Mexico eliminates trachoma through decades-long effort

Date Posted: 05/02/2017

The Pan American Health Organization (PAHO), the World Health Organization's (WHO) Regional Office for the Americas, announced that Mexico eliminated trachoma, reducing the list of countries still needing to eradicate the disease to 41. The effort to eliminate trachoma from the country is credited to the "Trachoma Brigades," a group of health professionals formed in 2004 by the Secretary of Health of the State of Chiapas, a southern Mexican state that borders Guatemala, to implement a strategy recommended by WHO to eliminate the disease. The so-called SAFE strategy involves four interventions: [S]urgery for people at imminent risk of blindness; [A]dministration of antibiotics in affected communities to reduce infection in children and to stop transmission; promotion of improved personal hygiene, especially [F]acial hygiene, to prevent community contagion; and improved [E]nvironmental conditions, with increased access to drinking water and sanitation.

One of the oldest contagious diseases known to humans, trachoma "was once extremely common in parts of the United States and accounted for a large proportion of blindness," and its prevalence in the United States did not decline until the 20th century, according to a 2002 article published in Survey of Ophthalmology. The disease, which is transmitted by direct contact with ocular or nasal secretions of infected people or with contaminated objects such as towels, currently affects the most impoverished communities around the world. Brazil, Guatemala, and Colombia are countries that continue to have new cases of trachoma, and PAHO is working with these countries to help strengthen implementation of the SAFE strategy.

In 2004, trachoma was endemic in 246 communities in 5 municipalities of Chiapas, and it affected a little more than 146,000 people. Through the field work conducted by the Trachoma Brigades and the national, state, and community efforts that were supported by international partners, Mexico has succeeded in eliminating this disease. Dey Carol González, coordinator of the Chiapas Trachoma Program, says the brigades have visited communities several times per year to take surveys, conduct eye examinations, identify cases, administer antibiotics, educate children about how to properly wash their faces and eyes, and perform surgeries. "Thus, we reduced the number of cases that were presented at the beginning of the program" from 1,794 in 2004 to 0 in 2016, he explained in the statement issued by PAHO. Through this approach, the country met the international criteria for elimination of trachoma as a public health problem, which are: prevalence of less than 5% in children aged 1 to 9 years and less than one case of trachomatous trichiasis (inverted eyelashes) per 1,000 inhabitants, an achievement that recently received validation from WHO after after an extensive and rigorous process.

"Mexico has shown that it is possible to eliminate poverty-related diseases through an integrated approach and multisectoral actions," said Carissa F. Etienne, director of PAHO. "It is not an easy road; it requires strategic and programmatic change, dedication and major political commitment in the medium and long term." PAHO has created a regional forum with experts from various organizations to provide recommendations and continue toward the goal of the elimination of blindness caused by trachoma in the year 2022. A key partner in this effort, the Dana Center for Preventive Ophthalmology at the Johns Hopkins Wilmer Eye Institute, located in Baltimore, Maryland, has helped train surgeons and health personnel to perform eye surgeries. For more information, contact: Pan American Health Organization, Regional Office for the Americas of the World Health Organization, 525 Twenty-Third Street NW, Washington, DC 20037; phone: 202-974-3000; e-mail: info@paho.org; website: http://www2.paho.org/hq. [Information for this piece was taken from the April 25, 2017, PAHO press release, "How Mexico eliminated trachoma, the leading preventable cause of blindness"; and the September–October 2002 Survey of Ophthalmology article, "The trachoma menace in the United States, 1897–1960," by Shannen K. Allen and Richard D. Semba.]

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