What is trachoma?

Trachoma is the leading cause of infectious blindness worldwide and is transmitted by direct contact with ocular and nasal secretions of persons infected with particular serovars of the bacterium Chlamydia trachomatis.

The active form of the disease presents as an inflammatory conjunctivitis, repeated episodes of which may result in scarring of the conjunctiva, leading in some cases to inversion of the eyelashes toward the eye. When one or more eyelashes of the upper eyelid turned inward and rub against the eye, or there is evidence of recent eyelash epilation of eyelashes directed toward the eye, trachomatous trichiasis (TT) occurs. This is the chronic form of the disease, which, if left untreated, can lead to the development of corneal opacity, visual impairment, and blindness.

Key facts

In the Region, trachoma is endemic in rural and remote areas from Brazil, Colombia, Guatemala, and Peru, where there are about 5.6 million people at risk from the disease, which disproportionately affects women and children. In 2017, Mexico became the first country in the Region to eliminate trachoma as a public health problem.

Trachoma can be eliminated as a public health problem. The SAFE strategy is the trachoma elimination strategy recommended by the World Health Organization (WHO), which includes interventions in S-surgery for TT management, A-antibiotics to treat infection, F-facial hygiene, and E-improved environmental conditions (improved access to water and basic sanitation) to prevent infection and interrupt disease transmission.

Elimination of trachoma as a public health problem is defined by:

  • a prevalence of cases of trachomatous trichiasis (TT) "unknown to the health system" of less than 0.2 % in adults aged 15 years or older (approximately 1 case per 1000 population);
  • a prevalence of trachomatous follicular inflammation (TF) in children aged 1-9 years of less than 5%, maintained for at least two years without massive administration of antibiotics, in all districts where the disease was previously endemic;
  • the existence of a health system capable of detecting and managing new cases of TT using defined strategies, with evidence that sufficient financial resources are available to implement these strategies.
PAHO Response
  • PAHO/WHO supports countries in implementing the SAFE (Surgery, Antibiotic, Facial cleanliness and Environmental improvement) strategy, which consists of implementing surgery to correct trichiasis, antibiotic treatment (azithromycin) to treat C. trachomatis infection, facial hygiene and environmental improvement to reduce person-to-person transmission.
  • The World Health Assembly adopted resolution WHA51.11 in 1998, which aimed at the global elimination of trachoma as a public health problem by 2020. The Roadmap for NTDs 2021-2030, which the World Health Assembly endorsed in 2020 in its decision 73(33), extended the new deadline for the global elimination of the disease to 2030.
  • PAHO is promoting an initiative for the elimination of communicable diseases and related conditions, which aims to eliminate more than 30 diseases by 2030 (including trachoma), with a common, integrated, and sustainable approach, promoting linkages and synergies within the health system and with other sectors.
  • The Organization supports the regional forum in which the countries of the Americas that have had communities affected by trachoma (Brazil, Colombia, Guatemala, Peru, and Mexico) participate, as well as other countries in which information needs to be gathered. At this forum, these countries, together with experts from other organizations, analyze the situation in the Region and provide technical recommendations for the elimination of trachoma.