{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:47:42Z","timestamp":1788173262993,"version":"build-2803163510"},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3_Suppl","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is the WHO\u2019s endorsed approach for eliminating trachoma as a public health problem; however, not all components have been treated equally. Historically, the F and E components have not been prioritized owing to their perceived complexity. With school enrollment increasing in Ethiopia, development of a national school health program that is focused on the F and E components represents an opportunity to strengthen the SAFE strategy in the country. In 2016, the Trachoma Control Program in Amhara, Ethiopia, along with its partners, developed a School Trachoma Program (STP) that offers grade-specific lessons to improve sanitation and hygiene knowledge and practices among primary school\u2013aged children. To assess its impact, schools were sampled before implementation and then up to 1\u2009year after STP rollout. The aim of this report is to detail STP outcomes and the associations between outcomes and school-level variables. By 2018, adoption of an STP was strong within Amhara, with 85% of the 137 surveyed schools completing their quarterly reports and nearly 80% having at least one teacher trained in the STP. By the end of the third quarter, nearly all schools (86%) had access to a latrine, and 89% of students had a clean face. A schoolwide orientation was associated with increased STP lessons and activities (<jats:italic>P<\/jats:italic> = 0.01). Development of an STP, with buy-in from principals and teachers, represents a promising approach for the adoption of a new F- and E-specific curriculum and may help advance efforts to eliminate trachoma.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0665","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T18:08:54Z","timestamp":1716919734000},"page":"114-120","source":"Crossref","is-referenced-by-count":5,"title":["Impact of a School Trachoma Program Emphasizing Facial Cleanliness and Environmental Improvement in Amhara, Ethiopia"],"prefix":"10.4269","volume":"111","author":[{"given":"Caleb D.","family":"Ebert","sequence":"first","affiliation":[{"name":"Francis I. Proctor Foundation, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayenachew","family":"Kerie","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melke","family":"Kifle","sequence":"additional","affiliation":[{"name":"Amhara Regional Bureau of Education, Bahir Dar, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Nash","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zerihun","family":"Tadesse","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abebe","family":"Fissha","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berhanu","family":"Melak","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassa","family":"Bulcha","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melak","family":"Haileleule","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awoke","family":"Dagnew","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewnetu","family":"Bazie","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitiku","family":"Adugna","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Kelly","family":"Callahan","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulaw","family":"Abebe","sequence":"additional","affiliation":[{"name":"Amhara Regional Bureau of Education, Bahir Dar, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Jensen","sequence":"additional","affiliation":[{"name":"The Carter Center, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshetu","family":"Sata","sequence":"additional","affiliation":[{"name":"The Carter Center, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Wkly Epidemiol Rec","first-page":"297","article-title":"WHO Alliance for the Global Elimination of Trachoma: Progress report on elimination of trachoma, 2022","volume":"98","year":"2023"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e0006178","article-title":"Interventions to maximize facial cleanliness and achieve environmental improvement for trachoma elimination: A review of the grey literature","volume":"12","author":"Delea","year":"2018"},{"key":"b3","series-title":"Bull World Health Organ","first-page":"723","article-title":"Behavioural change interventions for sustained trachoma elimination","volume":"96","author":"Dodson","year":"2018"},{"key":"b4","series-title":"Trop Med Int Health","first-page":"515","article-title":"Review of the evidence base for the \u2018F\u2019 and \u2018E\u2019 components of the SAFE strategy for trachoma 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