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Published on: August 11, 2012
Trachoma
Esmael Habtamu1, Emma M Harding-Esch2, Katie Greenland3
1Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK; Eyu-Ethiopia, Bahir Dar, Ethiopia; Department of Ophthalmology, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
Insights
Trachoma, a leading cause of infectious blindness, requires continued efforts for global elimination by 2030. Novel strategies are needed to address persistent active trachoma and achieve the World Health Organization
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Trachoma is the leading infectious cause of blindness globally and a major focus for the World Health Organization's 2030 elimination goal.
- It is caused by repeated Chlamydia trachomatis infections in childhood, leading to conjunctival scarring and potentially irreversible vision loss.
- Affected populations are often in impoverished, rural areas with limited access to water and sanitation, disproportionately impacting women and children.
Purpose of the Study:
- To review the global progress and challenges in eliminating trachoma as a public health problem.
- To highlight the effectiveness of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement).
- To identify the need for new or intensified approaches to combat persistent and recurring trachoma.
Main Methods:
- The study is a review of the current status of trachoma elimination programs worldwide.
- It analyzes the impact and success of the SAFE strategy over the past two decades.
- It identifies areas with persistent or recrudescent active trachoma.
Main Results:
- The SAFE strategy has led to considerable success, with 21 countries eliminating trachoma by December 2024.
- Several other countries are on track to meet elimination targets soon.
- However, challenges remain due to persistent and recrudescent active trachoma in certain populations.
Conclusions:
- While significant progress has been made, the 2030 global trachoma elimination target faces challenges.
- Continued success requires the development and implementation of novel or intensified interventions.
- Accelerating elimination efforts is crucial in settings with persistent disease.
Abstract:
Trachoma, the leading infectious cause of blindness worldwide, is one of several neglected tropical diseases targeted by WHO for elimination by 2030. The disease starts in childhood with repeated episodes of conjunctival Chlamydia trachomatis infection. This infection is associated with recurrent conjunctivitis (active trachoma), which, if left untreated, leads to cicatricial trachoma characterised by scarring of the conjunctiva, and potentially in-turned eyelashes (trachomatous trichiasis) in later life. Trachoma mainly affects the poorest and most rural communities; these populations typically have limited access to water and hygiene facilities. Blinding complications are most common in women who, in many cultures, act as caregivers from a young age for infected children. To eliminate trachoma as a public health problem, programmes implement a package of interventions known as SAFE; namely, surgery to treat trachomatous trichiasis, antibiotic mass drug administration to treat infection, facial cleanliness, and environmental improvement to limit transmission. The SAFE strategy has brought considerable success in the last two decades. As of December, 2024, 21 countries have eliminated the disease, and several others are on track to eliminate it soon. However, persistent and recrudescent active trachoma in some populations might challenge the success of the 2030 global elimination target. In such settings, novel, or more intensive, approaches must be promptly developed, tested, and scaled up to accelerate elimination.
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