The Global Trachoma Mapping Project

In the largest disease-mapping project ever conducted, health workers trained by the Global Trachoma Mapping Project have already examined the eyelids of more than 1 million people in nearly 1,000 districts since December 2012. The data collected are being used to create the first truly complete global map of trachoma and trichiasis, due in March 2015. Data on the prevalence of trachoma and trichiasis at country and district level are vital in order to plan public health interventions and to mobilise resources. The public health interventions are based on the SAFE strategy for trachoma elimination, a strategy endorsed by the World Health Organization (WHO). SAFE is short for Surgery, Antibiotics, Facial cleanliness and Environmental improvement. It involves offering individuals with trichiasis – the blinding consequence of trachoma – a surgical procedure to stop their lashes being in contact with the eyeball. In populations with active trachoma, SAFE also involves offering antibiotics, education (about facial cleanliness and other good hygiene practices) and environmental improvement to reduce the carriage and transmission of the bacterium that causes trachoma. In order to plan surgical services adequately, it is useful to know the prevalence of trichiasis: that is, where there are people with trichiasis and approximately how many are affected. To plan antibiotic distribution, facial cleanliness, education and improvements in water and sanitation for trachoma control purposes, it is essential to know the prevalence of active trachoma. This information must be collected at health district level, because health districts (populations of 100,000– 250,000) are the units in which SAFE is usually put into practice.