{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:54:00Z","timestamp":1793224440848,"version":"4.5.0"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T00:00:00Z","timestamp":1676246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007890","name":"University of North Carolina at Chapel Hill","doi-asserted-by":"publisher","award":["Graduate School Summer Research Fellowship and an American Rescue Plan Act Graduate Degree Completion Grant"],"award-info":[{"award-number":["Graduate School Summer Research Fellowship and an American Rescue Plan Act Graduate Degree Completion Grant"]}],"id":[{"id":"10.13039\/100007890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Trachoma is the leading infectious cause of blindness. To reduce transmission, water, sanitation, and hygiene (WaSH) improvements are promoted through a comprehensive public health strategy. Evidence supporting the role of WaSH in trachoma elimination is mixed and it remains unknown what WaSH coverages are needed to effectively reduce transmission.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods\/Findings<\/jats:title>\n<jats:p>We used g-computation to estimate the impact on the prevalence of trachomatous inflammation\u2014follicular among children aged 1\u20139 years (TF<jats:sub>1-9<\/jats:sub>) when hypothetical WaSH interventions raised the minimum coverages from 5% to 100% for \u201cnearby\u201d face-washing water (&lt;30 minutes roundtrip collection time) and adult latrine use in an evaluation unit (EU). For each scenario, we estimated the generalized prevalence difference as the TF<jats:sub>1-9<\/jats:sub> prevalence under the intervention scenarios minus the observed prevalence. Data from 574 cross-sectional surveys conducted in 16 African and Eastern Mediterranean countries were included. Surveys were conducted from 2015\u20132019 with support from the Global Trachoma Mapping Project and Tropical Data.<\/jats:p>\n<jats:p>When modeling interventions among EUs that had not yet met the TF<jats:sub>1-9<\/jats:sub> elimination target, increasing nearby face-washing water and latrine use coverages above 30% was generally associated with consistent decreases in TF<jats:sub>1-9<\/jats:sub>. For nearby face-washing water, we estimated a \u226525% decrease in TF<jats:sub>1-9<\/jats:sub> at 65% coverage, with a plateau upon reaching 85% coverage. For latrine use, the estimated decrease in TF<jats:sub>1-9<\/jats:sub> accelerated from 80% coverage upward, with a \u226525% decrease in TF<jats:sub>1-9<\/jats:sub> by 85% coverage. Among EUs that had previously met the elimination target, results were inconclusive.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our results support Sustainable Development Goal 6 and provide insight into potential WaSH-related coverage targets for trachoma elimination. Targets can be tested in future trials to improve evidence-based WaSH guidance for trachoma.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011103","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T19:33:49Z","timestamp":1676316829000},"page":"e0011103","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Exploring water, sanitation, and hygiene coverage targets for reaching and sustaining trachoma elimination: G-computation analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6810-4998","authenticated-orcid":true,"given":"Kristin M.","family":"Sullivan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma M.","family":"Harding-Esch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander 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