Informal consultation on end-game challenges for trachoma elimination, Task Force for Global Health, Decatur, United States of America, 7–9 December 2021
World Health Organization
Apr 2022 · World Health Organization
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About this ebook
Using the WHO-recommended “SAFE” strategy (surgery, antibiotics, facial cleanliness, environmental improvement), considerable progress is being made towards global elimination of trachoma as a public health problem. However, it has become apparent that in a small proportion of districts, despite apparently high-quality local implementation of the SAFE strategy, achieving the active trachoma criterion of elimination as a public health problem has been difficult to achieve. Such districts fall into at least two categories: (1) those in which the prevalence of trachomatous inflammation—follicular in 1–9-year-olds (TF1–9) continues to hover above the elimination threshold of 5% despite interventions; and (2) those in which TF1–9 5% is achieved but subsequently returns to ≥5% during the two-and-a-half-year period of surveillance after antibiotic mass drug administration ceases. How these districts should be managed is presently unclear. Uncertainty is deepened by programmatic reliance on TF1–9 as the WHO-recommended indicator for decision-making; TF prevalence is known to be a lagging marker as the prevalence of infection with trachoma’s causative organism, iChlamydia trachomatis/i, declines, and would likely also lag behind population-level infection recrudescence, too. Health ministries and their partners are keen to find solutions to this problem.brbrIn December 2021, WHO’s Department of Control of Neglected Tropical Diseases convened an informal consultation to allow discussion of the way forward with respect to this issue. This document is the meeting report.
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