Abstract
BackgroundThere remains a lack of epidemiological data on the geographical distribution of trachoma to support global mapping and scale up of interventions for the elimination of trachoma. The Global Atlas of Trachoma (GAT) was launched in 2011 to address these needs and provide standardised, updated and accessible maps. This paper uses data included in the GAT to describe the geographical distribution and burden of trachoma in Africa.MethodsData assembly used structured searches of published and unpublished literature to identify cross-sectional epidemiological data on the burden of trachoma since 1980. Survey data were abstracted into a standardised database and mapped using geographical information systems (GIS) software. The characteristics of all surveys were summarized by country according to data source, time period, and survey methodology. Estimates of the current population at risk were calculated for each country and stratified by endemicity class.ResultsAt the time of writing, 1342 records are included in the database representing surveys conducted between 1985 and 2012. These data were provided by direct contact with national control programmes and academic researchers (67%), peer-reviewed publications (17%) and unpublished reports or theses (16%). Prevalence data on active trachoma are available in 29 of the 33 countries in Africa classified as endemic for trachoma, and 1095 (20.6%) districts have representative data collected through population-based prevalence surveys. The highest prevalence of active trachoma and trichiasis remains in the Sahel area of West Africa and Savannah areas of East and Central Africa and an estimated 129.4 million people live in areas of Africa confirmed to be trachoma endemic.ConclusionThe Global Atlas of Trachoma provides the most contemporary and comprehensive summary of the burden of trachoma within Africa. The GAT highlights where future mapping is required and provides an important planning tool for scale-up and surveillance of trachoma control.
Highlights
The last decade has witnessed tremendous progress towards the global elimination of trachoma, the leading infectious cause of blindness worldwide
The aim of this paper is to describe the geographical distribution of trachoma in Africa using existing data from the Global Atlas of Trachoma and estimate the burden of disease in Africa
This diagnosis is based on ocular examination, usually using the 1987 WHO simplified grading system, to identify the presence of key clinical signs [9]: trachomatous inflammation–follicular (TF) in children aged 1–9 years and trachomatous trichiasis (TT) in adults aged over 14 years
Summary
The last decade has witnessed tremendous progress towards the global elimination of trachoma, the leading infectious cause of blindness worldwide. For some countries, especially those in Africa, there still remains a lack of epidemiological data on the geographical distribution of trachoma and efforts are required to first complete the global trachoma map, to keep it updated as interventions begin to take effect. This will help inform where and when to start and stop trachoma control efforts.
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