The WHO confirms Saudi Arabia for the elimination of trachoma as a public health problem

On January 26, 2022, the World Health Organization (WHO) confirmed to Saudi Arabia that it had eliminated trachoma as a public health problem.¹making it the fourth country in the WHO region of the eastern Mediterranean to reach this milestone.

“This is an extraordinary achievement that has saved people from preventable visual impairment or blindness. It’s about improving the quality of life and well-being, ” said Dr. Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean.
“Success stories like this encourage and help us eliminate more diseases in our region.”

Saudi Arabia’s success in combating trachoma is largely attributed to the integration of its national eye care program with primary health care services and through cross-sectoral cooperation, including close cooperation with the Ministry of Education and the Ministry of Environment, Water and Agriculture.

Saudi Arabia and the WHO will continue to closely monitor previously endemic areas to ensure a rapid, proportionate response to each recurrence.

Trachoma – the world’s leading contagious cause of blindness – remains endemic in five WHO countries in the eastern Mediterranean region, but progress has significantly reduced the number of people in need of antibiotic treatment by 28 million from 39 million in 2013 to 11 million in 2020. years.

Disease

Trachoma is a devastating eye disease caused by a bacterial infection Chlamydia trachomatis. The infection spreads from person to person through contaminated fingers, fomites and flies that have come in contact with the discharge from the eyes or nose of an infected person.

Environmental risk factors for trachoma transmission include poor hygiene, overcrowding of households, and inadequate access to water and sanitation.

Recurrent infections in childhood lead to the formation of scars on the inside of the upper eyelids, resulting in turning the edge of the eyelid inward, with the lashes touching the eyeball. This painful condition is known as trachomatous trichiasis – if left untreated, it can result in vision impairment and blindness.

To remove trachoma, the WHO recommends a SAFE strategy² achieve the elimination of trachoma as a public health problem.

Progress in the fight against trachoma and other neglected tropical diseases alleviates the human and economic burden imposed on the world’s most vulnerable communities.

Globally, Saudi Arabia joins 11 other countries that the WHO has confirmed have eliminated trachoma as a public health problem. These are Cambodia, China, the Islamic Republic of Iran, the Lao People’s Democratic Republic, the Gambia, Ghana, Mexico, Morocco, Myanmar, Nepal and Oman.

The NTD 2021-2030 roadmap aims to prevent, control the elimination and eradication of 20 diseases and disease groups by 2030.

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¹Elimination of trachoma as a public health problem is defined as:

• (i) a prevalence of trachomatous trichiasis “unknown to the health system” of <0.2% in adults aged ≥15 years (approximately 1 case per 1000 total population), in each former endemic district;
• (ii) prevalence of trachomatous follicular inflammation in children aged 1-9 years <5%, maintained for at least 2 years in the absence of mass antibiotic treatment, in each previously endemic district; and
• (iii) the existence of a system that can identify and manage trachomatous trichiasis incidents, using defined strategies, with evidence of adequate financial resources to implement those strategies

²The SAFE strategy consists of: Surgery to treat the blinding phase (trachomatous trichiasis); Antibiotics to eliminate infection, in particular the mass use of the antibiotic azithromycin, donated by the manufacturer, Pfizer, to elimination programs through the International Trachoma Initiative; Facial cleanliness; and improving the environment, especially improving access to water and sanitation.