032, Laura Frost, PhD, Department of Epidemiology and Public Health, University College Cork, Distillery House, North Mall, Cork, Ireland, Molly E. Rauch, MPH, Public Health Consultant, 37 Trumbull Street #4F, New Haven, CT 06510, and Sam Abbenyi, International Trachoma Initiative, 441 Lexington Avenue, 16th Floor, New York, NY 10017, 212-490-6460, sabbenyi@trachoma.org.

Trachoma is the world's leading cause of preventable blindness. While the clinical aspects of trachoma in individuals are well-understood, there is little comprehensive understanding of the social determinants of this preventable disease. This paper uses a social epidemiology framework to review current research on trachoma transmission. The goals are to identify gaps in our understanding of the social conditions that allow trachoma transmission to occur, and establish research priorities that will help improve trachoma control programs. Information used includes published and unpublished studies of trachoma transmission and trachoma control programs. These studies are summarized with respect to current knowledge about the social distribution of trachoma throughout the world. Risk factors for trachoma transmission are found to include female sex, older age, and low socioeconomic status, along with various factors that overlap with socioeconomic status: low educational attainment, residence on marginal land, lack of facial cleanliness, increased distance to water source, decreased use of water, and the presence of flies. Trachoma prevalence relies on social conditions that can be altered. Understanding the role of social groups is key to understanding disease distribution. The tools of social epidemiology suggest several research priorities for trachoma. Case-control studies with the community as the unit of analysis, comparing trachoma-endemic communities with non-trachomatous communities, should be initiated. Primary prevention interventions with strong community involvement should also be a priority. Finally, multi-disciplinary collaborations combining the expertise of historians, economists, sociologists, anthropologists, and political scientists would fruitfully contribute to research on trachoma control strategies.

Learning Objectives:

• At the end of the session, participants will be able to identify social groups at particular risk of trachoma, using a social epidemiology lens.

Keywords: Infectious Diseases, Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.