a doctor administers treatment to child

Trachoma

Trachoma is the world's leading infectious cause of blindness.

Trachoma is a bacterial eye infection caused by the bacterium Chlamydia trachomatis. It is spread through contact with infected eye and nose secretions, often through direct personal contact, shared towels or cloths, as well as eye-seeking flies.

Repeated infection can develop into a condition known as trichiasis, in which scarring and inward turning of the eyelid causes the eyelashes to scrape against the cornea of the eye. If left untreated, this painful condition can result in permanent blindness.

According to the World Health Organization (WHO), more than 190 million people in 41 countries are at risk for trachoma. Trachoma is responsible for the visual impairment of an estimated 1.9 million people worldwide, half a million of whom are irreversibly blind. Trachoma is commonly found in areas with limited access to adequate water, sanitation and basic hygiene.

Impact
  • Trachoma can result in loss of vision, blindness, loss of social status and stigmatization and can place a tremendous economic burden on individuals, families and communities.
  • Research suggests children have higher rates of trachoma infection than other age groups. In endemic areas, prevalence rates can be as high as 60 percent to 90 percent among school-aged children.
  • Women are blinded two to three times more often than men, likely due to their close contact with infected children and their resulting greater frequency of infection episodes.
  • An estimated 7.3 million require surgery for trachomatous trichiasis.
  • Blindness from unoperated trachomatous trichiasis strikes adults in their prime years (30–40 years of age), hindering their ability to care for themselves and their families.
  • The disease's long-term effects can have an impact on multiple generations of families.
  • Globally, trachoma causes between an estimated US$ 3—6 billion loss in productivity per year.

Learn more at the WHO Trachoma page

USAID’s support for trachoma elimination has resulted in an estimated 84.6 million people no longer at risk.

WHO recommends the SAFE strategy to eliminate trachoma. The SAFE strategy is a comprehensive public health approach that combines treatment (Surgery and Antibiotics) with prevention (Facial cleanliness and Environmental improvement), to reduce the occurrence of trachoma.

The Agency provides technical and financial support to countries in their efforts to eliminate infectious blinding trachoma as a public health problem. The primary focus of Agency support is on scale-up of mass drug administration with antibiotics (the “A” component of the SAFE strategy) in communities at risk. The Agency also provides support to countries to assist with the surgical component of the SAFE strategy, with a focus on high-quality treatment and care.

Global scale-up of the SAFE strategy requires dynamic public-private partnerships. The Agency works closely with a broad range of public and private partners dedicated to the global elimination of trachoma, including Pfizer, Inc., which has donated more than 500 million Zithromax® treatments to countries in support of the “A” component of the SAFE strategy.

Technical Guidelines

Trachoma Control: A Guide for Program Managers (WHO) [PDF, 424KB]

Preferred Practices for Zithromax® Mass Drug Administration [PDF, 5.6MB]

Trachoma Action Planning: A Planning Guide [PDF, 2.5MB]

Validation of Elimination of Trachoma as a Public Health Program [PDF, 424KB]

Design and Validation of a Trachomatous Trichiasis-only Survey [PDF, 1.1MB]

Policy and Advocacy Documents

The End in Sight: 2020 INSight [PDF, 1.6MB]

Water Sanitation and Hygiene for Accelerating and Sustaining Progress on Neglected Tropical Diseases – A Global Strategy 2015–2020

USAID Project Resources and Links (ENVISION/END in Africa/MMDP)

ENVISION website trachoma page

END in Africa website

MMDP Project website

Meeting Reports

Technical Consultation on Trachoma Surveillance: Meeting Report

Report of the 18th Meeting of the WHO Alliance for the Global Elimination of Trachoma by 2020 (Addis Ababa, 28–29 April 2014) [PDF, 748KB]

Training and Tools

Training: WHO Integrated NTD Programme Managers’ Course

Webinar: Assessing MDA Coverage: Are We Getting the Coverage We Need? (USAID Envision Project/RTI)

Tracking Geographic Coverage of TT Management Services (USAID MMDP Project/Helen Keller International) [PDF, 305KB]

Monitoring of Surgical Quality, Patient Satisfaction, and Data Quality during the 3–6-month Period Following Trichiasis Surgery (USAID MMDP Project/Helen Keller International) [PDF, 610KB]

Organizing Trichiasis Surgical Outreach – a Preferred Practice for Program Managers (International Coalition for Trachoma Control)

Useful Resource

Trachoma infographic from pfizer