Training Data Recorders with a Manual to Take High-Quality Trachoma Photographs in South Sudan

When a country has reached a low trachoma prevalence, it can be difficult to reliably train survey graders to accurately grade trachoma signs. Conjunctival photography provides an opportunity to capture images for grading. Recently, a training manual targeting survey data recorders was published. In July 2023, this manual was used during a photography training, after which certified trainees served as data recorders and photographers during the Enhancing the 'A' in SAFE (ETAS) study in South Sudan. Five of 10 trainees passed the training and became certified. These individuals took 7,064 smartphone photographs (two photographs per eye) of 1,766 children during the ETAS study. Certified photograph graders at the Gondar Grading Center in Ethiopia determined that nearly all eyes (>99%) had at least one gradable photograph. The new manual successfully facilitated the training of data recorders to take gradable conjunctival photos and will be an important tool for trachoma programs.