Implications of the COVID-19 pandemic in eliminating trachoma as a public health problem.

Seth Blumberg,Joaquin M Prada,Pamela J Hooper,Anthony W Solomon,Paul Emerson,Travis C Porco,Benjamin Amoah,Anna Borlase,T Déirdre Hollingsworth,Michael S Deiner,Thomas M Lietman

doi:10.1093/trstmh/traa170

Abstract

BackgroundProgress towards elimination of trachoma as a public health problem has been substantial, but the coronavirus disease 2019 (COVID-19) pandemic has disrupted community-based control efforts.MethodsWe use a susceptible-infected model to estimate the impact of delayed distribution of azithromycin treatment on the prevalence of active trachoma.ResultsWe identify three distinct scenarios for geographic districts depending on whether the basic reproduction number and the treatment-associated reproduction number are above or below a value of 1. We find that when the basic reproduction number is <1, no significant delays in disease control will be caused. However, when the basic reproduction number is >1, significant delays can occur. In most districts, 1 y of COVID-related delay can be mitigated by a single extra round of mass drug administration. However, supercritical districts require a new paradigm of infection control because the current strategies will not eliminate disease.ConclusionsIf the pandemic can motivate judicious, community-specific implementation of control strategies, global elimination of trachoma as a public health problem could be accelerated.

Highlights

Trachoma remains a major cause of preventable blindness, in sub-Saharan Africa
For elimination of trachoma as a public health problem, the World Health Organization (WHO) requirements include that the prevalence of trachomatous inflammation– follicular (TF) in children be reduced to
To simulate the prevalence of trachoma infection and estimate the delay in control caused by the COVID-19 pandemic we developed a simple model for trachoma transmission among children

Summary

Introduction

Trachoma remains a major cause of preventable blindness, in sub-Saharan Africa. Substantial reduction in the global prevalence of trachoma has been achieved, but the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruption of public health programs that combine surveillance of disease transmission with treatment for endemic districts. Since transmission cannot be measured directly, the World Health Organization (WHO) recommends monitoring trachoma by assessing the prevalence of trachomatous inflammation– follicular (TF) in the upper tarsal conjunctiva of children 1–9 y of age.[1,2] For elimination of trachoma as a public health problem (termed trachoma ‘control’ ), the WHO requirements include that the prevalence of TF in children be reduced to

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Conclusion