Impact of the Global Trachoma Mapping Project

Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys

PURPOSE

Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys.

METHODS

Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported.

RESULTS

Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma.

CONCLUSION

This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets.

Active trachoma prevalence and its associated factors among children aged 1-9 years in rural residents of Lare District, Southwest Ethiopia

AIM

To determine the prevalence of active trachoma and its associated factors among children in Lare District, Southwest Ethiopia, 2019.

METHODS

A community-based cross-sectional study was conducted. A total of 620 participants were recruited using a multi-stage sampling technique. A structured questionnaire, torch, and magnifying loupes were used for data collection. The data was entered into epidemiological information and exported to statistical package for social science version 20 for analysis. The bi-variable and multivariable Logistic regression analysis model was fitted to identify factors associated with active trachoma. Odds ratio with a 95%CI was used to show the direction and strength of association between independent and outcome variables.

RESULTS

A total of 610 children participated in this study with a response rate of 98.39%. The prevalence of active trachoma was 132 (21.60%; 95%CI: 18.40-24.70). Family size being 6-9 (AOR=2.34; 95%CI: 1.14-5.02), presence of more than two preschool children in a house (AOR=2.04; 95%CI: 1.12-3.70), open field waste disposal system (AOR=2.62; 95%CI: 1.00-6.80) and type of latrine being uncovered (AOR=4.12; 95%CI: 2.00-8.51) were positively associated with active trachoma. On the other side, water consumption being 40-60 liters per day was a protective factor for active trachoma.

CONCLUSION

The prevalence of active trachoma is high among children aged 1-9y in Lare District. Uncovered latrine, open field waste disposal system, family sizes of 6-9, and the presence of more than two preschool children in a house are associated with the occurrence of active trachoma. On the other side, water consumption of 40-60 liters is a protective factor.

Can we eradicate trachoma? A survey of stakeholders

BACKGROUND/AIMS

Although tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.

METHODS

We conducted a survey at the beginning of a trachoma eradication session at the 2019 Coalition for Operational Research on Neglected Tropical Diseases meeting in National Harbor, Maryland, USA. We asked respondents what the most important goal of azithromycin mass drug administration was for trachoma (control, elimination of infection or eradication) and if and when they believed trachoma eradication would occur. We then asked what the biggest obstacles were to global eradication.

RESULTS

Fifty-six surveys were returned (95%). Most (91%) participants reported that the most important goal of azithromycin mass drug administration was control or elimination of infection, and 24% of participants reported that global eradication was not possible. Of the 76% who reported a year by which they believed trachoma could be eradicated, most fell between 2040 and 2050. Commonly cited barriers to global eradication included lack of surveillance tools to confirm eradication or monitor for infection recrudescence (32%) and lack of resources (23%).

CONCLUSIONS

Development of alternative indicators for trachoma surveillance and continued investment in trachoma programmes, particularly focused support in the most heavily affected populations, might increase enthusiasm for the feasibility of eradication.

Milestones in the fight to eliminate trachoma

PURPOSE

Trachoma, a chronic conjunctivitis that can result in vision loss from trichiasis, is targeted for global elimination by 2020. Several milestones in the long process towards elimination are noteworthy for the impact they have had on changing or accelerating progress. The purpose of this review is to describe the milestones and the impact they have had both for trachoma elimination and beyond.

FINDINGS

Eight milestones are presented. They are discovery of the causative agent; development of a clinical grading scheme; establishment of the World Health Organization Alliance for the Global Elimination of Trachoma by 2020; setting targets that define elimination; building an evidence base for trichiasis surgery; azithromycin donation programme; use of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvement); and The Global Trachoma Mapping Project.

SUMMARY

These milestones have significantly pushed the progress towards elimination. Despite challenges to achieving the goal of elimination by 2020, there is continued commitment into the future to ensure that this preventable cause of blindness is no longer a threat.