Trachoma is the world’s leading infectious cause of blindness and one of 20 diverse conditions defined by WHO as neglected tropical diseases. Trachoma affects people living in the poorest areas of the world, often with limited access to clean water, sanitation and health services.
Trachoma is caused by the bacterium Chlamydia trachomatis, which presents in young children as a chronic inflammation of the eyelid: trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI). Repeated re-infection can cause scarring of the eyelid, which leads to entropion and trichiasis; the in-turning of the eyelid with painful contact between eyelashes and the eyeball (trachomatous trichiasis or TT) and scarring of the cornea. The combination of repeated cornea trauma and secondary infections can cause severe pain and may ultimately lead to corneal opacification and blindness.
To combat trachoma, WHO has endorsed a comprehensive package of interventions known as the SAFE strategy (Surgery, Antibiotics, Facial Cleanliness and Environmental Improvement). In 1998, the World Health Assembly adopted Resolution WHA 51:11, targeting trachoma for global elimination. The resolution called on Member States to implement the WHO-endorsed SAFE strategy and consider all possible intersectoral approaches for community development in endemic areas, particularly for greater access to clean water and basic sanitation for the populations concerned. The resolution also called for Member States to actively collaborate through the WHO Alliance for the Global Elimination of Trachoma (GET2020 Alliance) - formed in 1996 - to provide technical leadership and coordination to the international efforts aiming to eliminate trachoma as a public health problem.
Trachoma is targeted for elimination as a public health problem in the global NTD road map by 2030.
Elimination as a public health problem in this instance is defined as:
(i) a prevalence of trachomatous trichiasis “unknown to the health system” of <0.2% in adults aged ≥15 years and
(ii) a prevalence of trachomatous inflammation—follicular in children aged 1–9 years of <5%, sustained for at least two years in the absence of ongoing antibiotic mass treatment, in each formerly endemic district; plus
(iii) the existence of a system able to identify and manage incident trachomatous trichiasis cases, using defined strategies, with evidence of appropriate financial resources to implement those strategies.
- Find out more about the SAFE strategy
- For more information about the story of trachoma, read Katherine Schlosser's article on the history of trachoma.
- Trachoma - a devastating infectious eye disease made by Dr Ranil Appuhamy