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The simplified trachoma grading system, amended.

Anthony W Solomon1, Amir B Kello2, Mathieu Bangert1

  • 1Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.

Bulletin of the World Health Organization
|November 12, 2020
PubMed
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This summary is machine-generated.

The World Health Organization (WHO) updated its simplified trachoma grading system in 2018. This revised system, crucial for public health interventions, now excludes lower eyelid-only trichiasis.

Area of Science:

  • Ophthalmology
  • Public Health
  • Infectious Diseases

Background:

  • The World Health Organization (WHO) established a simplified trachoma grading system in 1987.
  • This system utilized five key signs to identify populations requiring interventions for trachoma elimination.
  • The signs included trachomatous trichiasis, corneal opacity, trachomatous inflammation-follicular, trachomatous inflammation-intense, and trachomatous scarring.

Purpose of the Study:

  • To present the amended World Health Organization (WHO) simplified grading system for trachoma.
  • To update the presentation of the grading system and provide guidance on its application.
  • To highlight ongoing discussions and areas of debate related to the trachoma grading system.

Main Methods:

  • Review and presentation of the WHO's 1987 simplified trachoma grading system.

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  • Inclusion of the 2018 amendment to the definition of trachomatous trichiasis.
  • Discussion of the system's utility, limitations, and areas for future consideration.

    • Main Results:

    • The definition of trachomatous trichiasis was amended in 2018 to exclude cases affecting only the lower eyelid.
    • The paper provides an updated presentation of the five-sign grading system.
    • The study acknowledges that the signs are neither perfectly sensitive nor specific for trachoma.

    Conclusions:

    • The amended WHO grading system remains an essential tool for guiding public health interventions against trachoma.
    • The updated definition of trachomatous trichiasis refines case identification.
    • Further discussion is needed regarding specific aspects of the grading system's application and interpretation.