Toward eliminating trachoma in Ethiopia
While trachoma continues to retreat on a global level, it is now clear that elimination will require more time in parts of the world where the disease burden is very high and the SAFE strategy is harder to implement due to insecurity, remoteness, lack of infrastructure, and entrenched poverty. In some of those places, trachoma is now being referred to as “persistent” by epidemiologists. ITI collaborates with partners to implement the SAFE strategy in places such as Ethiopia, which is the country most affected by trachoma. According to the International Coalition for Trachoma Control, as of May 2019, Ethiopia alone represented 51% of the global burden of the disease.
Hope, however, is coming from ongoing research on the effectiveness of azithromycin. Although currently suspended due to COVID-19, a clinical trial — led by The Carter Center and Emory University together with Ethiopia’s federal and health ministries — will measure the effectiveness of repeated rounds of antibiotics administered to children on reducing the community prevalence of trachoma.
This is important given that children are known to be the reservoir of disease and if the disease burden can be greatly decreased more efficiently in children through enhanced antibiotic administration, then the community burden will also decrease.
“This program was built on the best educated guess at the time, and that best educated guess was once-per-year treatment. However, that was 20 years ago and we have learned so much — and shared so much through peer-reviewed publications that we currently know that once per year in some of the highest disease burden areas is not appropriate, data-driven, or impact-oriented,” said Kelly Callahan, director of the trachoma program at The Carter Center.