{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:48:58Z","timestamp":1774435738988,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100024021","name":"Reckitt Global Hygiene Institute","doi-asserted-by":"publisher","award":["2021\u2013006"],"award-info":[{"award-number":["2021\u2013006"]}],"id":[{"id":"10.13039\/100024021","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014445","name":"Fred Hollows Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014445","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n \n A three\u2010arm, open, parallel\u2010group randomised trial compared three face\u2010washing methods for cleaning\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n from the faces of children with severe active trachoma. The impact of face\u2010washing on\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n on the hands of children and their caregivers and\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n duration on faces and hands were investigated as secondary objectives.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Children aged 1\u20137\u2009years in Oromia, Ethiopia, were screened for active trachoma. We aimed to recruit 470 children with severe conjunctival inflammation; 141 were expected to have concurrent conjunctival infection and facial\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n , detected by qPCR. Those with severe inflammation were randomly assigned to water alone, water with soap or damp, microfibre towel protocols. Swabs (children's faces\/hands, caregivers' hands) were collected pre\u2010wash, post\u2010wash, and at 1, 2, 4, 6 and 8\u2009h. Conjunctival swabs were tested for ocular\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n infection; only infected children with facial\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n were included in primary analysis, comparing the proportion of faces without\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n after each washing method.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 470 children screened with severe inflammation, 25 (5%) had conjunctival infection and facial\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n . All three protocols (\n n<\/jats:italic>\n \u2009=\u200912 water only,\n n<\/jats:italic>\n \u2009=\u20098 water and soap,\n n<\/jats:italic>\n \u2009=\u20095 damp towel) reduced discharge, but none removed\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n from faces immediately post\u2010wash. No major facial\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n load reduction was observed. Face\u2010washing removed\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n from some children's and caregivers' hands, but loads were not significantly reduced where\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n persisted. Though\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n was transiently absent from one face at 1\u2009h and four at 2\u2009h post\u2010wash, all baseline\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n \u2010positive children retained it at 8\u2009h.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n No evidence of differential or overall effectiveness of the three washing methods at removing facial\n \n Chlamydia trachomatis<\/jats:italic>\n <\/jats:styled-content>\n from children with trachoma was found. This finding is limited by a smaller\u2010than\u2010anticipated sample size, potentially hindering detection of subtle differences or overall effects.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n ISRCTN registry: ISRCTN12814010 (April 2023)<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/tmi.70078","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:02:21Z","timestamp":1767960141000},"page":"363-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Randomised Trial of Three Face\u2010Washing Methods for the Removal of\n Chlamydia trachomatis<\/i>\n From the Faces of Children With Severe Active Trachoma"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-0377","authenticated-orcid":false,"given":"Katie","family":"Greenland","sequence":"first","affiliation":[{"name":"Department for Disease Control London School of Hygiene & Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Butcher","sequence":"additional","affiliation":[{"name":"Department for Clinical Research London School of Hygiene & Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edao Sinba","family":"Etu","sequence":"additional","affiliation":[{"name":"Berhan Public Health & Eye Care Consultancy Addis Ababa Ethiopia"},{"name":"College of Health Science Madda Walabu University Bale\u2010Robe Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wake","family":"Abebe","sequence":"additional","affiliation":[{"name":"Adama Public Health Referral and Reference Laboratory Adama Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mesfin","family":"Bekele","sequence":"additional","affiliation":[{"name":"Adama Public Health Referral and Reference Laboratory Adama Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gebeyehu","family":"Dumessa","sequence":"additional","affiliation":[{"name":"Berhan Public Health & Eye Care Consultancy Addis Ababa Ethiopia"},{"name":"Adama Public Health Referral and Reference Laboratory Adama Ethiopia"},{"name":"The Fred Hollows Foundation Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohannes Sitotaw","family":"Addisie","sequence":"additional","affiliation":[{"name":"Ethiopian Bio and Emerging Technology Institute Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amen Tessema","family":"Ariya","sequence":"additional","affiliation":[{"name":"Berhan Public Health & Eye Care Consultancy Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony W.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Global Neglected Tropical Diseases Programme World Health Organization Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Czerniewska","sequence":"additional","affiliation":[{"name":"Department for Disease Control London School of Hygiene & Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Macleod","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology and International Health London School of Hygiene & Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Last","sequence":"additional","affiliation":[{"name":"Department for Clinical Research London School of Hygiene & Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oumer Shafi","family":"Abdurahman","sequence":"additional","affiliation":[{"name":"Department for Clinical Research London School of Hygiene & Tropical Medicine London UK"},{"name":"The Fred Hollows Foundation Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Burton","sequence":"additional","affiliation":[{"name":"Department for Clinical Research London School of Hygiene & Tropical Medicine London UK"},{"name":"National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida","family":"Abashawl","sequence":"additional","affiliation":[{"name":"Berhan Public Health & Eye Care Consultancy Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wondu","family":"Alemayehu","sequence":"additional","affiliation":[{"name":"Berhan Public Health & Eye Care Consultancy Addis Ababa Ethiopia"},{"name":"The Fred Hollows Foundation Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00359-5"},{"key":"e_1_2_13_3_1","volume-title":"Trachoma Control: A Guide for Program Managers","author":"Solomon A.","year":"2006"},{"key":"e_1_2_13_4_1","unstructured":"World Health Organization \u201cValidation of Elimination of Trachoma as a Public Health Problem (WHO\/HTM\/NTD\/2016.8) \u201d2016 World Health Organization."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000462"},{"issue":"4","key":"e_1_2_13_6_1","first-page":"507","article-title":"An Animal Model of Trachoma II. The Importance of Repeated Reinfection","volume":"23","author":"Taylor H. R.","year":"1982","journal-title":"Investigative Ophthalmology & Visual Science"},{"issue":"11","key":"e_1_2_13_7_1","first-page":"3194","article-title":"Nonocular Chlamydia Infection and Risk of Ocular Reinfection After Mass Treatment in a Trachoma Hyperendemic Area","volume":"34","author":"West S.","year":"1993","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-1599"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008120"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012759"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-3156.2000.00603.x"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.212514"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003659.pub4"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009962"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(94)90141-4"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007784"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.19-0726"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012399"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijheh.2020.113521"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-020-04410-w"},{"issue":"3","key":"e_1_2_13_21_1","first-page":"559","article-title":"The Ecology of Trachoma: An Epidemiological Study in Southern Mexico","volume":"63","author":"Taylor H. R.","year":"1985","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1989.01070020903037"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)90167-1"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(21)00409-5"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2004.03.011"},{"key":"e_1_2_13_26_1","doi-asserted-by":"crossref","unstructured":"R.Bailey B.Dowries R.Dowries andD.Mabey \u201cTrachoma and Water Use; a Case Control Study in a Gambian Village \u201d85(1991):824\u2013828.","DOI":"10.1016\/0035-9203(91)90470-J"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268899003076"},{"key":"e_1_2_13_28_1","unstructured":"World Health Organization Strategic and Technical Advisory Group on Neglected Tropical Diseases \u201cTechnical Consultation on Trachoma Surveillance \u201d2015 Task Force for Global Health (WHO\/HTM\/NTD\/2015.02)."},{"key":"e_1_2_13_29_1","volume-title":"Tropical Data: Training System for Trachoma Prevalence Surveys (Version 3)","author":"Courtright P.","year":"2019"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.19.248708"},{"key":"e_1_2_13_31_1","volume-title":"Guide to Trachoma Control in Programmes for the Prevention of Blindness","author":"Dawson C. R.","year":"1981"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-084478"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2017.00406"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18-0860"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2017.04.010"},{"key":"e_1_2_13_36_1","unstructured":"A.\u2010D.Negrel H. R.Taylor andS. K.West \u201cGuidelines for the Rapid Assessment of Trachoma \u201d2001."},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes13010162"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008449"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005080"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010532"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004863"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed9120298"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.24-0319"}],"container-title":["Tropical Medicine & International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70078","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.70078","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:09:29Z","timestamp":1772996969000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.70078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,9]]},"references-count":42,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/tmi.70078"],"URL":"https:\/\/doi.org\/10.1111\/tmi.70078","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,9]]},"assertion":[{"value":"2025-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}