An evaluation of household latrine coverage in Kewot woreda, Ethiopia three years after implementing interventions to control blinding trachoma Público

Abstract

Abstract

The SAFE strategy for trachoma control includes surgery, antibiotic distribution, facial cleanliness and environmental improvements including promotion of latrine construction. In this study we estimate household latrine coverage to evaluate SAFE implementation in an area of Ethiopia where reported coverage in rural areas was 97%, and explored characteristics of latrine adopters and non-adopters. Interviews were conducted in 442 households selected at random in a multi-stage, cluster survey. Estimated household latrine coverage was 56.2% (95% CI 37.5 - 74.8) and, in rural areas, was 67.7% (95% CI 59.6 - 75.7). Previous latrine ownership was reported by 12.7% (95% CI 8.9 - 16.5) of households of which 32.0% (95% CI 15.9 - 48.2) had built a replacement. Latrine adopters were more likely to be male, have more than 5 residents in their household and live in a rural area. Heads of household who were advised by a health extension worker or development agent were more likely to have built a latrine. Household latrine coverage has increased from the 2007 zonal estimate (8.9%), but was lower than that reported. Latrine promotion should include emphasis on re-building latrines. More support may be needed by small and female-headed households, if universal latrine access is to be achieved in Kewot.

Table of Contents

Table of Contents

Chapter I: Literature Review -------------------------------------------------------------------- 1
Disease Background ------------------------------------------------------------------------------ 1
Can antibiotics alone achieve elimination? --------------------------------------------------- 7
Flies, Latrines and Trachoma ------------------------------------------------------------------ 11
Latrine Promotion -------------------------------------------------------------------------------- 19
Chapter II: Manuscript -------------------------------------------------------------------------- 29
Chapter III: Public Health Implications ------------------------------------------------------ 55
References ------------------------------------------------------------------------------------------- 58
Appendices ------------------------------------------------------------------------------------------ 66
IRB Documentation ------------------------------------------------------------------------------ 66
Questionnaire ------------------------------------------------------------------------------------- 67
Household Sampling Methodology ------------------------------------------------------------ 73

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	sanitation coverage SAFE strategy latrine Trachoma sanitation promotion Ethiopia
Committee Chair / Thesis Advisor	Brachman, Philip, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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