Re-envisioning the "F" in SAFE: Facial cleanliness and hygiene metrics, personal hygiene practices, and trachoma risk: Operational research for enhanced evaluation

Reliability assessment: What is the intra- and inter-rater reliability of current qualitative F and novel quantitative hygiene metrics across study contexts?
Validity assessment: What is the validity of each metric of interest (i.e., quantitative hygiene and qualitative F metrics) with regard to recent personal hygiene practices and trachoma outcomes?
Utility assessment: What is the utility of each metric (i.e., qualitative and quantitative)?
Risk factor assessment: Do proxy facial and hand hygiene outcomes, as measured by the novel quantitative hygiene metric, represent risk factors of incident C. trachomatis infection?"


This study draws on prior work conducted by West and colleagues in Tanzania (qualitative metrics) and Delea and colleagues in Ethiopia (quantitative metric), but the work proposed in this EoI has not been executed in the manner proposed.

Phase I total: 1360 children, approximately, across all 4 study sites (i.e., 340 per study site for RQ1 and RQ2). Phase II total: Sample size determination to be finalized after Phase I data and OR4 baseline survey data are available.

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