02673nas a2200337   4500000000100000008004100001260002300042653001800065653001700083653001500100653002800115653001600143653001100159100001200170700001300182700001300195700001200208700001200220700001600232700001300248700001400261700001100275700001300286700002000299700001500319700001200334245013700346300000800483520181900491022002502310       2023                            d  bInforma UK Limited10aOphthalmology10aEpidemiology10aThe Gambia10aTrachomatous trichiasis10aElimination10aSurvey1 aKanyi S1 aHydara A1 aSillah A1 aMpyet C1 aHarte A1 aBakhtiari A1 aWillis R1 aJimenez C1 aAboe A1 aBailey R1 aHarding-Esch EM1 aSolomon AW1 aJoof BM00aThe Gambia Trachomatous Trichiasis Surveys: Results from Five Evaluation Units Confirm Attainment of Trachoma Elimination Thresholds  a1-93 a<p id="_i2"><strong>Introduction:&nbsp;</strong>Trichiasis is present when in-turned eyelashes touch the eyeball. It may result in permanent vision loss. Trachomatous trichiasis (TT) is caused by multiple rounds of inflammation associated with conjunctival Chlamydia trachomatis infection. Surveys have been designed to estimate the prevalence of TT in evaluation units (EUs) of trachoma-endemic countries in order to help develop appropriate programme-level plans. In this study, TT-only surveys were conducted in five EUs of The Gambia to determine whether further intensive programmatic action was required.</p>

<p id="_i3"><strong>Methods:&nbsp;</strong>Two-stage cluster sampling was used to select 27 villages per EU and ~25 households per village. Graders assessed the TT status of individuals aged ≥15 years in each selected household, including the presence or absence of conjunctival scarring in those with TT.</p>

<p id="_i4"><strong>Results:&nbsp;</strong>From February to March 2019, 11595 people aged ≥15 years were examined. A total of 34 cases of TT were identified. All five EUs had an age- and gender-adjusted prevalence of TT unknown to the health system &lt;0.2%. Three of five EUs had a prevalence of 0.0%.</p>

<p id="_i5"><strong>Conclusion:&nbsp;</strong>Using these and other previously collected data, in 2021, The Gambia was validated as having achieved national elimination of trachoma as a public health problem. Trachoma is still present in the population, but as its prevalence is low, it is unlikely that today’s youth will experience the exposure to C. trachomatis required to precipitate TT. The Gambia demonstrates that with political will and consistent application of human and financial resources, trachoma can be eliminated as a public health problem.</p>
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