Trachoma Skip to main contentSkip to searchLog inEnglish#{autosuggest.search}#{autosuggest.search}Trachoma MENULog in or subscribe to access all of BMJ Best PracticeLast reviewed:20 Nov 2023Last updated:19 Dec 2023SummaryTrachoma is a keratoconjunctivitis caused by ocular infection with particular serovars of Chlamydia trachomatis.Antibiotics, in conjunction with facial cleanliness campaigns and environmental improvements targeted at communities at risk, aim to reduce the reservoir of infection within a population.Occurs predominantly in children. Poor facial cleanliness may be the most important modifiable risk factor in children who develop trachoma.Children who have had multiple or severe episodes of active trachoma may develop cicatricial disease in later life.Trachomatous cicatricial disease
Access barriers and facilitators to implement mass drugs administration strategies for eliminating trachoma and geohelminthiasis in the department of Amazonas, Colombia. One of the most important pillars of action to achieve the elimination of trachoma and soil-transmitted helminth infections as a public health problem is the mass administration, at regular intervals, of azithromycin
Impact of trachoma elimination efforts in afar regional state, Ethiopia: survey findings from 26 evaluation units. Following interventions to eliminate trachoma in the Afar region of Ethiopia, our goal was to reassess the prevalence of trachomatous trichiasis (TT) and trachomatous inflammation-follicular (TF) at the woreda level, and to identify factors associated with the disease. Cross -sectional community-based surveys were conducted in 26 trachoma-endemic woredas, employing a standardized approach. Households were selected as the secondary sampling unit. Surveys involved interviews with household heads, direct assessment of water, sanitation, and hygiene (WASH) access, and clinical examination of eligible household members for trachomatous trichiasis (TT) and trachomatous inflammation
Identifying Borderline Trachoma Grades Using a Three-Latent Class Model. The WHO has a simplified grading system for assessing trachoma. However, even for experts, it can be difficult to classify certain cases as strictly positive or negative for a given grade. Given the absence of a true gold standard, we performed a Latent Class Analysis (LCA) on a set of 200 graded photos of the superior tarsal conjunctiva. Ten trained graders assessed the presence of two trachoma grades: trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI). The LCA was modeled in two different ways: first with two classes (presence/absence), and then with three classes, with the extra class presumed to represent a more discrepant "borderline" case. Cohen's κ-statistics measuring
Prevalence of Ocular Chlamydia trachomatis and Active Trachoma among Children in Merhabete District, Amhara, Ethiopia. There have been significant reductions in the burden of trachoma worldwide. However, some districts have experienced persistently high trachoma prevalence despite many years of intervention. Here, we report the epidemiology of trachoma in Merhabete, Ethiopia, a district in the Amhara Region that has been receiving azithromycin mass drug administration (MDA) since 2009. Data were obtained from the baseline survey of a cluster randomized trial evaluating targeted treatment strategies for trachoma elimination. An enumerative census was conducted in February 2022 to generate lists of children aged 6 months to 9 years in 80 sentinel communities participating in the trial. All
Eritrea's Blueprint for Trachoma Elimination: A Home-Grown Model for Sustainable Impact. This overview highlights Eritrea's progress in trachoma elimination from 2006 to 2024, emphasizing the Surgery, Antibiotics, Facial Cleanliness and Environmental Improvement (SAFE) strategy, pillars of the Neglected Tropical Diseases (NTD) Roadmap, and geostatistical mapping's role in achieving elimination targets. Trachoma Impact Surveys (TIS) and Surveillance Surveys (TSS) monitored WHO-endorsed SAFE strategy interventions and progress, with model-based geo-statistics providing more precise prevalence estimates. Eritrea has attained open defecation-free status in 93% of villages, performed 22,546 Trachomatous Trachiasis (TT) surgeries, and integrated surveillance data into the District Health
Testing for Antibodies to Four Parasites in Residual Blood Specimens from Trachoma Surveys in Kiribati, 2015-2019. To assess the prevalence of several parasitic infections in Kiribati, dried blood spots collected during trachoma prevalence surveys in the two major population centers in 2015, 2016, and 2019 were tested using multiplex bead-based serologic assays to detect IgG antibodies against
Modeling the "F" in "SAFE": The dynamic game of facial cleanliness in trachoma prevention. Trachoma, a neglected tropical disease (NTDs) caused by bacterium Chlamydia trachomatis, is a leading cause of infectious blindness. Efforts are underway to eliminate trachoma as a public health problem by using the "SAFE" strategy. While mathematical models are now standard tools used to support elimination efforts and there are a variety of models studying different aspects of trachoma transmission dynamics, the "F" component of the strategy corresponding to facial cleanliness has received very little attention so far. In this paper, we incorporate human behavior into a standard epidemiological model and develop a dynamical game during which individuals practice facial cleanliness based
Serological Responses to Trachoma Antigens prior to the Start of Mass Drug Administration: Results from Population-Based Baseline Surveys, North Darfur, Sudan. After years of programmatic inaccessibility, in 2019-2020 the Sudan Federal Ministry of Health Trachoma Control Program conducted population-based trachoma surveys in three localities (districts) in North Darfur state, Sudan . These baseline surveys were to determine the prevalence of trachomatous inflammation-follicular (TF) among children aged 1-9 years and to further use serological markers to understand the historical trachoma burden within this mass drug administration (MDA)-naive area. Trained and certified graders collected trachoma clinical data, and trained nurses collected dried blood spot (DBS) samples. The DBSs were
District-Level Forecast of Achieving Trachoma Elimination as a Public Health Problem By 2030: An Ensemble Modelling Approach. Assessing the feasibility of 2030 as a target date for global elimination of trachoma, and identification of districts that may require enhanced treatment to meet World Health Organization (WHO) elimination criteria by this date are key challenges in operational planning for trachoma programmes. Here we address these challenges by prospectively evaluating forecasting models of trachomatous inflammation-follicular (TF) prevalence, leveraging ensemble-based approaches. Seven candidate probabilistic models were developed to forecast district-wise TF prevalence in 11 760 districts, trained using district-level data on the population prevalence of TF in children aged 1-9 years
Trachoma: an underdiagnosed disease revealed by a survey carried out at Jaú, São Paulo. Trachoma is a notifiable disease in the state of São Paulo- Brazil. However, in Jaú, a municipality located in this state, in the last 10 years there are no records of cases. This study purpose is to assess if there are cases of inflammatory trachoma in schoolchildren aged 1 to 9 years in the municipality of Jaú as well if it is possible to detect clusters areas of the disease to establish elimination programs. An epidemiological study was performed in 2018, involving a stratified random sample of schoolchildren aged 1- to 9-year-old, from public day care centers and elementary schools in the municipality of Jaú. A trachoma screening following the criteria of the World Health Organization (WHO
An investigation of trachoma vaccine regimens by the chlamydia vaccine CTH522 administered with cationic liposomes in healthy adults (CHLM-02): a phase 1, double-blind trial. There is no vaccine against the major global pathogen Chlamydia trachomatis; its different serovars cause trachoma in the eye or chlamydia in the genital tract. We did a clinical trial administering CTH522, a recombinant -CAF09b (group E). Intradermal CTH522 (group C) induced high titres of serum IgG anti-CTH522 neutralising antibodies against serovars B (trachoma) and D (urogenital). Topical ocular CTH522 (group B) at day 28 and 112 induced higher total ocular IgA compared with baseline (p<0·001). Participants in all active vaccine groups, particularly groups B and E, developed cell mediated immune responses against
Active trachoma and associated factors in children aged 1 to 9 years living in Sasiga rural districts, East Wallaga Zone, Ethiopia, in 2022: a community- based cross-sectional study. Trachoma, caused by the bacteria Chlamydia trachomatous, is a contagious eye condition that frequently affects children and quickly spreads from child to child and from child to caregiver. The study aimed to assess the distribution of active trachoma and its associated risk factors among children 1-9 years aged in Households of Sasiga Rural District, Western Ethiopia, in 2022. A community-based cross-sectional study was conducted among 577 randomly selected children from March to May 2022. A multistage sampling technique was used. Data was collected through an interviewer-based questionnaire, physical observation
Impact of a School Trachoma Program Emphasizing Facial Cleanliness and Environmental Improvement in Amhara, Ethiopia. The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is the WHO's endorsed approach for eliminating trachoma as a public health problem; however, not all components have been treated equally. Historically, the F and E components have not been prioritized owing to their perceived complexity. With school enrollment increasing in Ethiopia, development of a national school health program that is focused on the F and E components represents an opportunity to strengthen the SAFE strategy in the country. In 2016, the Trachoma Control Program in Amhara, Ethiopia, along with its partners, developed a School Trachoma Program (STP) that offers grade
Severity of Trachomatous Scarring among Adults in Trachoma-Endemic Amhara Region of Ethiopia. Trachomatous scarring has been shown to progress regardless of active ocular Chlamydia trachomatis infection, indicating that scarring drivers may be unrelated to ongoing transmission. Although scarring prevalence is commonly associated with older age and female sex, less is known about other potential contributors to its development. This study identified and assessed risk factors associated with scarring magnitude in a trachoma-endemic setting, utilizing a five-point photographic scale (S0-S4). During 2017 trachoma surveys of Amhara, Ethiopia, photographers captured left and right conjunctival images of adults (ages 15 years and older) from 10 districts. Subsequently, two graders independently assessed
The Epidemiology of Ocular Chlamydia trachomatis Infection within Districts Persistently Endemic for Trachoma in Amhara, Ethiopia. Persistent trachoma is a growing concern to trachoma control programs globally and programs serving Ethiopia specifically. Persistent trachoma is defined as a district with two or more trachoma impact surveys (TISs) at which the prevalence of trachomatous inflammation -follicular (TF) among children ages 1-9 years is ≥5%, the elimination threshold. Because the global target for trachoma elimination as a public health problem is 2030, research is needed to better characterize persistent trachoma. This study described the epidemiology of ocular Chlamydia trachomatis infection, the causative bacteria of trachoma, in seven contiguous districts experiencing persistent
Photographic grading for trachoma diagnosis within trachoma impact surveys in Amhara region, Ethiopia. As countries reach the trachoma elimination threshold and cases of trachomatous inflammation follicular (TF) become rare, it becomes difficult to train survey graders to recognize clinical signs. We assess the use of photography as a grading tool, the efficiency of an in-country grading center
TrachomaTrachoma - Symptoms, diagnosis and treatment | BMJ Best PracticeSkip to main contentSkip to search * About us * Help * Subscribe * Access through your institution * Log inBMJ Best Practice * Help * Getting started * FAQs * Contact us * Recent updates * Specialties * Calculators * Patient leaflets * Videos * Evidence * Drugs * Recent updates * Specialties * Calculators at risk, aim to reduce the reservoir of infection within a population.Occurs predominantly in children. Poor facial cleanliness may be the most important modifiable risk factor in children who develop trachoma.Children who have had multiple or severe episodes of active trachoma may develop cicatricial disease in later life.Trachomatous cicatricial disease is characterised by tarsal conjunctival scarring
Effect of Biannual Mass Azithromycin Distributions to Preschool-Aged Children on Trachoma Prevalence in Niger: A Cluster Randomized Clinical Trial Because transmission of ocular strains of Chlamydia trachomatis is greatest among preschool-aged children, limiting azithromycin distributions to this age group may conserve resources and result in less antimicrobial resistance, which is a potential advantage in areas with hypoendemic trachoma and limited resources. To determine the efficacy of mass azithromycin distributions to preschool-aged children as a strategy for trachoma elimination in areas with hypoendemic disease. In this cluster randomized clinical trial performed from November 23, 2014, until July 31, 2017, thirty rural communities in Niger were randomized at a 1:1 ratio to biannual mass
Prevalence of active trachoma and associated factors among children 1-9 years old at Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia. Trachoma is a public health issue in more than 50 nations worldwide, mainly in Sub-Saharan Africa, where hundreds of millions of people are considered blind. Ethiopia is projected to have 30% of the global active trachoma burden . The frequency of Trachoma Folliculitis in children aged 1 to 9 years old is 30% in the Oromia Region. Therefore, the aim of this study was to assess the prevalence of active trachoma and associated variables among children aged 1 to 9 years old in Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia, December 24-26, 2019. A community-based cross-sectional study was conducted in the Arsi