Trachoma

Epidemiological situation

Blinding trachoma is endemic in many of the poorest and most remote areas of 51 countries in Africa, Asia, Central and South America, Australia and the Middle East.

Worldwide, an estimated 2.2 million people are visually impaired as a result of trachoma, of whom 1.2 million are blind. An estimated 232 million people living in trachoma-endemic districts are at risk. More than 21 million have active trachoma and about 7.3 million require surgery for trachomatous trichiasis.

Africa is the worst affected continent: 18 million cases of active trachoma (85% of all cases globally) and 3.2 million cases of trichiasis (44% of all cases globally) are thought to exist in 29 of the 47 countries in WHO’s African Region. Ethiopia and South Sudan have the highest prevalence of active trachoma: in some areas of these countries, active disease is present in more than 50% of children aged 1–9 years and trichiasis affects more than 10% of adults.

The risk of blinding trachoma is greater in women than in men.

Beyond the disability, distress, isolation and stigma that it causes, the economic burden of trachoma on affected individuals and communities is enormous, costing between US$ 2.9 - 5 billion annually, increasing to US$ 8 billion when trichiasis is included. At about US$ 40 per surgery, preventing this economic disaster is very affordable. Thanks in part to a large donation of azithromycin, preventive chemotherapy is also cost-effective.

WHO’s goal is to eliminate trachoma as a public health problem by the year 2020. Elimination of trachoma as a public-health problem is defined as a reduction in the prevalence of trichiasis “unknown to the health system” to less than 1 case per 1000 total population (“known” cases are those in whom trichiasis has recurred after surgery, those who refuse surgery, or those yet to undergo surgery whose surgical date is set); and a reduction in the prevalence of the active trachoma sign “TF” in children aged 1–9 years to less than 5%.