Publications & Reports

Latrine promotion for trachoma: assessment of mortality from a cluster-randomized trial in Ethiopia.

Teshome Gebre, Berhan Ayele, Mulat Zerihun, Jenafir I House, Nicole E Stoller, Zhaoxia Zhou, Kathryn J Ray, Bruce D Gaynor, Travis C Porco, Paul M Emerson, Thomas M Lietman, Jeremy D Keenan
Carter Center Ethiopia, Addis Ababa, Ethiopia.


Trachoma control strategies, including latrine construction and antibiotic distribution, are directed at reducing ocular chlamydia, but may have additional benefits. In a cluster-randomized clinical trial, 24 subkebeles (administrative geographic units) in Ethiopia were offered a single mass azithromycin treatment, and half were randomized to receive an intensive latrine promotion. At a follow-up census 26 months after the baseline treatment, 320 persons had died. The mortality rate of children 1-5 years of age was 3.87 (95% confidence interval [CI] = 2.19-6.82) per 1,000 person-years in the latrine promotion arm, and 2.72 (95% CI = 1.37-5.42) per 1,000 person-years in the control arm. In a multi-level mixed effects logistic regression model controlling for age, there was no difference in mortality in persons randomized into the latrine or control arms (odds ratio = 1.18, 95% CI = 0.89-1.58). Latrine promotion provided no additional effect on mortality in the context of an azithromycin distribution program (, #NCT00322972).


  • Journal: The American Journal of Tropical Medicine and Hygiene
  • Published: 01/09/2011
  • Volume: 85
  • Issue: 3
  • Pagination: 518-523