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TRACHOMA UPDATE SERIES The Trachoma Update series is kindly sponsored by the International Trachoma Initiative, www.trachoma.org We have ‘a very good chance’ of eliminating blinding trachoma by 2020 Elizabeth Kurylo er Communications Manager: International Pfi z Terkaucrhyolmo@a Itnaitsiaktfioverc, eD.eocragtur, USA. uezf for q az Former US President Jimmy Carter, m V speaking at the 15th anniversary of Willia Pfizer’s donation of Zithromax® in New York on 5th November 2013, said: "With the help of Pfizer, we are trying to eliminate blinding trachoma from the face of the earth by 2020. I think we have a very good chance of reaching this goal." During the past 15 years, Pfi zer – through the International Trachoma Initiative (ITI) – has donated more than 340 million doses of Zithromax® to 28 countries in Africa and Asia. After years of untreated trachoma infection, the eyelids turn inward and the eyelashes scrape the cornea with every Former President Jimmy Carter (left) with Pfizer CEO Ian Read and Pfizer Senior blink, causing pain and gradual loss of Director of Social Investments Kimberly Lewis at an event to mark the 15th vision from scarring of the cornea. An anniversary of Pfizer’s donation of Zithromax(R) to combat trichoma estimated 320 million people worldwide are at risk of contracting trachoma. tional alliance for elimination of blindness demonstrate the world can end blinding Mark Rosenberg, Director of the Task from trachoma implements the SAFE trachoma". He continued: “Millions of Force for Global Health, which includes strategy, approved by the WHO, to prevent people worldwide will be spared the the ITI programme, said: "Many of those and treat trachoma. SAFE stands for: injustice, indignity and pain of their eye- at risk are children and their mothers Surgery for the inturned eyelashes lashes scratching and scarring their eyes.” living in the poorest villages in the world (trichiasis); Antibiotics to treat active Pfi zer CEO Ian Read said Jimmy Carter’s with inadequate clean water and infection; promotion of Facial cleanliness; support is key to the success of trachoma sanitation, but trachoma can be and Environmental improvements, elimination, and Carter concluded: "Once prevented, treated and eliminated." including better water supply and latrines people in a village know what needs to be Pfi zer and the International Coalition to reduce the spread of disease by fl ies. done to get rid of trachoma, they are for Trachoma Control (ICTC), which President Carter said Pfi zer’s donation much more eager than any of us in this includes the Carter Center and ITI, of Zithromax® was "momentous in room to see it done." support the Global Alliance for the trachoma control", and added that it For 2014, the Trachoma Expert Elimination of Trachoma by the year 2020 allowed the Carter Center and other inter- Committee of ITI has approved 63 million (GET 2020), an initiative led by the World national nongovernmental organizations doses of Zithromax® for treatment of Health Organization (WHO). This interna- to "get the medicine into the villages and trachoma in 23 countries. Approaching elimination: Mali’s post-endemic surveillance strategy In Mali, the prevalence of trachoma in ≤ 10% in children aged 1–9 years. • If ≥10% of the children have TF, then 43 out of the originally 51 trachoma The surveillance method involves the entire health district/area is treated. endemic districts is low enough so that selecting two or four villages in each To date, this post-endemic surveillance mass drug administration (MDA) at the area in which to do a more detailed strategy has been implemented in 19 district level is no longer warranted. The investigation. If the population in the districts, and will be scaled up dramati- National Blindness Prevention Programme area is less than 200,000, two villages cally as Mali approaches the elimination in Mali began piloting an innovative are chosen, and if it is between date of 2015. It is seen as a cost- post-endemic surveillance protocol in 200,000 and 400,000, four villages are efficient strategy since it integrates 2011 to assess whether high-prevalence chosen. surgical camps and active infection pockets of active infection exist within In each village, 50 children under the districts that are eligible to stop district- surveillance. Having strong and cost- age of 10 are examined for TF. level MDA. The assessment is integrated efficient surveillance mechanisms in into surgical camps led by teams of • If < 5% of children examined have TF, place to detect areas with a high preva- surgeons that come from the capital and only the children with TF, their families, lence of trachoma is critical to reaching travel to areas where trachoma is endemic. and surrounding neighbours are full trachoma elimination. Post-endemic surveillance is treated with antibiotics (azithromax). With thanks to Sanoussi Bamani, Seydou Goita, conducted in districts where the preva- • If 5–9.9% of the children have TF, then Yaya Kamissoko, Sadi Moussa, Sidi Coulibaly, lence of follicular trachoma (TF) is the entire village is treated. Aryc W Mosher, and Emily Toubali. © The author/s and Community Eye Health Journal 2013. This is an Open Access article distributed under the Creative Commons Attribution Non-Commercial License. CEHJ84_OA.indd 18 16/12/2013 16:20