{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:23:31Z","timestamp":1767176611563,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012090","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000}}],"reference-count":5,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T00:00:00Z","timestamp":1712707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1190754"],"award-info":[{"award-number":["OPP1190754"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","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>The Alliance for the Global Elimination of Trachoma (GET) endorses the full SAFE strategy to eliminate trachoma; Surgery (for trichiasis), Antibiotics (to reduce the community pool of infection, Facial cleanliness, and Environmental improvement (to decrease transmission). There is no accepted measure of facial cleanliness. This study compared two possible metrics for facial cleanliness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method\/Findings<\/jats:title>\n                    <jats:p>Metric one: Clean face was defined as observed absence of ocular and nasal discharge on the face. Metric two: observing a grade of dirtiness (scale 10 = lightest to 0 = darkest) on a standard facial wipe. The reliability of grading a child\u2019s face or grading a facial wipe was determined in children in Kongwa Tanzania. We also observed both measurements in a cohort of 202 children ages 1 to &lt;7years prior to face cleaning, immediately afterwards, and 4 hours afterwards. Fifty of the children did not have face cleaning and were controls. Intra-and interobserver reliability was similar for both measures, the latter = 0.53 for observing a clean face and 0.52 for grading a facial wipe. There was no correlation between the two. Both measures detected facial cleaning, compared to control children who were not cleaned, immediately after cleaning; control children with 53% clean faces and wipe score of 6.7 compared to cleaned children with 88% clean faces and wipe score of 8 (p = .0001, p = &lt; .0001, respectively). Both measures also detected face washing 4 hours previously compared to controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The two metrics were equally reliable, and both measured the behavior of face washing. They measure different aspects of a clean face; one measures the amount of dirt on wiped area and the other measures ocular and nasal discharge. Both measurements appear to capture the behavior of facial cleaning, and the choice of metric would appear to rest on the measurement that captures the stated objective of the behavior, consideration of costs, training, logistics, and implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0012090","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T13:46:35Z","timestamp":1712756795000},"page":"e0012090","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of two approaches to measuring clean faces as part of the facial cleanliness component of the SAFE trachoma elimination strategy"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0818-8100","authenticated-orcid":true,"given":"Sheila K.","family":"West","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Munoz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harran","family":"Mkocha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C.","family":"Lynch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Gracewello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mabula","family":"Kasubi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meraf A.","family":"Wolle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,10]]},"reference":[{"key":"pntd.0012090.ref001","unstructured":"WHO Alliance for the Global Elimination of Trachoma: progress report on elimination of trachoma, 2022. Weekly epidemiological record [Internet]. Available from: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/371094\/WER9828-eng-fre.pdf. Accessed 8\/18\/2023."},{"key":"pntd.0012090.ref002","doi-asserted-by":"crossref","first-page":"e0006019","DOI":"10.1371\/journal.pntd.0006019","article-title":"The \u201cF\u201d in SAFE: reliability of assessing clean faces for trachoma control in the field.","volume":"11","author":"SK West","year":"2017","journal-title":"PLoSNegl Trop Dis"},{"key":"pntd.0012090.ref003","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/S0140-6736(95)90167-1","article-title":"Impact of face washing on trachoma in Kongwa","volume":"345","author":"S West","year":"1995","journal-title":"Tanzania. Lancet"},{"key":"pntd.0012090.ref004","doi-asserted-by":"crossref","first-page":"113521","DOI":"10.1016\/j.ijheh.2020.113521","article-title":"Development and reliability of a quantitative personal hygiene assessment tool","volume":"227","author":"MG Delea","year":"2020","journal-title":"Int J Hyg Environ Health"},{"key":"pntd.0012090.ref005","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.trstmh.2008.02.001","article-title":"Issues in defining and measuring facial cleanliness for national trachoma control programs","volume":"102","author":"R Zack","year":"2008","journal-title":"Trans R Soc Trop Med Hyg"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0012090","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0012090","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T13:35:33Z","timestamp":1713792933000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0012090"}},"subtitle":[],"editor":[{"given":"Scott D.","family":"Nash","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,10]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0012090","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,10]]}}}