Towards elimination of blinding trachoma in Burkina Faso, West Africa. The results of three consecutive years of mass antibiotic treatment and health education.
Introduction. Trachoma is the main infectious cause of blindness in the world, and is caused by repeated Chlamydia trachomatis infections of the inner eyelid from early childhood. Materials and methods. Following three rounds of mass drug administration (MDA) with azithromycin and implementation of the World Health Organization (WHO) s SAFE strategy, 11 districts in Burkina Faso were evaluated between 2010 and 2012. Probability sampling proportional to size was used to identify villages and households to be included in the survey. Children aged 1 to 9 years were examined for signs of active trachoma and individuals older than 15 years were examined for signs of the long-term complication trichiasis. Results. In total, 11 districts were surveyed, including 12,501 children and 11,365 individuals older than 15 years of age. The prevalence of trachoma in children was reduced from 21% to below 10% in all districts, with some local pockets of infection exceeding 10%. The prevalence of trichiasis in individuals older than 15 years varied from 0.0 to 0,6%. Access to an improved water source and availability to latrines was limited in all surveyed districts. Conclusions. Three consecutive years of MDAs of antibiotics has successfully reduced the overall prevalence of trachoma in these 11 districts in Burkina Faso. The prevalence of active trachoma is currently below the WHO recommended threshold for MDA of 10% in all districts; however, further interventions at a sub-district level are needed. Improved surgical treatment, access to clean water and improvements in sanitation must be prioritised in these resource-limited areas in order to ensure sustainable results in the control of trachoma.