Trachoma is estimated to affect approximately 500 million
people,
primarily in rural communities of the developing world and in the
arid
areas of tropical and subtropical zones. Approximately 6-9
million*
people are blind from trachoma, and many more have suffered partial
loss of vision.
Trachoma can be controlled, and blindness and visual loss can
be
prevented by appropriate application of relatively simple and
inexpensive measures. Therefore, communities with uncontrolled
trachoma should be identified so that appropriate control measures
can
be implemented. Such communities are likely to be found in
countries
where blindness rates are above the range of 0.5%-1%, and where
more
than 1%-2% of the population are blind from all causes.
In recent years, preventable and easily curable blindness has
been
recognized as a combatible public health problem. The need for
blindness prevention has led to a renewed interest in trachoma and
associated infections, which are still the most important causes of
preventable blindness in the world.
In 1975, the Twenty-Eighth World Health Assembly, in a
resolution
on the prevention of blindness, requested the Director General of
the
World Health Organization "to encourage member countries to develop
national programmes for the prevention of blindness, especially
aimed
at the control of trachoma, xerophthalmia, onchocerciasis, and
other
causes, and to introduce adequate measures for the early detection
and
treatment for other potentially blinding conditions such as
cataract
and glaucoma."
Trachoma-control programs must be aimed primarily at those
severely affected communities where the disease leads to blindness.
In planning and implementing control programs, consideration must
be
given to the simultaneous introduction of other specific measures
for
dealing with all causes of avoidable blindness. In recent years,
knowledge about the causative agent of trachoma and about the
epidemiologic patterns that determine the intensity of inflammation
and the gravity of disease has increased substantially. This new
information has led to a clearer definition of risk for the
individual
and for the community and has made it possible to distinguish
communities with "blinding trachoma" from those with "non-blinding
trachoma." In view of these developments and the importance of
trachoma control in the prevention of blindness, a revised guide to
trachoma control has been prepared (1).
This new field guide presents simple and effective methods
suitable for widespread implementation in underserved communities
with
blinding trachoma. It stresses the importance of maximum
participation of the people themselves in promotion of health care
for
the prevention and cure of blinding trachoma. This approach makes
the
best possible use of available but limited resources and is in
accord
with the defined health objectives and reorientation of health
activities found in the Declaration of Alma-Ata on Primary Health
Care.
The guide also outlines basic principles for the organization
of
trachoma-control programs. It summarizes present knowledge on the
epidemiologic and clinical aspects of the disease, explains the
most
commonly used approach of large-scale trachoma treatment through
control of infection transmission, and describes the more intensive
treatment of individual cases. It also contains recommendations on
training activities, health education, evaluation of results, and
monitoring of programs. The basic methods described can be
suitably
adapted to local conditions and should allow the swift and
effective
implementation of trachoma-control programs.
Reported by WHO Weekly Epidemiological Record 1982;57:189-90.
Reference
World Health Organization. Guide to trachoma control. Geneva:
World Health Organization 1981.
*Estimate endorsed by the WHO Programme Advisory Group on the
Prevention of Blindness in February 1982.
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