Trachoma is the leading infectious cause of blindness worldwide. It is caused by an obligate intracellular bacterium called Chlamydia trachomatis. The infection is transmitted through contact with eye and nose discharge of infected people, particularly young children who harbour the principal reservoir of infection. It is also spread by flies which have been in contact with the eyes and noses of infected people.
Prevention and Control
Elimination programmes in endemic countries are being implemented using the WHO-recommended SAFE strategy. This consists of:
- Surgery to treat the blinding stage of the disease (trachomatous trichiasis);
- Antibiotics to clear infection, particularly mass drug administration of the antibiotic azithromycin, which is donated by the manufacturer to elimination programmes, through the International Trachoma Initiative;
- Facial cleanliness; and
- Environmental improvement, particularly improving access to water and sanitation.
Most endemic countries have agreed to accelerate the implementation of this strategy to achieve their respective elimination targets, all by the year 2020.
Data reported to WHO by Member States for 2016 show that more than 260 000 people with trachomatous trichiasis were provided with corrective surgery in 2016, and 85 million people in endemic communities were treated with antibiotics to eliminate trachoma.
Elimination efforts need to continue to satisfy the target set by World Health Assembly resolution WHA 51.11, which is elimination of trachoma as a public health problem (1). Particularly important will be the full engagement of sectors involved in water, sanitation and socioeconomic development.