University of Helsinki
The Global Burden of Trachoma: A Review
/Matthew J. Burton, David C. W. Mabey
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
PLoS Negl Trop Dis 3(10): e460. doi:10.1371/journal.pntd.0000460
Editor: Simon Brooker, London School of Hygiene & Tropical Medicine, United Kingdom – Published October 27, 2009
Available online at:
http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000460
Trachoma is the commonest infectious cause of blindness worldwide. Recurrent infection of the ocular surface by Chlamydia trachomatis, the causative agent, leads to inturning of the eyelashes (trichiasis) and blinding corneal opacification.
Trachoma is endemic in more than 50 countries. It is currently estimated that there are about 1.3 million people blind from the disease and a further 8.2 million have trichiasis. Several estimates for the burden of disease from trachoma have been made, giving quite variable results.
The variation is partly because different prevalence data have been used and partly because different sequelae have been included. The most recent estimate from the WHO placed it at around 1.3 million Disability-Adjusted Life Years (DALYs). A key issue in producing a reliable estimate of the global burden of trachoma is the limited amount of reliable survey data from endemic regions .
.Several attempts have been made to estimate both the burden and cost of trachoma. It remains a significant problem with a high burden of disability. Encouragingly the reported numbers of people affected by trachoma appears to be steadily declining.
However, current burden estimates are limited in reliability because of the paucity of survey data available on which to base estimates of the total number of cases. There is also variability over whether to include trichiasis, in the absence of visual impairment.
In order to develop more robust estimates of the burden of trachoma there needs to be a coordinated effort to conduct population-based surveys with a national sampling frame in representative countries from endemic regions .