Trial of the Trachoma Rapid Assessment methodology in The Gambia

To test the validity and repeatability of a newly designed Trachoma Rapid Assessment (TRA) methodology.

Results from an initial TRA in 20 villages (TRA1) are compared with those of a second validation TRA (TRA2) after 6 weeks in 13 villages, randomly selected out of the original 20, conducted by different field staff. Findings of TRA1 and TRA2 are compared with those of a door-to-door survey of the entire population of all 13 villages.

There is a considerable amount of variation between the results of TRA1 and TRA2 and between the results of both TRA's and the door-to-door survey. Even indicators that should have remained the same, like distance to Primary Health Centre or distance to trichiasis surgery facility, scored differently.

The TRA methodology is easy to use and the results are quickly available. The scoring system indicates which intervention(s) of the SAFE strategy are needed and facilitates priority setting. The definition of some indicators, like availability and use of latrines, may need modification. In some cases, the scoring system seems to exaggerate differences between the actual findings. The consistency between two TRA's in the same village is low and the accuracy in measuring the actual situation is doubtful.