Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Trachoma is a public health problem in 38 countries and is responsible for the blindness or visual impairment of about 1.9 million people. […] Based on April 2024 data, 103 million people live in trachoma endemic areas and are at risk of trachoma blindness. […] In 2023, 130 746 people received surgical treatment for advanced stage of the disease, and 32.9 million people were treated with antibiotics. Global antibiotic coverage in 2023 was 29%. […] Trachoma is the leading infectious cause of blindness worldwide. […] The infection is transmitted by direct or indirect transfer of eye and nose discharges of infected people, particularly young children who harbour the principal reservoir of infection. […] Visual impairment or blindness results in a worsening of the life experience of affected individuals and their families, who are normally already amongst the poorest of the poor.

• #2 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The number of people at risk from trachoma, the world’s leading infectious cause of blindness, has been reduced from 115.7 million in April 2023 to 103.2 million in April 2024, the World Health Organization (WHO) has reported in its Weekly Epidemiological Record. […] The trachoma progress update presents data on the implementation of the WHO-endorsed SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in trachoma-endemic countries in 2023. […] The record shows that 18 countries have been validated as having eliminated trachoma as a public health problem as of 15 April 2024; 39 countries are known to require interventions for trachoma; and three countries may require interventions, but the necessary investigations in suspected trachoma-endemic areas have not yet been completed.

• #3 Trachoma – EyeWiki

  https://eyewiki.org/Trachoma

  The World Health Organization (WHO) reports trachoma is still endemic to more than 38 countries, with most blinding trachoma in major parts of Africa with cases still being reported in the Middle East. […] An estimated 21 million people are living with active trachoma and another 1.9 million people are visually impaired or blind. Furthermore, 7.3 million people suffer from trichiasis and are at risk for developing blindness. […] Epidemiologic studies have shown active trachoma is most common in young children with the prevalence of active trachoma decreasing with age. The long-term sequelae of trachoma infection, including scarring, trichiasis and corneal opacification in adults relates to their exposure to active trachoma when they were young. […] The gender distribution of active trachoma is similar; however, scarring and trichiasis are more common in women than men because women are more likely to care for young children and have longer exposure to the disease.

• #4 Trachoma | Doctor

  https://patient.info/doctor/trachoma.htm

  Trachoma is a public health problem in 42 countries, and is responsible for the blindness or visual impairment of about 1.9 million people. […] Trachoma is hyperendemic in many of the poorest and most rural areas of Africa, Central and South America, Asia, Australia and the Middle East. Overall, Africa remains the most affected continent. […] Based on June 2022 data, 125 million people live in trachoma endemic areas and are at risk of trachoma blindness. […] In areas where trachoma is endemic, active (inflammatory) trachoma is common among preschool-aged children, with prevalence rates which can be as high as 6090%.

• #5 Epidemiology and control of trachoma: systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3770928/

  Trachoma is the commonest infectious cause of blindness. Recurrent episodes of infection with serovars AC of Chlamydia trachomatis cause conjunctival inflammation in children who go on to develop scarring and blindness as adults. It was estimated that in 2002 at least 1.3 million people were blind from trachoma, and currently 40 million people are thought to have active disease and 8.2 million to have trichiasis. The disease is largely found in poor, rural communities in developing countries, particularly in sub-Saharan Africa. […] The number of people with active disease is estimated to be 40 million, and the number with trichiasis, 8.2 million. Trachoma is an ancient disease and has previously been a significant public health problem in many areas of the world including parts of Europe and North America. Today, however, trachoma is largely found in poor, rural communities in low-income countries, particularly in sub-Saharan Africa.

• #6 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  Trachoma is a neglected tropical disease caused by infection with conjunctival strains of Chlamydia trachomatis. It can result in blindness. Trachoma is found at highest prevalence in the poorest communities of low-income countries, particularly in sub-Saharan Africa; in June 2021, 1.8 million people worldwide were going blind from the disease. Global trachoma prevalence data are published annually by WHO and summarized on the WHO Global Health Observatory. As of March 2022, 44 countries were known to require interventions against trachoma, of which 26 were in the WHO African Region. In trachoma-endemic communities, individuals with trachomatous trichiasis (TT) are likely to be poorer than age-matched and gender-matched peers without TT and are less likely than those peers to participate in economically productive activities even after controlling for visual impairment. The disease affects the population groups that are poorest, most marginalized and most remote from services (particularly water and sanitation). At any spatial scale at which observations are made, trachoma is found in the poorest people.

• #7

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Overall, Africa remains the most affected continent and the one with the most intensive control efforts. […] As of 21 October 2024, 21 countries had been validated by WHO as having eliminated trachoma as a public health problem. […] Data reported to WHO by Member States for 2023 show that 130 746 people with trachomatous trichiasis were provided with corrective surgery in that year, and 32.9 million people in endemic communities were treated with antibiotics to eliminate trachoma. […] WHO’s mandate is to provide leadership and coordination to international efforts aiming to eliminate trachoma as a public health problem, and to report on progress towards that target. […] The Alliance is a partnership which supports implementation of the SAFE strategy by Member States, and the strengthening of national capacity through epidemiological surveys, monitoring, surveillance, project evaluation, and resource mobilization.

• #8 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The record reveals that 130,746 people were managed for trachomatous trichiasis (TT) in 2023. […] Additionally, the record shows that 33.9 million people were treated across 19 countries with antibiotics in 2023. […] The presentation of gender disaggregated data is important to the global trachoma program because women are 1.8 times more likely to require TT management than men. […] However, ongoing challenges, including limited financing, persistent and recrudescent trachoma, hard-to-reach populations and insecurity threaten the elimination of trachoma as a public health problem by 2030. […] As of April 2024, Ethiopia continued to account for the worlds largest burden of trachoma, with 61 million people living in trachoma-endemic areas, representing 59% of the global burden. […] To date, 18 countries (Benin, Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Iraq, Lao Peoples Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu) have been validated by WHO as having eliminated trachoma as a public health problem.

• #9

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Trachoma is a public health problem in 38 countries and is responsible for the blindness or visual impairment of about 1.9 million people. […] Based on April 2024 data, 103 million people live in trachoma endemic areas and are at risk of trachoma blindness. […] In 2023, 130 746 people received surgical treatment for advanced stage of the disease, and 32.9 million people were treated with antibiotics. Global antibiotic coverage in 2023 was 29%. […] Trachoma is the leading infectious cause of blindness worldwide. […] The infection is transmitted by direct or indirect transfer of eye and nose discharges of infected people, particularly young children who harbour the principal reservoir of infection. […] Visual impairment or blindness results in a worsening of the life experience of affected individuals and their families, who are normally already amongst the poorest of the poor.

• #10 Trachoma: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1202088-overview

  Trachoma is endemic in parts of Africa, Asia, the Middle East, Latin America, the Pacific Islands, and aboriginal communities in Australia. Worldwide, an estimated 229 million people in 53 countries live in trachoma-endemic areas. In hyperendemic areas, most members of nearly all families may have active disease. When the overall community prevalence decreases to around 20%, active disease is clearly seen to cluster in families. In 1 of 5 families, most children have active trachoma (as opposed to 1 in 5 children in most families). […] Blindness from any cause is associated with increased risk of mortality in endemic communities. Approximately 1.2 million people are blind because of trachoma. […] Trachoma persists in areas with poor personal and community hygiene, for example, in communities with inadequate access to water and sanitation in hot, dry, dusty climates.

• #11 Trachoma – EyeWiki

  https://eyewiki.org/Trachoma

  The World Health Organization (WHO) reports trachoma is still endemic to more than 38 countries, with most blinding trachoma in major parts of Africa with cases still being reported in the Middle East. […] An estimated 21 million people are living with active trachoma and another 1.9 million people are visually impaired or blind. Furthermore, 7.3 million people suffer from trichiasis and are at risk for developing blindness. […] Epidemiologic studies have shown active trachoma is most common in young children with the prevalence of active trachoma decreasing with age. The long-term sequelae of trachoma infection, including scarring, trichiasis and corneal opacification in adults relates to their exposure to active trachoma when they were young. […] The gender distribution of active trachoma is similar; however, scarring and trichiasis are more common in women than men because women are more likely to care for young children and have longer exposure to the disease.

• #12 Australian Trachoma Surveillance Report 2022 | Kirby Institute

  https://www.kirby.unsw.edu.au/research/reports/australian-trachoma-surveillance-report-2022

  Trachoma is an eye infection caused by serotypes of the Chlamydia trachomatis bacteria and is a major cause of preventable blindness globally. Australia is the only high-income country where trachoma is a public health problem, primarily in remote and very remote Aboriginal communities in the Northern Territory (NT), South Australia (SA) and Western Australia (WA). The Australian Government funds the National Trachoma Surveillance and Reporting Unit to collate and analyse trachoma prevalence data and control strategies annually. […] The number of communities at risk of trachoma in Australia has steadily declined in all jurisdictions since 2010. Communities at-risk of trachoma fell by 50% in NT (84 in 2010 to 42 in 2022), 85% in SA (72 in 2010 to 11 in 2022) and 64% in WA (86 in 2010 to 31 in 2022).

• #13 Trachoma – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/trachoma

  Trachoma is the leading cause of infectious blindness worldwide and is transmitted by direct contact with ocular and nasal secretions of persons infected with particular serovars of the bacterium Chlamydia trachomatis. […] In the Region, trachoma is endemic in rural and remote areas from Brazil, Colombia, Guatemala, and Peru, where there are about 5.6 million people at risk from the disease, which disproportionately affects women and children. […] Trachoma can be eliminated as a public health problem. […] Elimination of trachoma as a public health problem is defined by: a prevalence of cases of trachomatous trichiasis (TT) „unknown to the health system” of less than 0.2 % in adults aged 15 years or older (approximately 1 case per 1000 population); a prevalence of trachomatous follicular inflammation (TF) in children aged 1-9 years of less than 5%, maintained for at least two years without massive administration of antibiotics, in all districts where the disease was previously endemic; the existence of a health system capable of detecting and managing new cases of TT using defined strategies, with evidence that sufficient financial resources are available to implement these strategies.

• #14 Trachoma – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/trachoma

  Globally, in April 2023, an estimated 115.7 million people lived in areas where the prevalence of trachoma in children aged 1 to 9 years was 5%, down from 125 million as of June 1, 2022. […] In the Region of the Americas, there is evidence of trachoma in four countries and an estimated 5.6 million people live in areas where elimination interventions need to be implemented-Colombia, Brazil, Guatemala, and Peru. […] The main risk factors for the occurrence of the disease are related to lack of access to water, the presence of flies, poor hygienic conditions, and overcrowding. […] Major interventions should be directed at preventing trachoma infection including improved sanitation and increased facial hygiene activities (with clean water) for children at risk for the disease. […] Depending on the prevalence of follicular trachomatous inflammation (TF) in children aged 1 to 9 years at the district level, mass administration of antibiotics to all residents of these communities is recommended once a year.

• #15

  https://journals.lww.com/ijo/fulltext/2022/09000/current_status_of_trachoma_in_india__results_from.20.aspx

  In the mid-twentieth century, trachoma was endemic in the northwestern states of India. […] We aimed to generate recent estimates of prevalence of trachomatous inflammation, follicular (TF) and trachomatous trichiasis (TT) in ten suspected-endemic districts across seven previously hyper-endemic states and union territories for trachoma in India including Delhi, Rajasthan, Haryana, Punjab, Gujarat, Uttarakhand and the Andaman and Nicobar Islands. […] A total of 13,802 households were surveyed in which 19,662 children were examined for TF and 44,135 adults aged 15 years were examined for TT. […] TF was not a public health problem in any of the districts surveyed; thus, antibiotic mass drug administration is not needed. However, TT among adults was found to be above 0.2% in four districts; thus, further trichiasis surgery interventions at the public health level are warranted to achieve elimination.

• #16 Epidemiology and control of trachoma: systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3770928/

  The prevalence of active disease is highest in pre-school children and declines to low levels in adulthood. This parallels the distribution of C. trachomatis infection, with up to half of the community bacterial load being found in children under the age of 1 year in some studies. […] The first study from Tanzania had a standardised, prospective design but the others did not. There is considerable variation in the reported rates of progression, which may reflect both variation in progression rates in different populations and methodology. A key determinant of the rate of disease progression is probably the burden of C. trachomatis infection in a community over time, although the direct evidence for this is limited. […] Trachoma is a major cause of blindness in many less-developed countries, especially in poor, rural areas. Blinding trachoma is believed to be endemic in over 50 countries, with the highest prevalence of active disease and trichiasis in Africa, predominantly in the savannah areas of East and Central Africa and the Sahel of West Africa.

• #17 Epidemiology and control of trachoma: systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3770928/

  The prevalence of active disease is highest in pre-school children and declines to low levels in adulthood. This parallels the distribution of C. trachomatis infection, with up to half of the community bacterial load being found in children under the age of 1 year in some studies. […] The first study from Tanzania had a standardised, prospective design but the others did not. There is considerable variation in the reported rates of progression, which may reflect both variation in progression rates in different populations and methodology. A key determinant of the rate of disease progression is probably the burden of C. trachomatis infection in a community over time, although the direct evidence for this is limited. […] Trachoma is a major cause of blindness in many less-developed countries, especially in poor, rural areas. Blinding trachoma is believed to be endemic in over 50 countries, with the highest prevalence of active disease and trichiasis in Africa, predominantly in the savannah areas of East and Central Africa and the Sahel of West Africa.

• #18 Trachoma – EyeWiki

  https://eyewiki.org/Trachoma

  The World Health Organization (WHO) reports trachoma is still endemic to more than 38 countries, with most blinding trachoma in major parts of Africa with cases still being reported in the Middle East. […] An estimated 21 million people are living with active trachoma and another 1.9 million people are visually impaired or blind. Furthermore, 7.3 million people suffer from trichiasis and are at risk for developing blindness. […] Epidemiologic studies have shown active trachoma is most common in young children with the prevalence of active trachoma decreasing with age. The long-term sequelae of trachoma infection, including scarring, trichiasis and corneal opacification in adults relates to their exposure to active trachoma when they were young. […] The gender distribution of active trachoma is similar; however, scarring and trichiasis are more common in women than men because women are more likely to care for young children and have longer exposure to the disease.

• #19 Trachoma: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1202088-overview

  Active disease most commonly occurs in preschool children of both sexes and their care providers. Severe blinding trachoma may be nearly twice as common in women as in men; this pattern is believed to result from women assuming more childcare responsibilities, with the proximity to children resulting in increased microbial exposure. […] Active disease most commonly occurs in preschool children, with the highest prevalence in children aged 3-5 years. Cicatricial disease is most common in middle-aged adults. The age group in which cicatricial disease begins to appear depends on the intensity of transmission in the community. In areas of extremely high endemicity, rare cases of trichiasis occur in children younger than 10 years. […] Because of repeat infection, aging may be accompanied by sequential worsening of disease. Young children have follicular trachoma with intense conjunctival inflammation; young adults, especially mothers, have trachomatous scarring; and middle-aged patients or grandparents have trichiasis and corneal opacity. However, these signs are not mutually exclusive. Individuals may have episodes of follicular trachoma with intense conjunctival inflammation even after cicatricial complications develop; therefore, follicles, scarring, and trichiasis may all be present in the same patient.

• #20 WHO reports continued progress towards trachoma elimination – The International Agency for the Prevention of Blindness

  https://www.iapb.org/news/who-reports-continued-progress-towards-trachoma-elimination/

  Ensuring equitable access to trachoma interventions continues to be a focus for national trachoma programs, particularly because the relative risk of TT among women is 1.8 times that of men. […] To date, 17 countries have been validated by WHO as having eliminated trachoma as a public health problem.

• #21 Trachoma: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1202088-overview

  Trachoma is endemic in parts of Africa, Asia, the Middle East, Latin America, the Pacific Islands, and aboriginal communities in Australia. Worldwide, an estimated 229 million people in 53 countries live in trachoma-endemic areas. In hyperendemic areas, most members of nearly all families may have active disease. When the overall community prevalence decreases to around 20%, active disease is clearly seen to cluster in families. In 1 of 5 families, most children have active trachoma (as opposed to 1 in 5 children in most families). […] Blindness from any cause is associated with increased risk of mortality in endemic communities. Approximately 1.2 million people are blind because of trachoma. […] Trachoma persists in areas with poor personal and community hygiene, for example, in communities with inadequate access to water and sanitation in hot, dry, dusty climates.

• #22 Trachoma – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/trachoma

  Globally, in April 2023, an estimated 115.7 million people lived in areas where the prevalence of trachoma in children aged 1 to 9 years was 5%, down from 125 million as of June 1, 2022. […] In the Region of the Americas, there is evidence of trachoma in four countries and an estimated 5.6 million people live in areas where elimination interventions need to be implemented-Colombia, Brazil, Guatemala, and Peru. […] The main risk factors for the occurrence of the disease are related to lack of access to water, the presence of flies, poor hygienic conditions, and overcrowding. […] Major interventions should be directed at preventing trachoma infection including improved sanitation and increased facial hygiene activities (with clean water) for children at risk for the disease. […] Depending on the prevalence of follicular trachomatous inflammation (TF) in children aged 1 to 9 years at the district level, mass administration of antibiotics to all residents of these communities is recommended once a year.

• #23

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Trachoma is a public health problem in 38 countries and is responsible for the blindness or visual impairment of about 1.9 million people. […] Based on April 2024 data, 103 million people live in trachoma endemic areas and are at risk of trachoma blindness. […] In 2023, 130 746 people received surgical treatment for advanced stage of the disease, and 32.9 million people were treated with antibiotics. Global antibiotic coverage in 2023 was 29%. […] Trachoma is the leading infectious cause of blindness worldwide. […] The infection is transmitted by direct or indirect transfer of eye and nose discharges of infected people, particularly young children who harbour the principal reservoir of infection. […] Visual impairment or blindness results in a worsening of the life experience of affected individuals and their families, who are normally already amongst the poorest of the poor.

• #24

  https://www.who.int/health-topics/trachoma

  Trachoma is a disease of the eye and the leading infectious cause of blindness worldwide. Infection is transmitted from person to person by direct or indirect transfer of ocular and nasal discharges of infected people; indirect transfer includes carriage on the body of species of flies. Preschool-age children harbour the principal reservoir of infection. Models suggest that an individual requires more than 150 lifetime infections to develop the blinding complications of trachoma. […] Trachoma is endemic in some of the worlds poorest populations, who live in rural and remote areas and have highly inadequate access to water, sanitation and healthcare. Africa is the most affected continent, but it also has the most widespread control efforts. The disease is also found in Central and South America, Asia, Australia, and the Middle East. As of 19 March 2024, 18 countries had been validated as having eliminated trachoma as a public health problem.

• #25

  https://www.who.int/health-topics/trachoma

  Trachoma is a disease of the eye and the leading infectious cause of blindness worldwide. Infection is transmitted from person to person by direct or indirect transfer of ocular and nasal discharges of infected people; indirect transfer includes carriage on the body of species of flies. Preschool-age children harbour the principal reservoir of infection. Models suggest that an individual requires more than 150 lifetime infections to develop the blinding complications of trachoma. […] Trachoma is endemic in some of the worlds poorest populations, who live in rural and remote areas and have highly inadequate access to water, sanitation and healthcare. Africa is the most affected continent, but it also has the most widespread control efforts. The disease is also found in Central and South America, Asia, Australia, and the Middle East. As of 19 March 2024, 18 countries had been validated as having eliminated trachoma as a public health problem.

• #26 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  Evidence now substantiates these proposed routes. C. trachomatis DNA can be detected on flies caught leaving the faces of children in trachoma-endemic communities. Infected eye discharge or cultured C. trachomatis can induce active trachoma when directly inoculated into an eye, suggesting that simple mechanical transfer of infectious material from an infected to an uninfected eye may be all that is necessary to create a transmission event. […] Trachoma is a disease of poverty; it affects the poorest of the poor. In Europe and most of North America, trachoma disappeared decades ago as living standards improved and without the implementation of specific interventions. Similar trends have been seen in some low-income and middle-income countries with previously hyperendemic disease. However, prevalence has remained high in some populations despite prolonged intensive intervention with a comprehensive, four-component strategy recommended by WHO.

• #27

  https://www.who.int/health-topics/trachoma

  Trachoma is a disease of the eye and the leading infectious cause of blindness worldwide. Infection is transmitted from person to person by direct or indirect transfer of ocular and nasal discharges of infected people; indirect transfer includes carriage on the body of species of flies. Preschool-age children harbour the principal reservoir of infection. Models suggest that an individual requires more than 150 lifetime infections to develop the blinding complications of trachoma. […] Trachoma is endemic in some of the worlds poorest populations, who live in rural and remote areas and have highly inadequate access to water, sanitation and healthcare. Africa is the most affected continent, but it also has the most widespread control efforts. The disease is also found in Central and South America, Asia, Australia, and the Middle East. As of 19 March 2024, 18 countries had been validated as having eliminated trachoma as a public health problem.

• #28 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  Trachoma can trap affected individuals, families and communities in successive generations of despair. The association between increasing age and increasing prevalence of cicatricial sequelae of trachoma (conjunctival scarring, TT and corneal opacity) indicate that these signs are cumulative. The different time courses of conjunctival infection and active trachoma explain the partial mismatch observed between infection and disease at the individual level. This disparity has important implications for trachoma programmes, as individually targeted antibiotic treatment decisions based on observable conjunctival inflammation of at least moderate intensity would miss many infected individuals with a mild clinical response. […] Epidemiological observations have informed mathematical models of trachoma, which suggest that 100 conjunctival C. trachomatis infections in an individual’s lifetime are required to generate clinically significant conjunctival scarring and that 150 infections are required to precipitate TT. The limited longitudinal data available indicate that a primary infection episode in a child is characterized by a short preclinical phase of a few days before the development of signs of inflammation. In adult human volunteer experiments, clinical inflammation developed ~10 days after conjunctival C. trachomatis inoculation.

• #29 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  Trachoma can trap affected individuals, families and communities in successive generations of despair. The association between increasing age and increasing prevalence of cicatricial sequelae of trachoma (conjunctival scarring, TT and corneal opacity) indicate that these signs are cumulative. The different time courses of conjunctival infection and active trachoma explain the partial mismatch observed between infection and disease at the individual level. This disparity has important implications for trachoma programmes, as individually targeted antibiotic treatment decisions based on observable conjunctival inflammation of at least moderate intensity would miss many infected individuals with a mild clinical response. […] Epidemiological observations have informed mathematical models of trachoma, which suggest that 100 conjunctival C. trachomatis infections in an individual’s lifetime are required to generate clinically significant conjunctival scarring and that 150 infections are required to precipitate TT. The limited longitudinal data available indicate that a primary infection episode in a child is characterized by a short preclinical phase of a few days before the development of signs of inflammation. In adult human volunteer experiments, clinical inflammation developed ~10 days after conjunctival C. trachomatis inoculation.

• #30 Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-019-0585-x

  In 2009 Ghana began to design a trachoma pre-validation surveillance plan, based on then-current WHO recommendations. The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases, through both active and passive surveillance approaches. […] Ghana developed a comprehensive surveillance system that exceeded the WHO recommendations but issues with sensitivity and specificity likely led to an inefficient use of resources. Improved targeted surveillance strategies for identification of recrudescence and trichiasis case searches, need to be evaluated. […] Trachoma surveillance has been defined by WHO as the monitoring and evaluation activities that assess the outcome of a trachoma elimination programme, conducted after elimination prevalence targets appear to have been achieved, in a defined trachoma endemic area.

• #31 Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7872237/

  A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease. […] The experiences of both the Guinea worm and onchocerciasis surveillance strategies have very useful lessons for trachoma surveillance, pre- and post-validation. The use of a monetary reward for identification of TT cases and further exploration into the use of infection and serological indicators particularly in a post-validation setting to assist in identifying recrudescence would be of particular relevance.

• #32 The utility of serology for elimination surveillance of trachoma

  https://stacks.cdc.gov/view/cdc/81496

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. […] To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. […] We show SCRs below 0.015 (95% confidence interval (CI): 0.0-0.049) per year correspond to a prevalence of trachomatous inflammation-follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. […] As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.

• #33 Diagnostic target product profiles for trachoma surveillance | InfoNTD

  https://www.infontd.org/practical-material/diagnostic-target-product-profiles-trachoma-surveillance

  The need for interventions against active trachoma has traditionally been determined using the prevalence of clinical signs that are associated with conjunctival Chlamydia trachomatis infection. […] The target product profiles in this publication present the minimum and ideal characteristics for diagnostics needed by trachoma programmes to detect evidence of past and/or present C. trachomatis infection at evaluation unit level. […] Health systems factors Epidemiology Diagnosis

• #34 The utility of serology for elimination surveillance of trachoma

  https://stacks.cdc.gov/view/cdc/81496

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. […] To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. […] We show SCRs below 0.015 (95% confidence interval (CI): 0.0-0.049) per year correspond to a prevalence of trachomatous inflammation-follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. […] As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.

• #35 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Although trachoma causes more cases of preventable blindness than any other infectious disease, a combination of strategies is reducing its global prevalence. […] As a district moves toward eliminating trachoma as a public health problem, national programs conduct trachoma impact surveys (TIS) to assess whether to stop preventative interventions and trachoma surveillance surveys (TSS) to determine whether the prevalence of active trachoma has rebounded after interventions have halted. […] The World Health Organization requires trachoma prevalence estimates for validating the elimination of trachoma as a public health problem. […] To eliminate trachoma as a public health problem, a country must meet three requirements: (1) a trachomatous inflammationfollicular (TF) prevalence sustained below 5% for at least two years in 19-year-olds without antibiotic mass drug administration in each formerly-endemic evaluation unit (EU), (2) a TT prevalence of less than 0.2% in people 15 years of age or older in each formerly-endemic EU, and (3) a system in place for identifying and treating new cases of TT.

• #36 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Before validating elimination, WHO requires evidence that the prevalence of TF and TT very likely falls below the elimination thresholds. […] To generate this evidence, national programs often use surveys. […] After national programs implement these interventions, they can conduct trachoma impact surveys (TIS) to assess TF and TT prevalence to see if a district can stop implementing the SAFE strategy at a population level. […] At least 24 months after stopping interventions, trachoma surveillance surveys (TSS) are conducted to ensure that trachoma has not re-emerged as a public health problem. […] National programs must factor the costs of all surveys into their annual and long-term budgets. […] This study examines the costs of TIS and TSS in 11 countries and of TT-only surveys in four countries.

• #37 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Although trachoma causes more cases of preventable blindness than any other infectious disease, a combination of strategies is reducing its global prevalence. […] As a district moves toward eliminating trachoma as a public health problem, national programs conduct trachoma impact surveys (TIS) to assess whether to stop preventative interventions and trachoma surveillance surveys (TSS) to determine whether the prevalence of active trachoma has rebounded after interventions have halted. […] The World Health Organization requires trachoma prevalence estimates for validating the elimination of trachoma as a public health problem. […] To eliminate trachoma as a public health problem, a country must meet three requirements: (1) a trachomatous inflammationfollicular (TF) prevalence sustained below 5% for at least two years in 19-year-olds without antibiotic mass drug administration in each formerly-endemic evaluation unit (EU), (2) a TT prevalence of less than 0.2% in people 15 years of age or older in each formerly-endemic EU, and (3) a system in place for identifying and treating new cases of TT.

• #38 Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4605-0

  Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is 0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of 10% in 19 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 19 year-olds falls 5%).

• #39 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Although trachoma causes more cases of preventable blindness than any other infectious disease, a combination of strategies is reducing its global prevalence. […] As a district moves toward eliminating trachoma as a public health problem, national programs conduct trachoma impact surveys (TIS) to assess whether to stop preventative interventions and trachoma surveillance surveys (TSS) to determine whether the prevalence of active trachoma has rebounded after interventions have halted. […] The World Health Organization requires trachoma prevalence estimates for validating the elimination of trachoma as a public health problem. […] To eliminate trachoma as a public health problem, a country must meet three requirements: (1) a trachomatous inflammationfollicular (TF) prevalence sustained below 5% for at least two years in 19-year-olds without antibiotic mass drug administration in each formerly-endemic evaluation unit (EU), (2) a TT prevalence of less than 0.2% in people 15 years of age or older in each formerly-endemic EU, and (3) a system in place for identifying and treating new cases of TT.

• #40 Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4605-0

  Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is 0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of 10% in 19 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 19 year-olds falls 5%).

• #41 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Although trachoma causes more cases of preventable blindness than any other infectious disease, a combination of strategies is reducing its global prevalence. […] As a district moves toward eliminating trachoma as a public health problem, national programs conduct trachoma impact surveys (TIS) to assess whether to stop preventative interventions and trachoma surveillance surveys (TSS) to determine whether the prevalence of active trachoma has rebounded after interventions have halted. […] The World Health Organization requires trachoma prevalence estimates for validating the elimination of trachoma as a public health problem. […] To eliminate trachoma as a public health problem, a country must meet three requirements: (1) a trachomatous inflammationfollicular (TF) prevalence sustained below 5% for at least two years in 19-year-olds without antibiotic mass drug administration in each formerly-endemic evaluation unit (EU), (2) a TT prevalence of less than 0.2% in people 15 years of age or older in each formerly-endemic EU, and (3) a system in place for identifying and treating new cases of TT.

• #42 Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4605-0

  With a prevalence 5%, TF does not appear to be a significant public health problem in this region. However, TF monitoring and surveillance at sub-district level will be required to ensure that elimination targets are sustained and that TF does not re-emerge as a public health problem. TT surgery remains the priority for trachoma elimination efforts in the region, with an estimated 1819 TT surgeries to conduct. […] The WHO determines that trachoma elimination has been achieved in a country if the TF prevalence in 19 year olds is 5% (precision of 4%, with a confidence interval of 2%) and the prevalence of TT cases unknown to the health system is 0.2% (2 cases per 1000 people aged 15 years) […] The prevalence of TT far exceeds the 0.2% WHO threshold in adults aged 15 years for elimination of trachoma as a public health problem, with surgery needing to be prioritised urgently to meet the WHO elimination targets.

• #43 The utility of serology for elimination surveillance of trachoma | Nature Communications

  https://www.nature.com/articles/s41467-018-07852-0

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Following elimination of trachoma as a public health problem, robust surveillance for disease recrudescence will be needed. […] There is therefore a clear need for surveillance methods that accurately monitor low levels of transmission, and serology is potentially one such method. […] To evaluate the utility of serology as a tool for early detection of recrudescence, evidence must be analysed from a range of epidemiological settings. […] The collection and analysis of Ct serology data is an ongoing and active area of trachoma research. […] Our results suggested that SCRs below 0.015 per year correspond to TF 5%, and that the mean sero-prevalence for 19 year olds when TF 5% was 7%.

• #44 School-Based versus Community-Based Sampling for Trachoma Surveillance in: The American Journal of Tropical Medicine and Hygiene Volume 99 Issue 1 (2018)

  https://www.ajtmh.org/view/journals/tpmd/99/1/article-p150.xml

  Trachoma surveillance is typically performed via random sampling of endemic districts. This strategy minimizes bias and allows examination of preschool children, but is also expensive. […] The overall prevalence of TF was 39.1% (95% confidence interval [CI]: 35.0-43.1%) among children aged 19 years in the community-based sample and 18.8% (95% CI: 15.9-21.7%) among children in grades 1-3 of the school-based sample. […] School-based estimates of TF explained 35% of the variation in the community-based prevalences (P < 0.001). [...] Thus, although school-based monitoring was necessarily biased relative to population-based monitoring of 1- to 9-year olds, the two methods provided a similar amount of information about the community burden of ocular chlamydia in this trachoma-hyperendemic setting.

• #45 School-Based versus Community-Based Sampling for Trachoma Surveillance in: The American Journal of Tropical Medicine and Hygiene Volume 99 Issue 1 (2018)

  https://www.ajtmh.org/view/journals/tpmd/99/1/article-p150.xml

  Trachoma surveillance is typically performed via random sampling of endemic districts. This strategy minimizes bias and allows examination of preschool children, but is also expensive. […] The overall prevalence of TF was 39.1% (95% confidence interval [CI]: 35.0-43.1%) among children aged 19 years in the community-based sample and 18.8% (95% CI: 15.9-21.7%) among children in grades 1-3 of the school-based sample. […] School-based estimates of TF explained 35% of the variation in the community-based prevalences (P < 0.001). [...] Thus, although school-based monitoring was necessarily biased relative to population-based monitoring of 1- to 9-year olds, the two methods provided a similar amount of information about the community burden of ocular chlamydia in this trachoma-hyperendemic setting.

• #46 School-Based versus Community-Based Sampling for Trachoma Surveillance in: The American Journal of Tropical Medicine and Hygiene Volume 99 Issue 1 (2018)

  https://www.ajtmh.org/view/journals/tpmd/99/1/article-p150.xml

  Trachoma surveillance is typically performed via random sampling of endemic districts. This strategy minimizes bias and allows examination of preschool children, but is also expensive. […] The overall prevalence of TF was 39.1% (95% confidence interval [CI]: 35.0-43.1%) among children aged 19 years in the community-based sample and 18.8% (95% CI: 15.9-21.7%) among children in grades 1-3 of the school-based sample. […] School-based estimates of TF explained 35% of the variation in the community-based prevalences (P < 0.001). [...] Thus, although school-based monitoring was necessarily biased relative to population-based monitoring of 1- to 9-year olds, the two methods provided a similar amount of information about the community burden of ocular chlamydia in this trachoma-hyperendemic setting.

• #47 School-Based versus Community-Based Sampling for Trachoma Surveillance.

  https://escholarship.org/uc/item/26b782x7

  Trachoma surveillance is typically performed via random sampling of endemic districts. This strategy minimizes bias and allows examination of preschool children, but is also expensive. […] The overall prevalence of TF was 39.1% (95% confidence interval [CI]: 35.0-43.1%) among children aged 1-9 years in the community-based sample and 18.8% (95% CI: 15.9-21.7%) among children in grades 1-3 of the school-based sample. […] School-based estimates of TF explained 35% of the variation in the community-based prevalences (P 0.001). […] Thus, although school-based monitoring was necessarily biased relative to population-based monitoring of 1- to 9-year olds, the two methods provided a similar amount of information about the community burden of ocular chlamydia in this trachoma-hyperendemic setting. The generalizability of these findings to areas with less prevalent trachoma is unclear.

• #48 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011986

  Trachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains 5%. […] In Amhara, Ethiopia, most TSS which result in a TF 5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. […] This studys aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence 5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. […] Both study districts had a TF prevalence 5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which could lead to fewer MDA campaigns and surveys and thus cost savings with reduced antibiotic usage.

• #49 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011986

  The return of trachoma transmission after elimination as a public health problem has been reached is a concern for control programs globally. Currently, many district-level trachoma surveillance surveys (conducted 2 years since elimination threshold has been reached) are resulting in a prevalence above the established threshold. […] This studys aim was to monitor recrudescence through a wait and watch approach within Amhara, Ethiopia. This entailed waiting to restart mass drug administration within 2 districts with trachoma prevalence above but close to the threshold at surveillance survey, then surveying the districts 1 year later using traditional and alternative indicators. […] The wait and watch approach represents a surveillance strategy for trachoma control programs which could reduce the human and financial resource demand on programs required for MDA and surveys and limit unnecessary antibiotic treatments over the long term.

• #50 School-Based versus Community-Based Sampling for Trachoma Surveillance in: The American Journal of Tropical Medicine and Hygiene Volume 99 Issue 1 (2018)

  https://www.ajtmh.org/view/journals/tpmd/99/1/article-p150.xml

  Trachoma surveillance is typically performed via random sampling of endemic districts. This strategy minimizes bias and allows examination of preschool children, but is also expensive. […] The overall prevalence of TF was 39.1% (95% confidence interval [CI]: 35.0-43.1%) among children aged 19 years in the community-based sample and 18.8% (95% CI: 15.9-21.7%) among children in grades 1-3 of the school-based sample. […] School-based estimates of TF explained 35% of the variation in the community-based prevalences (P < 0.001). [...] Thus, although school-based monitoring was necessarily biased relative to population-based monitoring of 1- to 9-year olds, the two methods provided a similar amount of information about the community burden of ocular chlamydia in this trachoma-hyperendemic setting.

• #51 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011986

  The return of trachoma transmission after elimination as a public health problem has been reached is a concern for control programs globally. Currently, many district-level trachoma surveillance surveys (conducted 2 years since elimination threshold has been reached) are resulting in a prevalence above the established threshold. […] This studys aim was to monitor recrudescence through a wait and watch approach within Amhara, Ethiopia. This entailed waiting to restart mass drug administration within 2 districts with trachoma prevalence above but close to the threshold at surveillance survey, then surveying the districts 1 year later using traditional and alternative indicators. […] The wait and watch approach represents a surveillance strategy for trachoma control programs which could reduce the human and financial resource demand on programs required for MDA and surveys and limit unnecessary antibiotic treatments over the long term.

• #52 Epidemiology and control of trachoma: systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3770928/

  Current WHO estimates for the prevalence of active disease, trichiasis and blindness are significantly lower than previous ones and declines in the prevalence have been noted in several countries, but there is considerable uncertainty around these estimates, as little recent information is available from India and China. […] Notwithstanding the aforementioned limitations of the available data, there does appear to be a downward trend in the number of people affected by trachoma. Improved living standards in many countries probably account for at least part of this trend, as was the case with the disappearance of trachoma from industrialised countries a century ago. The establishment of trachoma control programmes has probably played a major role, although this is difficult to quantify. […] The most recent estimate from the WHO places the burden of trachoma at 1.3 million disability-adjusted life years. This measures the gap between a normal, healthy population and the cost of a disease from premature mortality and disability.

• #53 Trachoma Eye Causes, Stages, Types, Transmission & Diagnosis

  https://www.medicinenet.com/trachoma/article.htm

  Trachoma is the leading infectious cause of blindness in the world. […] Around 1.9 million people worldwide are blind or visually impaired by trachoma, and it remains a public health problem in 44 countries. […] Approximately 21 million people in the world have active trachoma. […] The World Health Organization reported that the number of people at risk for trachoma has fallen from 1.5 billion in 2002 to just over 142 million in 2019. […] Community-based implementation of the SAFE strategy improved the prognosis for millions of at-risk individuals. […] If a doctor diagnoses trachoma and treats it early, before scarring of the eyelids and cornea, the prognosis for the preservation of vision is excellent. […] Some individuals who have trachoma infection of the eyes will have it only once and scarring will not necessarily occur. However, reinfections are common, and over many years, the untreated disease can progress through the five stages of blindness.

• #54 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The number of people at risk from trachoma, the world’s leading infectious cause of blindness, has been reduced from 115.7 million in April 2023 to 103.2 million in April 2024, the World Health Organization (WHO) has reported in its Weekly Epidemiological Record. […] The trachoma progress update presents data on the implementation of the WHO-endorsed SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvement) in trachoma-endemic countries in 2023. […] The record shows that 18 countries have been validated as having eliminated trachoma as a public health problem as of 15 April 2024; 39 countries are known to require interventions for trachoma; and three countries may require interventions, but the necessary investigations in suspected trachoma-endemic areas have not yet been completed.

• #55 WHO reports continued progress towards trachoma elimination – The International Agency for the Prevention of Blindness

  https://www.iapb.org/news/who-reports-continued-progress-towards-trachoma-elimination/

  The number of people at risk from trachoma, the worlds leading infectious cause of blindness, fell from 125 million in 2022 to 115.7 in 2023, the World Health Organization (WHO) reported in its Weekly Epidemiological Record. […] The record shows that, as of 25 April 2023, there were 40 countries for which trachoma is a public health problem in at least part of the country. […] In 2022, 129,224 people were managed for trachomatous trichiasis (TT) worldwide, an 87% increase from the 69,266 managed in 2021. […] The trachoma progress update highlights that progress continues to be made against targets set in the global NTD road map, said PJ Hooper, Chair, International Coalition for Trachoma Control. […] There has been a 92% reduction in the number of people at risk of trachoma since 2002.

• #56 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/trachoma–europe

  Trachoma is the most common infectious cause of blindness worldwide. […] Global prevalence of active cases of trachoma has decreased from 146 million in 1995 to 84 million in 2007. […] Trachoma is most commonly found in large parts of Africa (particularly Ethiopia and Sudan), the Middle East, the Indian Subcontinent, South-East Asia, and South America. […] Trachoma was once endemic in Europe but disappeared because of improved living standards.

• #57

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Trachoma is a public health problem in 38 countries and is responsible for the blindness or visual impairment of about 1.9 million people. […] Based on April 2024 data, 103 million people live in trachoma endemic areas and are at risk of trachoma blindness. […] In 2023, 130 746 people received surgical treatment for advanced stage of the disease, and 32.9 million people were treated with antibiotics. Global antibiotic coverage in 2023 was 29%. […] Trachoma is the leading infectious cause of blindness worldwide. […] The infection is transmitted by direct or indirect transfer of eye and nose discharges of infected people, particularly young children who harbour the principal reservoir of infection. […] Visual impairment or blindness results in a worsening of the life experience of affected individuals and their families, who are normally already amongst the poorest of the poor.

• #58

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Overall, Africa remains the most affected continent and the one with the most intensive control efforts. […] As of 21 October 2024, 21 countries had been validated by WHO as having eliminated trachoma as a public health problem. […] Data reported to WHO by Member States for 2023 show that 130 746 people with trachomatous trichiasis were provided with corrective surgery in that year, and 32.9 million people in endemic communities were treated with antibiotics to eliminate trachoma. […] WHO’s mandate is to provide leadership and coordination to international efforts aiming to eliminate trachoma as a public health problem, and to report on progress towards that target. […] The Alliance is a partnership which supports implementation of the SAFE strategy by Member States, and the strengthening of national capacity through epidemiological surveys, monitoring, surveillance, project evaluation, and resource mobilization.

• #59

  https://journals.lww.com/ijo/fulltext/2024/72110/india_eliminates_trachoma_as_a_public_health.1.aspx

  Results from the National Trachoma Prevalence Survey[2] and National Trachoma Rapid Assessment Survey 2014-17[3] outlined the current status of trachoma control in India. India now joins the list of 20 trachoma-free nations, along with 19 other countries that have been declared Trachoma-Free by the WHO: Benin, Cambodia, China, The Gambia, the Islamic Republic of Iran, the Lao Peoples Democratic Republic, Ghana, Iraq, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Saudi Arabia, Togo and Vanuatu, all of which have been validated by the WHO as having eliminated trachoma as a public health problem. […] Trachoma monitoring involves the scrutiny of two related but morphologically different clinical presentations: (i) the active infectious form of trachoma (TI) and (ii) trachomatous trichiasis (TT), the progression of the disease. The control and elimination of trachoma as a public health problem in India is a commendable success story in the field of Indian Public Health.

• #60 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The record reveals that 130,746 people were managed for trachomatous trichiasis (TT) in 2023. […] Additionally, the record shows that 33.9 million people were treated across 19 countries with antibiotics in 2023. […] The presentation of gender disaggregated data is important to the global trachoma program because women are 1.8 times more likely to require TT management than men. […] However, ongoing challenges, including limited financing, persistent and recrudescent trachoma, hard-to-reach populations and insecurity threaten the elimination of trachoma as a public health problem by 2030. […] As of April 2024, Ethiopia continued to account for the worlds largest burden of trachoma, with 61 million people living in trachoma-endemic areas, representing 59% of the global burden. […] To date, 18 countries (Benin, Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Iraq, Lao Peoples Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu) have been validated by WHO as having eliminated trachoma as a public health problem.

• #61 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The record reveals that 130,746 people were managed for trachomatous trichiasis (TT) in 2023. […] Additionally, the record shows that 33.9 million people were treated across 19 countries with antibiotics in 2023. […] The presentation of gender disaggregated data is important to the global trachoma program because women are 1.8 times more likely to require TT management than men. […] However, ongoing challenges, including limited financing, persistent and recrudescent trachoma, hard-to-reach populations and insecurity threaten the elimination of trachoma as a public health problem by 2030. […] As of April 2024, Ethiopia continued to account for the worlds largest burden of trachoma, with 61 million people living in trachoma-endemic areas, representing 59% of the global burden. […] To date, 18 countries (Benin, Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Iraq, Lao Peoples Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu) have been validated by WHO as having eliminated trachoma as a public health problem.

• #62 Correlates of Trachoma Recrudescence: Results from 51 District-Level Trachoma Surveillance Surveys in Amhara, Ethiopia

  https://www.mdpi.com/2414-6366/9/12/298

  Trachoma recrudescence is a serious concern for trachoma control programs. Programs define recrudescence as the return of trachomatous inflammation-follicular (TF) prevalence above elimination threshold (≥5%) on district-level trachoma surveillance surveys (TSSs). This study aimed to determine potential correlates of trachoma recrudescence within a historically highly endemic region. […] Recrudescence is a major threat to the global elimination of trachoma. Recrudescent TF has recently been defined in a WHO-convened meeting as “an enumeration unit with at least one TSS at which the TF among children ages 1 to 9 years is ≥5%.” […] The aim of this study was to better understand the correlates of recrudescence (≥5% TF at the TSS) at the district level. Indicators such as the historical burden of trachoma, historical levels of ocular Ct infection, programmatic MDA indicators, and current water and sanitation (WASH) indicators were selected based on their biological mechanisms that may contribute to recrudescence as well as their use as key indicators for Trachoma Control Programs worldwide.

• #63 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The record reveals that 130,746 people were managed for trachomatous trichiasis (TT) in 2023. […] Additionally, the record shows that 33.9 million people were treated across 19 countries with antibiotics in 2023. […] The presentation of gender disaggregated data is important to the global trachoma program because women are 1.8 times more likely to require TT management than men. […] However, ongoing challenges, including limited financing, persistent and recrudescent trachoma, hard-to-reach populations and insecurity threaten the elimination of trachoma as a public health problem by 2030. […] As of April 2024, Ethiopia continued to account for the worlds largest burden of trachoma, with 61 million people living in trachoma-endemic areas, representing 59% of the global burden. […] To date, 18 countries (Benin, Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Iraq, Lao Peoples Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu) have been validated by WHO as having eliminated trachoma as a public health problem.

• #64 The Epidemiology of Ocular Chlamydia trachomatis Infection within Districts Persistently Endemic for Trachoma in Amhara, Ethiopia in: The American Journal of Tropical Medicine and Hygiene Volume 111 Issue 3_Suppl (2024)

  https://www.ajtmh.org/view/journals/tpmd/111/3_Suppl/article-p105.xml

  The global program will need to strengthen and enhance intervention strategies within persistent districts if elimination by 2030 is to be achieved. […] Despite the progress observed in Amhara, a considerable number of districts in the region are experiencing persistent trachoma. […] Persistent trachoma is increasingly being recognized as a threat to the global elimination of trachoma. […] The aim of this study was to examine the epidemiology of ocular C. trachomatis infection at the district, community, and individual levels in Amhara within seven contiguous districts experiencing persistent trachoma after 10 years of SAFE interventions. […] The 2019 district prevalence of TF among children ages 19 years ranged from 11.8% (95% CI: 7.6-16.0%) in Menz-Keya to 36.1% (95% CI: 27.4-44.2%) in Merhabete.

• #65 WHO trachoma progress update shows sustained progress for trachoma elimination | International Coalition for Trachoma Control

  https://www.trachomacoalition.org/news-blogs/who-trachoma-progress-update-shows-sustained-progress-for-trachoma-elimination

  The record reveals that 130,746 people were managed for trachomatous trichiasis (TT) in 2023. […] Additionally, the record shows that 33.9 million people were treated across 19 countries with antibiotics in 2023. […] The presentation of gender disaggregated data is important to the global trachoma program because women are 1.8 times more likely to require TT management than men. […] However, ongoing challenges, including limited financing, persistent and recrudescent trachoma, hard-to-reach populations and insecurity threaten the elimination of trachoma as a public health problem by 2030. […] As of April 2024, Ethiopia continued to account for the worlds largest burden of trachoma, with 61 million people living in trachoma-endemic areas, representing 59% of the global burden. […] To date, 18 countries (Benin, Cambodia, China, Gambia, Ghana, Islamic Republic of Iran, Iraq, Lao Peoples Democratic Republic, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Saudi Arabia, Togo and Vanuatu) have been validated by WHO as having eliminated trachoma as a public health problem.

• #66 Correlates of Trachoma Recrudescence: Results from 51 District-Level Trachoma Surveillance Surveys in Amhara, Ethiopia

  https://www.mdpi.com/2414-6366/9/12/298

  Trachoma recrudescence is a serious concern for trachoma control programs. Programs define recrudescence as the return of trachomatous inflammation-follicular (TF) prevalence above elimination threshold (≥5%) on district-level trachoma surveillance surveys (TSSs). This study aimed to determine potential correlates of trachoma recrudescence within a historically highly endemic region. […] Recrudescence is a major threat to the global elimination of trachoma. Recrudescent TF has recently been defined in a WHO-convened meeting as “an enumeration unit with at least one TSS at which the TF among children ages 1 to 9 years is ≥5%.” […] The aim of this study was to better understand the correlates of recrudescence (≥5% TF at the TSS) at the district level. Indicators such as the historical burden of trachoma, historical levels of ocular Ct infection, programmatic MDA indicators, and current water and sanitation (WASH) indicators were selected based on their biological mechanisms that may contribute to recrudescence as well as their use as key indicators for Trachoma Control Programs worldwide.

• #67 Correlates of Trachoma Recrudescence: Results from 51 District-Level Trachoma Surveillance Surveys in Amhara, Ethiopia

  https://www.mdpi.com/2414-6366/9/12/298

  Trachoma recrudescence is a serious concern for trachoma control programs. Programs define recrudescence as the return of trachomatous inflammation-follicular (TF) prevalence above elimination threshold (≥5%) on district-level trachoma surveillance surveys (TSSs). This study aimed to determine potential correlates of trachoma recrudescence within a historically highly endemic region. […] Recrudescence is a major threat to the global elimination of trachoma. Recrudescent TF has recently been defined in a WHO-convened meeting as “an enumeration unit with at least one TSS at which the TF among children ages 1 to 9 years is ≥5%.” […] The aim of this study was to better understand the correlates of recrudescence (≥5% TF at the TSS) at the district level. Indicators such as the historical burden of trachoma, historical levels of ocular Ct infection, programmatic MDA indicators, and current water and sanitation (WASH) indicators were selected based on their biological mechanisms that may contribute to recrudescence as well as their use as key indicators for Trachoma Control Programs worldwide.

• #68 Correlates of Trachoma Recrudescence: Results from 51 District-Level Trachoma Surveillance Surveys in Amhara, Ethiopia

  https://www.mdpi.com/2414-6366/9/12/298

  Understanding the correlates of recrudescence, and thus having a better idea of which districts may be at risk of recrudescence, is essential for developing strategies to sustain trachoma elimination. […] The history of the Trachoma Control Program in Amhara highlights considerable progress while also drawing attention to the complexities of reaching and sustaining the elimination of trachoma as a public health problem in regions with historically high trachoma prevalence. […] Considering the high baseline prevalence of trachoma throughout Amhara, the considerable Ct infection still remaining in the region, and that 108/166 (65.1%) of districts are still endemic (TF ≥ 5%), it is likely that as more districts reach the elimination threshold, the proportion of districts with recrudescent TSS results in Amhara will increase.

• #69 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Before validating elimination, WHO requires evidence that the prevalence of TF and TT very likely falls below the elimination thresholds. […] To generate this evidence, national programs often use surveys. […] After national programs implement these interventions, they can conduct trachoma impact surveys (TIS) to assess TF and TT prevalence to see if a district can stop implementing the SAFE strategy at a population level. […] At least 24 months after stopping interventions, trachoma surveillance surveys (TSS) are conducted to ensure that trachoma has not re-emerged as a public health problem. […] National programs must factor the costs of all surveys into their annual and long-term budgets. […] This study examines the costs of TIS and TSS in 11 countries and of TT-only surveys in four countries.

• #70 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Given the need to conduct surveys at a high level of quality and according to standardized protocol templates, many of the component costs for TIS, TSS, and TT-only surveys are inflexible. […] The costs of surveys funded through FOGs and the costs of surveys funded directly did not differ significantly. […] Costing studies like this one therefore provide crucial planning data as countries advance toward the elimination of trachoma as a public health problem.

• #71 The costs of monitoring trachoma elimination: Impact, surveillance, and trachomatous trichiasis (TT)-only surveys | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007605

  Given the need to conduct surveys at a high level of quality and according to standardized protocol templates, many of the component costs for TIS, TSS, and TT-only surveys are inflexible. […] The costs of surveys funded through FOGs and the costs of surveys funded directly did not differ significantly. […] Costing studies like this one therefore provide crucial planning data as countries advance toward the elimination of trachoma as a public health problem.

• #72 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011986

  The return of trachoma transmission after elimination as a public health problem has been reached is a concern for control programs globally. Currently, many district-level trachoma surveillance surveys (conducted 2 years since elimination threshold has been reached) are resulting in a prevalence above the established threshold. […] This studys aim was to monitor recrudescence through a wait and watch approach within Amhara, Ethiopia. This entailed waiting to restart mass drug administration within 2 districts with trachoma prevalence above but close to the threshold at surveillance survey, then surveying the districts 1 year later using traditional and alternative indicators. […] The wait and watch approach represents a surveillance strategy for trachoma control programs which could reduce the human and financial resource demand on programs required for MDA and surveys and limit unnecessary antibiotic treatments over the long term.

• #73 The utility of serology for elimination surveillance of trachoma | Nature Communications

  https://www.nature.com/articles/s41467-018-07852-0

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Following elimination of trachoma as a public health problem, robust surveillance for disease recrudescence will be needed. […] There is therefore a clear need for surveillance methods that accurately monitor low levels of transmission, and serology is potentially one such method. […] To evaluate the utility of serology as a tool for early detection of recrudescence, evidence must be analysed from a range of epidemiological settings. […] The collection and analysis of Ct serology data is an ongoing and active area of trachoma research. […] Our results suggested that SCRs below 0.015 per year correspond to TF 5%, and that the mean sero-prevalence for 19 year olds when TF 5% was 7%.

• #74 Optimising sampling regimes and data collection to inform surveillance for trachoma control – ORA – Oxford University Research Archive

  https://ora.ox.ac.uk/objects/uuid:006e933c-1e85-4d71-a855-b15925ed5f25

  It is estimated that 190 million individuals are at risk of blindness from trachoma, and that control by mass drug administration (MDA) is reducing this risk in many populations. […] Programs are monitored using prevalence of follicular trachoma disease (TF) in children. […] However, as programs progress to low prevalence there are challenges interpreting this indirect measure of infection. […] PCR and sero-surveillance are being considered as complementary tools to monitor low-level transmission.

• #75 The utility of serology for elimination surveillance of trachoma | Nature Communications

  https://www.nature.com/articles/s41467-018-07852-0

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Following elimination of trachoma as a public health problem, robust surveillance for disease recrudescence will be needed. […] There is therefore a clear need for surveillance methods that accurately monitor low levels of transmission, and serology is potentially one such method. […] To evaluate the utility of serology as a tool for early detection of recrudescence, evidence must be analysed from a range of epidemiological settings. […] The collection and analysis of Ct serology data is an ongoing and active area of trachoma research. […] Our results suggested that SCRs below 0.015 per year correspond to TF 5%, and that the mean sero-prevalence for 19 year olds when TF 5% was 7%.

• #76 Optimising sampling regimes and data collection to inform surveillance for trachoma control – ORA – Oxford University Research Archive

  https://ora.ox.ac.uk/objects/uuid:006e933c-1e85-4d71-a855-b15925ed5f25

  It is estimated that 190 million individuals are at risk of blindness from trachoma, and that control by mass drug administration (MDA) is reducing this risk in many populations. […] Programs are monitored using prevalence of follicular trachoma disease (TF) in children. […] However, as programs progress to low prevalence there are challenges interpreting this indirect measure of infection. […] PCR and sero-surveillance are being considered as complementary tools to monitor low-level transmission.

• #77 The utility of serology for elimination surveillance of trachoma | Nature Communications

  https://www.nature.com/articles/s41467-018-07852-0

  We have presented a novel approach to account for secondary (non-trachoma-related) antigen exposure that arises through infection with urogenital Ct, allowing more accurate estimation of the SCR for trachoma. […] We would expect to see estimates of declining transmission reflected by reductions in Ct PCR positivity and TF prevalence between the two cross-sections. […] In regions aiming to eliminate trachoma as a public health problem, there are key opportunities for serological data to contribute to future decisions on when to stop, or if necessary, when to restart MDA. […] We have initiated an evidence base for the use of sero-surveillance by programmes in low-transmission and post-elimination settings (where TF 5%), and have provided an operational threshold for sero-surveillance.

• #78 Trachoma elimination and surveillance strategies | Research | Sightsavers

  https://research.sightsavers.org/project/trachoma-elimination-and-surveillance-strategies/

  Surveillance for additional infections (including other NTDs and possible WASH-associated diseases) was also included by testing for antibodies to the various pathogens using the same sera collected for trachoma (using Luminex multiplex assays). […] Finally, document analysis and qualitative methodologies were employed to review the operationalisation of the trachoma surveillance system used in Ghana.

• #79 The utility of serology for elimination surveillance of trachoma | Nature Communications

  https://www.nature.com/articles/s41467-018-07852-0

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Following elimination of trachoma as a public health problem, robust surveillance for disease recrudescence will be needed. […] There is therefore a clear need for surveillance methods that accurately monitor low levels of transmission, and serology is potentially one such method. […] To evaluate the utility of serology as a tool for early detection of recrudescence, evidence must be analysed from a range of epidemiological settings. […] The collection and analysis of Ct serology data is an ongoing and active area of trachoma research. […] Our results suggested that SCRs below 0.015 per year correspond to TF 5%, and that the mean sero-prevalence for 19 year olds when TF 5% was 7%.

• #80 Trachoma elimination and surveillance strategies | Research | Sightsavers

  https://research.sightsavers.org/project/trachoma-elimination-and-surveillance-strategies/

  Surveillance for additional infections (including other NTDs and possible WASH-associated diseases) was also included by testing for antibodies to the various pathogens using the same sera collected for trachoma (using Luminex multiplex assays). […] Finally, document analysis and qualitative methodologies were employed to review the operationalisation of the trachoma surveillance system used in Ghana.

• #81 Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7872237/

  A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease. […] The experiences of both the Guinea worm and onchocerciasis surveillance strategies have very useful lessons for trachoma surveillance, pre- and post-validation. The use of a monetary reward for identification of TT cases and further exploration into the use of infection and serological indicators particularly in a post-validation setting to assist in identifying recrudescence would be of particular relevance.

• #82 Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7872237/

  A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease. […] The experiences of both the Guinea worm and onchocerciasis surveillance strategies have very useful lessons for trachoma surveillance, pre- and post-validation. The use of a monetary reward for identification of TT cases and further exploration into the use of infection and serological indicators particularly in a post-validation setting to assist in identifying recrudescence would be of particular relevance.

• #83

  https://www.who.int/health-topics/trachoma

  WHO adopted the SAFE strategy in 1993 and continues in its mandate to provide leadership and coordination of international efforts to eliminate trachoma as a public health problem. […] The need for interventions against active trachoma has traditionally been determined using the prevalence of clinical signs that are associated with conjunctival… […] Call for public consultation Target Product Profiles (TPP) for trachoma surveillance.

• #84 Trachoma – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/trachoma

  The Global Alliance for the Elimination of Trachoma by 2020 GET2020 (Global Elimination of Trachoma) was launched under the leadership of WHO in 1996. […] PAHO/WHO supports countries in implementing the SAFE (Surgery, Antibiotic, Facial cleanliness and Environmental improvement) strategy, which consists of implementing surgery to correct trichiasis, antibiotic treatment (azithromycin) to treat C. trachomatis infection, facial hygiene and environmental improvement to reduce person-to-person transmission. […] The Roadmap for NTDs 2021-2030, which the World Health Assembly endorsed in 2020 in its decision 73(33), extended the new deadline for the global elimination of the disease to 2030.

• #85 Australian Trachoma Surveillance Report 2022 | Kirby Institute

  https://www.kirby.unsw.edu.au/research/reports/australian-trachoma-surveillance-report-2022

  Trachoma is an eye infection caused by serotypes of the Chlamydia trachomatis bacteria and is a major cause of preventable blindness globally. Australia is the only high-income country where trachoma is a public health problem, primarily in remote and very remote Aboriginal communities in the Northern Territory (NT), South Australia (SA) and Western Australia (WA). The Australian Government funds the National Trachoma Surveillance and Reporting Unit to collate and analyse trachoma prevalence data and control strategies annually. […] The number of communities at risk of trachoma in Australia has steadily declined in all jurisdictions since 2010. Communities at-risk of trachoma fell by 50% in NT (84 in 2010 to 42 in 2022), 85% in SA (72 in 2010 to 11 in 2022) and 64% in WA (86 in 2010 to 31 in 2022).

• #86 Australian Trachoma Surveillance Report 2021 | Kirby Institute

  https://www.kirby.unsw.edu.au/research/reports/australian-trachoma-surveillance-report-2021

  Trachoma is an eye infection caused by serotypes of the Chlamydia trachomatis bacteria, which continues to be the worlds leading cause of infectious, preventable blindness and the fifth leading cause of blindness. Australia is the only highincome country where trachoma is still endemic. It occurs primarily in remote and very remote Aboriginal communities in the Northern Territory (NT), South Australia (SA) and Western Australia (WA). […] The National Trachoma Surveillance and Reporting Unit (NTSRU) is responsible for data collation, analysis and reporting related to the ongoing evaluation of trachoma control strategies in Australia. […] Jurisdictions identified 92 remote communities as being at risk of trachoma. Of the at risk communities, 93% (86/92) required screening and/or treatment for trachoma according to current guidelines. Of the communities that required screening and/or treatment, 95% (82/86) received the required service. A total of 1,833 children aged 59 years in at risk communities were examined for trachoma with a screening coverage of 90%. The overall prevalence of trachoma in children aged 59 years was 3.3%, with 3.8% in the NT, 0% in QLD, 0.9% in SA 5% in WA. Trachoma treatment strategies were applied in all 53 communities of those the required treatment, with a treatment coverage of 73% (1815/2,485). Overall, 11,435 adults aged 15 years and over were screened for trichiasis with a prevalence of 0.11%.

• #87 Australian Trachoma Surveillance Report 2021 | Kirby Institute

  https://www.kirby.unsw.edu.au/research/reports/australian-trachoma-surveillance-report-2021

  Trachoma is an eye infection caused by serotypes of the Chlamydia trachomatis bacteria, which continues to be the worlds leading cause of infectious, preventable blindness and the fifth leading cause of blindness. Australia is the only highincome country where trachoma is still endemic. It occurs primarily in remote and very remote Aboriginal communities in the Northern Territory (NT), South Australia (SA) and Western Australia (WA). […] The National Trachoma Surveillance and Reporting Unit (NTSRU) is responsible for data collation, analysis and reporting related to the ongoing evaluation of trachoma control strategies in Australia. […] Jurisdictions identified 92 remote communities as being at risk of trachoma. Of the at risk communities, 93% (86/92) required screening and/or treatment for trachoma according to current guidelines. Of the communities that required screening and/or treatment, 95% (82/86) received the required service. A total of 1,833 children aged 59 years in at risk communities were examined for trachoma with a screening coverage of 90%. The overall prevalence of trachoma in children aged 59 years was 3.3%, with 3.8% in the NT, 0% in QLD, 0.9% in SA 5% in WA. Trachoma treatment strategies were applied in all 53 communities of those the required treatment, with a treatment coverage of 73% (1815/2,485). Overall, 11,435 adults aged 15 years and over were screened for trichiasis with a prevalence of 0.11%.

• #88 Australian Trachoma Surveillance Report 2021 | Kirby Institute

  https://www.kirby.unsw.edu.au/research/reports/australian-trachoma-surveillance-report-2021

  Trachoma is an eye infection caused by serotypes of the Chlamydia trachomatis bacteria, which continues to be the worlds leading cause of infectious, preventable blindness and the fifth leading cause of blindness. Australia is the only highincome country where trachoma is still endemic. It occurs primarily in remote and very remote Aboriginal communities in the Northern Territory (NT), South Australia (SA) and Western Australia (WA). […] The National Trachoma Surveillance and Reporting Unit (NTSRU) is responsible for data collation, analysis and reporting related to the ongoing evaluation of trachoma control strategies in Australia. […] Jurisdictions identified 92 remote communities as being at risk of trachoma. Of the at risk communities, 93% (86/92) required screening and/or treatment for trachoma according to current guidelines. Of the communities that required screening and/or treatment, 95% (82/86) received the required service. A total of 1,833 children aged 59 years in at risk communities were examined for trachoma with a screening coverage of 90%. The overall prevalence of trachoma in children aged 59 years was 3.3%, with 3.8% in the NT, 0% in QLD, 0.9% in SA 5% in WA. Trachoma treatment strategies were applied in all 53 communities of those the required treatment, with a treatment coverage of 73% (1815/2,485). Overall, 11,435 adults aged 15 years and over were screened for trichiasis with a prevalence of 0.11%.

• #89 Australian Trachoma Surveillance Report 2022 | Kirby Institute

  https://www.kirby.unsw.edu.au/research/reports/australian-trachoma-surveillance-report-2022

  Trachoma is an eye infection caused by serotypes of the Chlamydia trachomatis bacteria and is a major cause of preventable blindness globally. Australia is the only high-income country where trachoma is a public health problem, primarily in remote and very remote Aboriginal communities in the Northern Territory (NT), South Australia (SA) and Western Australia (WA). The Australian Government funds the National Trachoma Surveillance and Reporting Unit to collate and analyse trachoma prevalence data and control strategies annually. […] The number of communities at risk of trachoma in Australia has steadily declined in all jurisdictions since 2010. Communities at-risk of trachoma fell by 50% in NT (84 in 2010 to 42 in 2022), 85% in SA (72 in 2010 to 11 in 2022) and 64% in WA (86 in 2010 to 31 in 2022).

• #90 Epidemiology of trachoma and its implications for implementing the “SAFE” strategy in Somali Region, Ethiopia | RTI

  https://www.rti.org/publication/epidemiology-trachoma-implications-implementing-safe-strategy-somali-region-ethiopia-results-14-popu

  Ethiopia is highly trachoma endemic. […] Baseline mapping was needed in Ethiopias Somali Region to guide elimination efforts. […] The prevalence of trachomatous inflammationfollicular (TF) among children aged 19 years ranged from 4.1% in the EU covering Danot, Boh, and Geladin woredas in Doolo Subzone to 38.1% in the EU covering Kebribeyah and Hareshen woredas in Fafan Subzone (East). […] The trichiasis prevalence among adults aged over 15 years varied from 0.1% in the EU covering Afder, Bare, and Dolobay woredas in Afder Subzone (West) to 1.2% in the EU covering Awbere in Fafan Subzone (West). […] Mass drug administration (MDA) with azithromycin is needed in 13 EUs (population 2,845,818). […] Two EUs (population 667,599) had TF prevalences in 19-year-olds of 30% and will require at least 5 years of MDA; 5 EUs (population 1,1193,032) had TF prevalences of 1029.9% and need at least three years of MDA; 6 EUs (population 985,187) had TF prevalences of 59.9% and need at least one round of azithromycin distribution before re-survey. […] In all 13 of these EUs, implementation of facial cleanliness and environmental improvement measures is also needed. […] Surveys are still needed in the remaining 34 unmapped woredas of Somali Region.

• #91 The Epidemiology of Ocular Chlamydia trachomatis Infection within Districts Persistently Endemic for Trachoma in Amhara, Ethiopia in: The American Journal of Tropical Medicine and Hygiene Volume 111 Issue 3_Suppl (2024)

  https://www.ajtmh.org/view/journals/tpmd/111/3_Suppl/article-p105.xml

  The global program will need to strengthen and enhance intervention strategies within persistent districts if elimination by 2030 is to be achieved. […] Despite the progress observed in Amhara, a considerable number of districts in the region are experiencing persistent trachoma. […] Persistent trachoma is increasingly being recognized as a threat to the global elimination of trachoma. […] The aim of this study was to examine the epidemiology of ocular C. trachomatis infection at the district, community, and individual levels in Amhara within seven contiguous districts experiencing persistent trachoma after 10 years of SAFE interventions. […] The 2019 district prevalence of TF among children ages 19 years ranged from 11.8% (95% CI: 7.6-16.0%) in Menz-Keya to 36.1% (95% CI: 27.4-44.2%) in Merhabete.

• #92 The Epidemiology of Ocular Chlamydia trachomatis Infection within Districts Persistently Endemic for Trachoma in Amhara, Ethiopia in: The American Journal of Tropical Medicine and Hygiene Volume 111 Issue 3_Suppl (2024)

  https://www.ajtmh.org/view/journals/tpmd/111/3_Suppl/article-p105.xml

  The 2019 district-level prevalence of C. trachomatis infection among children ages 15 years in South Wollo ranged from 6.4% in Kalala to 8.9% in Wogide, and in North Shoa the prevalence was 2.7% in Menz-Keya, 15.2% in Moretna Jiru, 16.5% in Mida Woremo, and 34.4% in Merhabete. […] Although reductions in TF prevalence were observed, the districts surveyed as part of this study were clearly experiencing persistent trachoma despite a decade of SAFE interventions. Ocular C. trachomatis infection data further supported this finding, as infection was found in all seven districts, reaching as high as 34% in Merhabete. […] If the Amhara Trachoma Control Program is to achieve its goals of trachoma elimination by 2030, renewed efforts and enhanced approaches will be needed.

• #93 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011986

  Trachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains 5%. […] In Amhara, Ethiopia, most TSS which result in a TF 5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. […] This studys aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence 5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. […] Both study districts had a TF prevalence 5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which could lead to fewer MDA campaigns and surveys and thus cost savings with reduced antibiotic usage.

• #94 Wait and watch: A trachoma surveillance strategy from Amhara region, Ethiopia | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011986

  The return of trachoma transmission after elimination as a public health problem has been reached is a concern for control programs globally. Currently, many district-level trachoma surveillance surveys (conducted 2 years since elimination threshold has been reached) are resulting in a prevalence above the established threshold. […] This studys aim was to monitor recrudescence through a wait and watch approach within Amhara, Ethiopia. This entailed waiting to restart mass drug administration within 2 districts with trachoma prevalence above but close to the threshold at surveillance survey, then surveying the districts 1 year later using traditional and alternative indicators. […] The wait and watch approach represents a surveillance strategy for trachoma control programs which could reduce the human and financial resource demand on programs required for MDA and surveys and limit unnecessary antibiotic treatments over the long term.

• #95 Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-019-0585-x

  Pre-validation surveillance aims to ensure that elimination thresholds are sustainably achieved, detect any possible re-emergence of disease (recrudescence) in a timely manner and continue to identify incident (and recurrent) TT cases. […] The WHO recommendations and guidance were primarily based on expert opinion and expectations of a suitable approach. Ghana was one of the first sub-Saharan African countries to implement a pre-validation surveillance plan and therefore the approach had to be adapted to fit local context, systems and understanding. […] Ghana implemented their trachoma pre-validation surveillance strategy between 2011 and 2016, being one of the first countries in Africa to develop and implement such a surveillance plan. In general, the strategy closely followed the 2008 WHO recommendations, employing both passive and active surveillance approaches, with a population-based survey providing the ultimate evidence that TF and TT elimination thresholds had been maintained and validation of elimination of trachoma as a public health problem achieved. However, GHS employed a number of adaptations to the WHO surveillance recommendations at the time, with varying success. […] Issues with the sensitivity and specificity of the passive surveillance system impeded the achievement of the surveillance objectives and resulted in an inefficient use of resources.

• #96 Trachoma elimination and surveillance strategies | Research | Sightsavers

  https://research.sightsavers.org/project/trachoma-elimination-and-surveillance-strategies/

  To review the effectiveness and operationalisation of the trachoma surveillance strategy in Ghana […] To compare the different indicators (clinical, infection and antibody) for trachoma surveillance and their use in decision making to validate elimination […] Ghana achieved the thresholds in 2008, and since 2011 has been implementing its trachoma surveillance strategy, which includes community and school screening for signs of follicular trachoma, in each trachoma-endemic district. […] In 2015 and 2016, a district-level, population-based survey was conducted to validate elimination of blinding trachoma. […] Further evidence is required to determine the optimal surveillance strategy and indicators for trachoma. […] Pre-validation surveillance surveys were conducted in all previously trachoma-endemic districts of Ghana but with the addition of eye swabbing to test for chlamydia trachomatis infection (using PCR) and finger pricking to collect bloodspots for antibody testing (using ELISA).

• #97 Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-019-0585-x

  In 2009 Ghana began to design a trachoma pre-validation surveillance plan, based on then-current WHO recommendations. The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases, through both active and passive surveillance approaches. […] Ghana developed a comprehensive surveillance system that exceeded the WHO recommendations but issues with sensitivity and specificity likely led to an inefficient use of resources. Improved targeted surveillance strategies for identification of recrudescence and trichiasis case searches, need to be evaluated. […] Trachoma surveillance has been defined by WHO as the monitoring and evaluation activities that assess the outcome of a trachoma elimination programme, conducted after elimination prevalence targets appear to have been achieved, in a defined trachoma endemic area.

• #98 Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-019-0585-x

  In 2009 Ghana began to design a trachoma pre-validation surveillance plan, based on then-current WHO recommendations. The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases, through both active and passive surveillance approaches. […] Ghana developed a comprehensive surveillance system that exceeded the WHO recommendations but issues with sensitivity and specificity likely led to an inefficient use of resources. Improved targeted surveillance strategies for identification of recrudescence and trichiasis case searches, need to be evaluated. […] Trachoma surveillance has been defined by WHO as the monitoring and evaluation activities that assess the outcome of a trachoma elimination programme, conducted after elimination prevalence targets appear to have been achieved, in a defined trachoma endemic area.

• #99 Guinea’s Milestone: Survey confirms significant progress against trachoma | ActNTDs

  https://www.actntdswest.org/news/guineas-milestone-survey-confirms-significant-progress-against-trachoma

  Following years of dedicated effort, Guinea has reached a major milestone in its journey to eliminate trachoma, the leading infectious cause of blindness worldwide: all districts in Guinea have now successfully maintained the trachoma elimination targets with the most recent Trachoma Surveillance Surveys (TSS). […] TSS are specialized surveys designed to assess the prevalence of trachoma in a population at least two years after mass drug administration of antibiotics has ended. […] The mapping, carried out between 2011 and 2015, assessed the geographical distribution and severity of trachoma, identifying it as a public health problem in 18 of the 31 health districts. […] The prevalence of TF dropped below 5% in children aged 1-9 years across Guinea in all endemic districts by 2021 and MDA was stopped countrywide.

• #100 Guinea’s Milestone: Survey confirms significant progress against trachoma | ActNTDs

  https://www.actntdswest.org/news/guineas-milestone-survey-confirms-significant-progress-against-trachoma

  Following years of dedicated effort, Guinea has reached a major milestone in its journey to eliminate trachoma, the leading infectious cause of blindness worldwide: all districts in Guinea have now successfully maintained the trachoma elimination targets with the most recent Trachoma Surveillance Surveys (TSS). […] TSS are specialized surveys designed to assess the prevalence of trachoma in a population at least two years after mass drug administration of antibiotics has ended. […] The mapping, carried out between 2011 and 2015, assessed the geographical distribution and severity of trachoma, identifying it as a public health problem in 18 of the 31 health districts. […] The prevalence of TF dropped below 5% in children aged 1-9 years across Guinea in all endemic districts by 2021 and MDA was stopped countrywide.

• #101 Guinea’s Milestone: Survey confirms significant progress against trachoma | ActNTDs

  https://www.actntdswest.org/news/guineas-milestone-survey-confirms-significant-progress-against-trachoma

  Following years of dedicated effort, Guinea has reached a major milestone in its journey to eliminate trachoma, the leading infectious cause of blindness worldwide: all districts in Guinea have now successfully maintained the trachoma elimination targets with the most recent Trachoma Surveillance Surveys (TSS). […] TSS are specialized surveys designed to assess the prevalence of trachoma in a population at least two years after mass drug administration of antibiotics has ended. […] The mapping, carried out between 2011 and 2015, assessed the geographical distribution and severity of trachoma, identifying it as a public health problem in 18 of the 31 health districts. […] The prevalence of TF dropped below 5% in children aged 1-9 years across Guinea in all endemic districts by 2021 and MDA was stopped countrywide.

• #102 Guinea’s Milestone: Survey confirms significant progress against trachoma | ActNTDs

  https://www.actntdswest.org/news/guineas-milestone-survey-confirms-significant-progress-against-trachoma

  The results of the final TSS in 2024 in Dinguiraye therefore marked a significant achievement by the people and government of Guinea. […] In response to the TSS results, the PNLMTN has announced its intention to submit the trachoma elimination dossier to the WHO in the near future. […] Over 6 million Guineans now live in areas where trachoma is no longer considered a public health problem.

• #103 Guinea’s Milestone: Survey confirms significant progress against trachoma | ActNTDs

  https://www.actntdswest.org/news/guineas-milestone-survey-confirms-significant-progress-against-trachoma

  The results of the final TSS in 2024 in Dinguiraye therefore marked a significant achievement by the people and government of Guinea. […] In response to the TSS results, the PNLMTN has announced its intention to submit the trachoma elimination dossier to the WHO in the near future. […] Over 6 million Guineans now live in areas where trachoma is no longer considered a public health problem.

• #104

  https://journals.lww.com/ijo/fulltext/2022/09000/current_status_of_trachoma_in_india__results_from.20.aspx

  In the mid-twentieth century, trachoma was endemic in the northwestern states of India. […] We aimed to generate recent estimates of prevalence of trachomatous inflammation, follicular (TF) and trachomatous trichiasis (TT) in ten suspected-endemic districts across seven previously hyper-endemic states and union territories for trachoma in India including Delhi, Rajasthan, Haryana, Punjab, Gujarat, Uttarakhand and the Andaman and Nicobar Islands. […] A total of 13,802 households were surveyed in which 19,662 children were examined for TF and 44,135 adults aged 15 years were examined for TT. […] TF was not a public health problem in any of the districts surveyed; thus, antibiotic mass drug administration is not needed. However, TT among adults was found to be above 0.2% in four districts; thus, further trichiasis surgery interventions at the public health level are warranted to achieve elimination.

• #105

  https://journals.lww.com/ijo/fulltext/2022/09000/current_status_of_trachoma_in_india__results_from.20.aspx

  The TF prevalence estimates generated through this survey demonstrated a very low prevalence across all ten EUs. […] TT continues to be common in certain pockets of the country, and surgical interventions are required to achieve the trachoma elimination goal by 2030. […] Before India can be validated as having eliminated trachoma, adequate surveillance of the disease must be done. […] The findings from these surveys suggest that TF was not a public health problem in any of the EUs, so antibiotic mass drug administration will not be needed for trachoma elimination. However, four EUs need to undertake public-health-level trichiasis surgery interventions to attain elimination of trachoma.

• #106

  https://journals.lww.com/ijo/fulltext/2022/09000/current_status_of_trachoma_in_india__results_from.20.aspx

  The TF prevalence estimates generated through this survey demonstrated a very low prevalence across all ten EUs. […] TT continues to be common in certain pockets of the country, and surgical interventions are required to achieve the trachoma elimination goal by 2030. […] Before India can be validated as having eliminated trachoma, adequate surveillance of the disease must be done. […] The findings from these surveys suggest that TF was not a public health problem in any of the EUs, so antibiotic mass drug administration will not be needed for trachoma elimination. However, four EUs need to undertake public-health-level trichiasis surgery interventions to attain elimination of trachoma.

• #107

  https://journals.lww.com/ijo/fulltext/2022/09000/current_status_of_trachoma_in_india__results_from.20.aspx

  The World Health Organization (WHO) has recommended a prevalence of trachomatous inflammation, follicular (TF), an indicator of active trachoma, of 5% among children aged 19 years and trachomatous trichiasis (TT) prevalence threshold of 2/1000 population aged 15+ years in each formerly endemic evaluation unit (EU) as two of the elimination criteria for trachoma. […] The National Trachoma Prevalence Survey, India, was implemented in the suspected endemic region of the country to estimate the prevalence of TF and TT. […] This survey in India demonstrated that trachoma was not a public health problem in six of the ten EUs for which we generated data. […] Four EUs (Car Nicobar, Dholpur, Hoshiarpur and Tonk) had trichiasis prevalence of 0.2% in adults aged 15 years, indicating a requirement for a health system to deliver trichiasis surgery to achieve the TT elimination target.

• #108

  https://journals.lww.com/ijo/fulltext/2024/72110/india_eliminates_trachoma_as_a_public_health.1.aspx

  Results from the National Trachoma Prevalence Survey[2] and National Trachoma Rapid Assessment Survey 2014-17[3] outlined the current status of trachoma control in India. India now joins the list of 20 trachoma-free nations, along with 19 other countries that have been declared Trachoma-Free by the WHO: Benin, Cambodia, China, The Gambia, the Islamic Republic of Iran, the Lao Peoples Democratic Republic, Ghana, Iraq, Malawi, Mali, Mexico, Morocco, Myanmar, Nepal, Oman, Pakistan, Saudi Arabia, Togo and Vanuatu, all of which have been validated by the WHO as having eliminated trachoma as a public health problem. […] Trachoma monitoring involves the scrutiny of two related but morphologically different clinical presentations: (i) the active infectious form of trachoma (TI) and (ii) trachomatous trichiasis (TT), the progression of the disease. The control and elimination of trachoma as a public health problem in India is a commendable success story in the field of Indian Public Health.

• #109

  https://journals.lww.com/ijo/fulltext/2022/09000/current_status_of_trachoma_in_india__results_from.20.aspx

  The TF prevalence estimates generated through this survey demonstrated a very low prevalence across all ten EUs. […] TT continues to be common in certain pockets of the country, and surgical interventions are required to achieve the trachoma elimination goal by 2030. […] Before India can be validated as having eliminated trachoma, adequate surveillance of the disease must be done. […] The findings from these surveys suggest that TF was not a public health problem in any of the EUs, so antibiotic mass drug administration will not be needed for trachoma elimination. However, four EUs need to undertake public-health-level trichiasis surgery interventions to attain elimination of trachoma.

• #110 Epidemiology and control of trachoma: systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3770928/

  Current WHO estimates for the prevalence of active disease, trichiasis and blindness are significantly lower than previous ones and declines in the prevalence have been noted in several countries, but there is considerable uncertainty around these estimates, as little recent information is available from India and China. […] Notwithstanding the aforementioned limitations of the available data, there does appear to be a downward trend in the number of people affected by trachoma. Improved living standards in many countries probably account for at least part of this trend, as was the case with the disappearance of trachoma from industrialised countries a century ago. The establishment of trachoma control programmes has probably played a major role, although this is difficult to quantify. […] The most recent estimate from the WHO places the burden of trachoma at 1.3 million disability-adjusted life years. This measures the gap between a normal, healthy population and the cost of a disease from premature mortality and disability.

• #111 Trachoma Eye Causes, Stages, Types, Transmission & Diagnosis

  https://www.medicinenet.com/trachoma/article.htm

  Trachoma is the leading infectious cause of blindness in the world. […] Around 1.9 million people worldwide are blind or visually impaired by trachoma, and it remains a public health problem in 44 countries. […] Approximately 21 million people in the world have active trachoma. […] The World Health Organization reported that the number of people at risk for trachoma has fallen from 1.5 billion in 2002 to just over 142 million in 2019. […] Community-based implementation of the SAFE strategy improved the prognosis for millions of at-risk individuals. […] If a doctor diagnoses trachoma and treats it early, before scarring of the eyelids and cornea, the prognosis for the preservation of vision is excellent. […] Some individuals who have trachoma infection of the eyes will have it only once and scarring will not necessarily occur. However, reinfections are common, and over many years, the untreated disease can progress through the five stages of blindness.

• #112 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  The SAFE strategy, which includes surgery for individuals with trichiasis, antibiotic mass drug administration, and interventions to stimulate facial cleanliness and environmental improvement, is designed to reduce infection prevalence and transmission. Together, these interventions comprise the SAFE strategy, which is achieving considerable success. Although much work remains, a continuing public health problem from trachoma in the year 2030 will be difficult for the world to excuse.

• #113 Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7872237/

  A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease. […] The experiences of both the Guinea worm and onchocerciasis surveillance strategies have very useful lessons for trachoma surveillance, pre- and post-validation. The use of a monetary reward for identification of TT cases and further exploration into the use of infection and serological indicators particularly in a post-validation setting to assist in identifying recrudescence would be of particular relevance.

• #114 The utility of serology for elimination surveillance of trachoma

  https://stacks.cdc.gov/view/cdc/81496

  Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. […] Here, we analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low-transmission and post-elimination settings. […] To accurately estimate sero-conversion rates (SCR) for trachoma in populations with high-seroprevalence in adults, the model accounts for secondary exposure to Chlamydia trachomatis due to urogenital infection. […] We show SCRs below 0.015 (95% confidence interval (CI): 0.0-0.049) per year correspond to a prevalence of trachomatous inflammation-follicular below 5%, the current threshold for elimination of active trachoma as a public health problem. […] As global trachoma prevalence declines, we may need cross-sectional serological survey data to inform programmatic decisions.

• #115 Optimising sampling regimes and data collection to inform surveillance for trachoma control – ORA – Oxford University Research Archive

  https://ora.ox.ac.uk/objects/uuid:006e933c-1e85-4d71-a855-b15925ed5f25

  It is estimated that 190 million individuals are at risk of blindness from trachoma, and that control by mass drug administration (MDA) is reducing this risk in many populations. […] Programs are monitored using prevalence of follicular trachoma disease (TF) in children. […] However, as programs progress to low prevalence there are challenges interpreting this indirect measure of infection. […] PCR and sero-surveillance are being considered as complementary tools to monitor low-level transmission.

• #116 Trachoma elimination and surveillance strategies | Research | Sightsavers

  https://research.sightsavers.org/project/trachoma-elimination-and-surveillance-strategies/

  Surveillance for additional infections (including other NTDs and possible WASH-associated diseases) was also included by testing for antibodies to the various pathogens using the same sera collected for trachoma (using Luminex multiplex assays). […] Finally, document analysis and qualitative methodologies were employed to review the operationalisation of the trachoma surveillance system used in Ghana.

• #117

  https://journals.lww.com/ijo/fulltext/2024/72110/india_eliminates_trachoma_as_a_public_health.1.aspx

  Corporate health initiatives, such as the International Trachoma Initiative (ITI), an antibiotic donation program, and several others, have contributed to the elimination of trachoma once the most neglected of all the neglected tropical diseases (NTD) by promoting the SAFE strategy. Trachoma control and prevention programs must continue post-validation epidemiological surveillance for identifying active cases and implementing the SAFE strategy in formerly endemic regions, to prevent the emergence of new cases in alarming proportions. […] A retrospective analysis of national survey and implementation data from all countries previously endemic for trachoma, including data collated up until November 10 2021, for 38 countries representing 2097 ever-endemic implementation units, highlighted the challenges in achieving global trachoma elimination as a public health problem by 2020.[5] However, the progress attained till date should not to be undermined by the delay in reaching global elimination, as ongoing implementation initiatives and programs now reflect a renewed commitment to achieve global elimination by 2030.

• #118

  https://journals.lww.com/ijo/fulltext/2024/72110/india_eliminates_trachoma_as_a_public_health.1.aspx

  Corporate health initiatives, such as the International Trachoma Initiative (ITI), an antibiotic donation program, and several others, have contributed to the elimination of trachoma once the most neglected of all the neglected tropical diseases (NTD) by promoting the SAFE strategy. Trachoma control and prevention programs must continue post-validation epidemiological surveillance for identifying active cases and implementing the SAFE strategy in formerly endemic regions, to prevent the emergence of new cases in alarming proportions. […] A retrospective analysis of national survey and implementation data from all countries previously endemic for trachoma, including data collated up until November 10 2021, for 38 countries representing 2097 ever-endemic implementation units, highlighted the challenges in achieving global trachoma elimination as a public health problem by 2020.[5] However, the progress attained till date should not to be undermined by the delay in reaching global elimination, as ongoing implementation initiatives and programs now reflect a renewed commitment to achieve global elimination by 2030.

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