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Trachoma and Relative Poverty: A Case-Control Study
BACKGROUND: Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. METHODOLOG...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657919/ https://www.ncbi.nlm.nih.gov/pubmed/26600211 http://dx.doi.org/10.1371/journal.pntd.0004228 |
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author | Habtamu, Esmael Wondie, Tariku Aweke, Sintayehu Tadesse, Zerihun Zerihun, Mulat Zewdie, Zebideru Callahan, Kelly Emerson, Paul M. Kuper, Hannah Bailey, Robin L. Mabey, David C. W. Rajak, Saul N. Polack, Sarah Weiss, Helen A. Burton, Matthew J. |
author_facet | Habtamu, Esmael Wondie, Tariku Aweke, Sintayehu Tadesse, Zerihun Zerihun, Mulat Zewdie, Zebideru Callahan, Kelly Emerson, Paul M. Kuper, Hannah Bailey, Robin L. Mabey, David C. W. Rajak, Saul N. Polack, Sarah Weiss, Helen A. Burton, Matthew J. |
author_sort | Habtamu, Esmael |
collection | PubMed |
description | BACKGROUND: Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified ‘Stylised Activity List’ developed for the World Bank’s Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06–3.78; p<0.0001), self-rated wealth (OR, 4.41, 95%CI, 2.75–7.07; p<0.0001) and peer-rated wealth (OR, 8.22, 95% CI, 4.59–14.72; p<0.0001). Cases had less access to latrines (57% v 76.5%, p = <0.0001) and higher person-to-room density (4.0 v 3.31; P = 0.0204) than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities. CONCLUSIONS/SIGNIFICANCE: This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a good proxy of inequality within communities and it could be used to target and evaluate interventions for health and poverty alleviation. |
format | Online Article Text |
id | pubmed-4657919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-46579192015-12-02 Trachoma and Relative Poverty: A Case-Control Study Habtamu, Esmael Wondie, Tariku Aweke, Sintayehu Tadesse, Zerihun Zerihun, Mulat Zewdie, Zebideru Callahan, Kelly Emerson, Paul M. Kuper, Hannah Bailey, Robin L. Mabey, David C. W. Rajak, Saul N. Polack, Sarah Weiss, Helen A. Burton, Matthew J. PLoS Negl Trop Dis Research Article BACKGROUND: Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified ‘Stylised Activity List’ developed for the World Bank’s Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06–3.78; p<0.0001), self-rated wealth (OR, 4.41, 95%CI, 2.75–7.07; p<0.0001) and peer-rated wealth (OR, 8.22, 95% CI, 4.59–14.72; p<0.0001). Cases had less access to latrines (57% v 76.5%, p = <0.0001) and higher person-to-room density (4.0 v 3.31; P = 0.0204) than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities. CONCLUSIONS/SIGNIFICANCE: This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a good proxy of inequality within communities and it could be used to target and evaluate interventions for health and poverty alleviation. Public Library of Science 2015-11-23 /pmc/articles/PMC4657919/ /pubmed/26600211 http://dx.doi.org/10.1371/journal.pntd.0004228 Text en © 2015 Habtamu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Habtamu, Esmael Wondie, Tariku Aweke, Sintayehu Tadesse, Zerihun Zerihun, Mulat Zewdie, Zebideru Callahan, Kelly Emerson, Paul M. Kuper, Hannah Bailey, Robin L. Mabey, David C. W. Rajak, Saul N. Polack, Sarah Weiss, Helen A. Burton, Matthew J. Trachoma and Relative Poverty: A Case-Control Study |
title | Trachoma and Relative Poverty: A Case-Control Study |
title_full | Trachoma and Relative Poverty: A Case-Control Study |
title_fullStr | Trachoma and Relative Poverty: A Case-Control Study |
title_full_unstemmed | Trachoma and Relative Poverty: A Case-Control Study |
title_short | Trachoma and Relative Poverty: A Case-Control Study |
title_sort | trachoma and relative poverty: a case-control study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657919/ https://www.ncbi.nlm.nih.gov/pubmed/26600211 http://dx.doi.org/10.1371/journal.pntd.0004228 |
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