Relationship between water handling practices and trachoma disease occurrence in rural Gambia

Although it is one of the so called “Neglected Tropical Diseases”, Trachoma is also the world's leading cause of preventable blindness. Repeated trachoma infection leads to scarring, thickening of the conjunctiva, distortion of the eyelid, and ultimately corneal opacity and blindness, typically in adulthood. The World Health Organization designed ‘SAFE' strategy (Surgery, Antibiotics, Facial Cleanliness, and Environment) toward the eradication of Trachoma by the year 2020. Despite a seemingly well designed initiative, there are concerns over the mechanism of the association between water supply/handling practices and trachoma disease. Studies suggest an association between trachoma, environmental sanitation and personal hygiene, but the details of how water supply may impact trachoma have not been well studied.

This research, conducted in rural Gambia, explored epidemiologic relationships between household trachoma and domestic water handling practices in Gambian villages amongst villages with considerably high prevalence of trachoma. The specific objectives of this research are: to appraise the water-handling situation in terms of procurement, transportation and usage; and draw plausible connections between the water situation and trachoma disease.

It was found that distance traveled to water source, time spent collecting water per trip, the frequency of water collection within the day, availability of water for face washing, and daily frequency of face washing may all impact household trachoma. We conclude that the details of how water use and handling affect trachoma require more attention, especially if the World Health Organization's bid of eliminating the disease is expected to succeed.