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Can we eradicate trachoma? A survey of stakeholders
  1. Catherine E Oldenburg1,2,
  2. Solomon Aragie3,
  3. Abdou Amza4,5,
  4. Anthony W Solomon6,
  5. Jessica Brogdon7,
  6. Benjamin F Arnold1,7,
  7. Jeremy D Keenan1,2,7,
  8. Thomas M Lietman1,2,7
  1. 1 Department of Ophthalmology, University of California, San Francisco, California, USA
  2. 2 Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
  3. 3 The Carter Center, Addis Ababa, Ethiopia
  4. 4 Faculté Des Sciences De La Santé, Université Abdou Moumouni De Niamey, Niamey, Niger
  5. 5 Programme National De Santé Oculaire, Niamey, Niger
  6. 6 Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
  7. 7 F.I. Proctor Foundation, University of California, San Francisco, California, USA
  1. Correspondence to Catherine Oldenburg, 513 Parnassus Ave, Box 0412, San Francisco, CA 94143, USA;catherine.oldenburg{at}ucsf.edu

Abstract

Background/Aims Although tremendous progress towards the 2020 goal of global elimination of trachoma as a public health problem has been made, it will not be achieved. Future targets are now being considered. One option is changing the goal to eradication. We surveyed trachoma experts to assess beliefs related to trachoma eradication and determine perceived obstacles to achieving it.

Methods We conducted a survey at the beginning of a trachoma eradication session at the 2019 Coalition for Operational Research on Neglected Tropical Diseases meeting in National Harbor, Maryland, USA. We asked respondents what the most important goal of azithromycin mass drug administration was for trachoma (control, elimination of infection or eradication) and if and when they believed trachoma eradication would occur. We then asked what the biggest obstacles were to global eradication.

Results Fifty-six surveys were returned (95%). Most (91%) participants reported that the most important goal of azithromycin mass drug administration was control or elimination of infection, and 24% of participants reported that global eradication was not possible. Of the 76% who reported a year by which they believed trachoma could be eradicated, most fell between 2040 and 2050. Commonly cited barriers to global eradication included lack of surveillance tools to confirm eradication or monitor for infection recrudescence (32%) and lack of resources (23%).

Conclusions Development of alternative indicators for trachoma surveillance and continued investment in trachoma programmes, particularly focused support in the most heavily affected populations, might increase enthusiasm for the feasibility of eradication.

  • Cornea
  • Epidemiology
  • Infection
  • Public health
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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Twitter AnthonyW.Solomon@anthonywsolomon and CatherineE.Oldenburg@CatieOldenburg.

  • Contributors CO, TML: study design, acquisition of data, interpretation of data, drafting article. SA, AWS, JB, BFA, JDK: study design, acquisition of data, interpretation of data, critical revision of article. AA: study design, interpretation of data, critical revision of article.

  • Funding CO was supported by a Research to Prevent Blindness Career Development Award (no award number).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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