On 26 January 2022, the World Health Organization (WHO) validated Saudi Arabia for having eliminated trachoma as a public health problem1, making it the fourth country in WHO’s Eastern Mediterranean Region to achieve this milestone.
“This is a remarkable achievement that has saved people from preventable visual impairment or blindness. It is about improving quality of life and well-being,” said Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean.
“Such success stories are encouraging and help us to eliminate more diseases in our Region.”
Saudi Arabia’s success against trachoma is largely attributed to integrating its national eye care programme with primary health care services and through cross-sector collaboration, including working closely with the ministry of education and that
of environment, water and agriculture.
Saudi Arabia and WHO will continue to closely monitor previously endemic areas to ensure that there is a rapid, proportionate response to any resurgence.
Trachoma – the leading infectious cause of blindness worldwide – remains endemic in five countries of WHO’s Eastern Mediterranean Region but progress has substantially reduced the number of people requiring antibiotic treatment by 28 million from
39 million in 2013 to 11 million in 2020.
The disease
Trachoma is a devastating eye disease caused by infection with the bacterium Chlamydia trachomatis. The infection spreads from person to person through contaminated fingers, fomites and flies that have 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, and inadequate access to water, and sanitation facilities.
Repeated infections in childhood lead to scarring of the inner side of the upper eyelids, resulting in inward turning of the eyelid margin, with the eyelashes touching the eyeball. This is a painful condition known as trachomatous trichiasis – if
left untreated, it can result in visual impairment and blindness.
To eliminate trachoma, WHO recommends the SAFE strategy2 to achieve elimination of trachoma as a public health problem.
Progress against trachoma and other neglected tropical diseases is alleviating the human and economic burden that they impose on the world’s most disadvantaged communities.
Globally, Saudi Arabia joins 11 other countries that have been validated by WHO for having eliminated trachoma as a public health problem. These are Cambodia, China, Islamic Republic of Iran, Lao People’s Democratic Republic, Gambia, Ghana, Mexico,
Morocco, Myanmar, Nepal and Oman.
The 2021–2030 NTD road map targets the prevention, control elimination and eradication of 20 diseases and disease groups by 2030.
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1Elimination of trachoma as a public health problem is defined as:
- (i) prevalence of trachomatous trichiasis “unknown to the health system” of <0.2% in adults aged ≥15 years (approximately 1 case per 1000 total population), in each formerly endemic district;
- (ii) prevalence of trachomatous inflammation—follicular in children aged 1–9 years of <5%, sustained for at least 2 years in the absence of ongoing antibiotic mass treatment, in each formerly endemic district; and
- (iii) existence of a system able to identify and manage incident trachomatous trichiasis cases, using defined strategies, with evidence of appropriate financial resources to implement those strategies
2The SAFE strategy consists of: Surgery to treat the blinding stage (trachomatous trichiasis); Antibiotics to clear the infection, particularly mass drug administration of the antibiotic azithromycin, which is donated by the manufacturer, Pfizer,
to elimination programmes, through the International Trachoma Initiative; Facial cleanliness; and Environmental improvement, particularly improving access to water and sanitation.
