Situation and trends
Trachoma is the leading infectious cause of blindness, and also one of the neglected tropical diseases. It is responsible for the visual impairment of about 2.2 million people, of whom 1.2 million are irreversibly blind. Globally, 53 countries are assessed or estimated to be endemic for blinding trachoma. Trachoma results from ocular infection with the bacterium Chlamydia trachomatis which is spread by direct contact with eye and nose discharges from infected individuals or by contact with fomites (inanimate objects that carry infectious agents) such as towels and/or washcloths. Eye-seeking flies can also be a route of mechanical transmission. The number of people living in trachoma endemic districts is estimated to be reduced from 317 million in 2010 to 241 million in 2012; this reduction is attributable to the number of districts that were surveyed and found with active trachoma below the set threshold (<5% TF–TI in children aged 1–9 years) and to the successful implementation of the SAFE strategy in most of the endemic districts in the world. In 2012, 28 countries reported data on implementation of SAFE Strategy (Surgery, Antibiotic treatment, Facial cleanliness, Environmental improvement) worldwide – 48.8 million people received treatment with antibiotic for preventing and curing active trachoma, and 169 thousand people were operated for trachomatous entropion trichiasis. In 2012, several countries (the Gambia, Ghana, Morocco, Myanmar, Oman and Viet Nam) reported to WHO the achievement of the intervention targets for the elimination of blinding trachoma as a public health problem (i.e. <1 case of trichiasis per 1000 population and a prevalence of active trachoma (grade TF) in children aged 1–9 years of <5%).