How to monitor and evaluate trachoma programmes
Deciding whether to start SAFE interventionsBaseline surveys must be undertaken before any SAFE interventions are started. Population-based surveys should be undertaken using methods recommended by the World Health Organization (WHO).The key indicators which guide the decision on beginning SAFE interventions are:
- Prevalence of trachomatous inflammation—follicular (TF) ≥ 5% in children aged 1 – 9 years
- Prevalence of trachomatous trichiasis (TT) ≥ 0.2% in people aged 15 years and above.
Evaluation of SAFE interventions
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Impact surveysImpact surveys are conducted 6 – 12 months after the final planned round of mass drug administration (MDA). In other words, they should be done:
- 6 – 12 months after 1 MDA round if baseline TF prevalence was 5 – 9.9%
- 6 – 12 months after 3 annual rounds of MDA if baseline TF prevalence was 10 – 29.9%
- 6 – 12 months after 5 annual rounds of MDA if baseline TF prevalence was ≥ 30%
- Interventions have achieved the active trachoma elimination threshold (TF prevalence < 5% in children aged 1 – 9 years), or
- Further A, F, E interventions are needed.
Surveillance surveysSurveillance surveys use ongoing data collection and methods interpretation which guides key decisions. These surveys can be:
- Pre-validation surveillance surveys
- Post-validation surveillance surveys.
- Sentinel surveillance for active trachoma in communities (Ghana)
- Routine surveillance for trachoma in healthcare facilities and schools (Oman)
- Active case searches for trachomatous trichiasis (TT) in the community (Ghana and Morocco).
Read alsoGhana became the first sub-Saharan African country to be validated for elimination of trachoma as a public health problem. This paper shares some insights into the process of surveillance that was undertaken: Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges.
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