Trachoma is a painful disease that can turn eyelashes inwards so that they scrape against the eyeball, and can eventually lead to irreversible blindness. Ethiopia has the highest burden of the disease in the world.
“As of 2020, there were around 350,000 people in the country who were suffering from trichiasis [the advanced form of trachoma],” says Michael Dejene.
Michael is a medical doctor and epidemiologist who has been working with Sightsavers and partners to map the burden of trachoma in Ethiopia and other African and Asian countries, through a series of surveys that have now been running for 10 years.
The surveys began in 2012 as part of the Global Trachoma Mapping Project (GTMP), which was followed by Tropical Data in 2016. The scale of the initiative has grown significantly over the years, and the two projects have collectively supported surveys in 55 countries worldwide. On average, one person has been examined for trachoma every 26 seconds since 2012.
Michael explains that these surveys are helping to turn the tide against this ancient disease. “It’s vital for governments and non-governmental organisations to have access to high-quality data, as this allows them to target drug treatments and other resources to the areas that are most in need. These surveys therefore play a critical role in helping countries around the world to eliminate trachoma.”
Trachoma is the world’s leading infectious cause of blindness, and is part of a group of conditions known as neglected tropical diseases (NTDs).Learn about trachoma
In a typical Tropical Data survey, field teams will go to randomly selected households in predetermined communities to examine the eyes of everyone aged one year or above. The team includes graders who examine people’s eyes for signs of trachoma and recorders who use mobile phones to note down the results.
In a country as vast as Ethiopia, reaching these communities is far from easy. Michael is often required to act as a ‘trouble-shooter’ for teams out in the field. “Field teams have to cross rivers, and sometimes vehicles might break down so that they have to walk long distances on foot. Occasionally they stray into the wrong areas, but their data are linked to GPS coordinates, so we can help them to correct their errors and conduct the surveys in the right place.
“This is just one of the ways that we are making sure countries have high-quality data,” he adds. “I am glad to be part of a team of epidemiologists and data scientists who are working together on this. This feeling of teamwork is one of the things I enjoy most about my job.”
Michael tells us that survey teams may also encounter communities who are wary of having their eyes examined. He and his colleagues try to anticipate any issues and work with local community leaders and religious leaders to explain that the surveys are beneficial. If field teams discover that there is a high prevalence of trachoma, then health workers can take steps to tackle this.
Despite the challenges he faces, Michael and his colleagues at Tropical Data have made incredible progress in the fight against trachoma, both in his home country and around the world.
The surveys have so far helped the Ethiopian government and partners such as Sightsavers to eliminate the disease as a public health problem in 230 of the country’s districts. Around the world, GTMP and Tropical Data have together supported eight of the 15 countries that have eliminated trachoma as a public health problem. This includes four nations in the WHO’s African region: Gambia, Ghana, Togo and Malawi.
“I’m happy to be contributing to the global effort to eliminate trachoma,” says Michael. However, he notes that there is still more to be done in Ethiopia and elsewhere, to consign this painful and poverty-trapping disease to the history books.
“The Tropical Data programme needs to continue supporting countries to produce quality data until every country has beaten trachoma.”
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