Analysis: Tackling Trachoma Through a Three-pronged Approach

Thursday, 25 Mar 2021

Analysis: tackling trachoma through a three-pronged approach


What is trachoma?

Trachoma is an eye disease caused by infection from personal contact (hands, clothes, or bedding) and by flies. Reinfection over time can result in the eyelashes rubbing on the surface of the eye causing damage to the cornea and resulting in permanent blindness. According to the WHO, trachoma is a public health concern in 44 countries, and affects the vision of about 1.9 million people, while another 137 million people live in trachoma endemic areas, and are at risk of contracting trachoma. Treating trachoma involves a number of steps, which spell out the acronym SAFE:

  • Surgery for advanced cases of the disease;
  • Antibiotics to clear the bacterial infection;
  • Facial cleanliness and personal hygiene;
  • Environmental improvement to prevent further spread of the disease.

The WHO estimates that in 2019 more than 95.2 million people were able to access trachoma treatment and support, and CBM is glad to be able to contribute towards this positive change. Our dedicated trachoma project in Amhara, Ethiopia aims to eliminate trachoma from the region.

CBM recognises just how vital it is to do more than just treat trachoma where it occurs, but also support the local healthcare workers to improve education around the transmission of the disease and what steps can be taken to improve personal hygiene and environmental factors. Training these healthcare workers and community groups helps address the underlying causes and helps prevent future spreads of the disease. For these reasons, CBM prioritises a three-pronged model.


Addressing the symptoms: trachoma treatment

CBM’s project has set trachoma screening and treatment targets and tracks follow-up consultations to reduce the prevalence of trachoma in the community.  The project team run health education sessions with the community on the transmission, treatment and prevention of trachoma. COVID-19 prevention messages have been seamlessly integrated into these education sessions  – given they both have a focus on personal hygiene.


For people already affected by trachoma, getting access to surgery and medication will prevent blindness. Follow-up appointments ensure we track that treatment was effective. We support the upskilling of local health workers to screen and refer patients for further treatment.


Addressing the underlying causes: improving sanitation and hygiene

Part of the challenge of trachoma is to reduce the spread of the infection through improving community sanitation and hygiene practices. Flies can carry the bacteria so the challenge is to prevent flies accessing contaminated water and waste.  Improving community water supplies through installing improved bore water and wells has been a focus. Our teams have also focussed on changing people’s behaviour regarding hygiene and working with communities to improve latrine access and reduce open defecation.


The provision of safe water and latrines has led to an increase in girls attending schools and women no longer have to cover vast distances to fetch safe water, where they were at risk from assault and animal attacks, including hyenas.


Future-Focused: upskilling community health workers

Providing further training for community health workers and the formation of local water sanitation and hygiene committee (WASHCOs) will ensure the community continues to reduce the prevalence of trachoma in the regions.


Following training, 20 committees have taken over management and maintenance of the clean water schemes and sanitation facilities. Female village hygiene educators (VHEs) have also been trained up to assist the WASHCOs on raising awareness about the importance of good hygiene and sanitation. Water infrastructure maintenance training has also been provided by the government.


Changes are evident everywhere: in the facial cleanness of children, better water management, and sanitation of the communities had improved.


“I am the eyewitness of the project in prevention and control of trachoma. I was a person with disabilities because I lost my sight due to trachoma. But now I’ve got my sight back and lead my life properly. Similarly, many women get back their sight and live comfortably. We receive eye treatment and medication. We also received proper health education to prevent trachoma.” – female beneficiary


CBM Australia acknowledges the support of the Australian Government through the Australian NGO Cooperation Program (ANCP).




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