Trachoma, affecting almost 40 million people in 51 endemic countries worldwide, is an eye infection with the bacterium Chlamydia trachomatis. It is the leading infectious cause of visual impairment, affecting 2.2 million people of whom 1.2 million develop irreversible blindness. The disease affects mainly marginalized communities and pre-school aged children who live in areas without access to clean water and sanitation. Infection spreads through personal contact (hands, clothing) and by flies that have been in contact with the eyes or nose of an infected person. If left untreated, repeated trachoma infections result in severe scarring of the inside of the eyelid causing the eyelid to turn inwards which causes eyelashes to scratch the cornea (trichiasis). In addition to causing pain and discomfort, the permanent damage to the cornea caused by trichiasis leads to visual impairments and irreversible blindness. The disabling effects of vision loss can further destroy the economic well-being of families, can lead to participation restriction and social exclusion. Therefore, early treatment with antibiotics, stimulating facial cleanliness, access to clean water and sanitation, and surgery to correct the eyelid, are vital to prevent trichiasis and blindness.

Towards elimination - SAFE strategy & Global Trachoma Mapping Project

The WHO has targeted trachoma for elimination by 2020 through the implementation of a multi-faceted health strategy called S.A.F.E. that includes WASH elements. The SAFE strategy consists of:

  • Surgery to correct trichiasis,
  • Antibiotics to treat active infection,
  • Facial cleanliness and,
  • Environmental improvements in the areas of water and sanitation

In 2015 the WHO reported that more than 185 000 people received surgical treatment for advanced disease, and 56 million people were treated with antibiotics for trachoma. As of 1 March 2016, 7 countries had reported achieving elimination goals, which signifies a major milestone in the campaign to eliminate trachoma. These countries are: China, Gambia, Ghana, the Islamic Republic of Iran, Morocco, Myanmar and Oman. As defined by the WHO, elimination of trachoma is achieved when a country reports a prevalence of less than one case of trachomatous trichiasis per 1,000 population (0.1%) and a prevalence of trachomatous inflammation - follicular of less than 5% among children aged 1-9 years old. 

The Global Trachoma Mapping Project, successfully completed in January 2016, has shown that 100 million people are at risk of blindness from trachoma. Led by Sightsavers and funded by UK government and USAID, this largest infectious disease survey ever undertaken, saw surveyors collect and transmit data from 2.6 million people in 29 countries using Android smartphones. The use of smartphones and tablets was a crucial element in the ability to deliver the project on such a massive scale. The technology enabled organizers to coordinate teams from around the world and ensure that data could be easily collected in even the most remote parts of the world and then subsequently transmitted for analysis.

 

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