Technical consultation on trachoma surveillance

Overview

Based on disease prevalence, several national trachoma programmes have now discontinued one or more components of the intervention strategy against trachoma1 and are ready to initiate trachoma surveillance. The role for surveillance in this context is to provide some level of certainty that elimination prevalence targets have been sustainably achieved, following the first assessment that demonstrates their attainment, by revealing disease re-emergence if (and only if) reemergence is occurring.

The trachoma surveillance guidance previously provided by the World Health Organization (WHO), presented in the 2008 report on the “Meeting on Post-Endemic Surveillance for Blinding Trachoma”, is excerpted in Annex A. Unfortunately, as noted at an informal meeting on trachoma surveillance held in conjunction with the 13th International Symposium on Human Chlamydial Infections in June 2014, that guidance is perceived both to be difficult to implement in a standardized way, and to lack an evidence base that might promote confidence in its sensitivity and specificity for detecting disease re-emergence. The brief for the present consultation, held in September 2014, was to revise, where indicated, the WHO guidance on the nature and frequency of surveillance data that programmes should collect and compile in order to successfully declare elimination of blinding trachoma as a public health problem.