Togo eliminates trachoma as a public health problem

On 28 May 2022, the World Health Organization (WHO) validated Togo as having eliminated trachoma as a public health problem, making it the third country in the WHO African Region, after Ghana and the Gambia, in achieving this milestone. Globally, Togo becomes the thirteenth country in eliminating trachoma as a public health problem.

Trachoma is the leading infectious cause of blindness and is caused by infection with the bacterium Chlamydia trachomatis, which spreads from person-to-person through contaminated fingers, fomites, and flies that come into contact with discharge from the eyes or nose of an infected person. Environmental risk factors for trachoma transmission include poor hygiene, overcrowded households, inadequate access to water and inadequate access to, or use of, proper sanitation facilities.

Trachoma is an endemic disease that mostly affects underserved remote rural communities. Infection mainly affects children, becoming less common with increasing age. Repeated infections in early childhood can result in complications later in life. In adults, women are up to four times more likely than men to be affected by the blinding complications of trachoma, mainly due to close contact with infected children.

Repeated infections in childhood lead to scarring of the inner part of the upper eyelids, which in some individuals leads to one or more eyelashes on the upper eyelids touching the eye, a debilitating condition known as trachomatous trichiasis, or TT, which causes extreme pain with each blink of the eyelids. TT can be managed surgically but, if left untreated, may lead to scarring of the cornea resulting in visual impairment and blindness. Trachoma can be eliminated using the WHO’s SAFE strategy.

Globally, trachoma remains a public health problem in 43 countries, with an estimated 136 million people living in areas endemic for the disease. Trachoma is found mainly in the poorest and most rural areas of Africa, Central and South America, Asia, Australia and the Middle East. The African region is disproportionately affected by trachoma, with 116 million people living in at-risk areas, amounting to around 85% of the global trachoma burden.

Significant progress has been made over the past few years, with the number of people requiring antibiotic treatment for trachoma infection in the WHO African Region falling from 189 million in 2014, to 116 million as of June 2021. Trachoma remains endemic in 26 countries in the region.

Togo and the WHO will continue to closely monitor previously endemic populations, to ensure there is a rapid and proportionate response to any resurgence of disease.

Source: WHO, 28 May 2022