WHO criteria for intervention against and elimination of trachoma as a public health problem
| Interventions | Population group surveyed | Sign measured | Decision |
| Criteria for initiation of trachoma elimination programmes (district level): baseline survey | |||
| AFE | Children aged 1–9 years. | TF | <5%=no intervention (active trachoma not a public health problem). 5%–9.9%=1 year of AFE, then impact survey. 10%–29.9%=3 years of AFE, then impact survey. ≥30%=5 years of AFE, then impact survey. |
| S | Adults aged 15 years and above. | TT | <0.2%=no public health-level intervention (TT not a public health problem). ≥0.2%=community-based TT management programme. |
| Criteria for cessation of interventions (district level): impact survey | |||
| AFE | Children aged 1–9 years. | TF | <5%=discontinue A, maintain F&E. 5%–9.9%=1 year of AFE, then impact survey. 10%–29.9%=3 years of AFE, then impact survey. ≥30%=5 years of AFE, then impact survey. |
| S | Adults aged 15 years and above. | TT | <0.2%=discontinue community-based TT management; strengthen facility-based management. ≥0.2%=continue community-based TT management programme. |
| Criteria for elimination (district level): surveillance survey | |||
| AFE | <5% TF in children aged 1–9 years. | ||
| S | <0.2% of unmanaged TT in adults aged 15 years and above.* | ||
*WHO.26
†Standardised trachoma prevalence surveys paved the way for evidence-based planning.
‡Practical planning with trachoma elimination as the goal enabled scale-up of interventions to be undertaken as quickly as possible, while keeping within capacity restraints and maximising strengthening of local health systems.
§Government, partner and donor support can be maintained through to projected elimination dates, but concerns about reaching the ‘end game’ persist.
AFE, antibiotics, facial cleanliness, environmental improvement; S, surgery; TF, trachomatous inflammation-follicular; TT, trachomatous trichiasis.