Elimination of trachoma as a public health problem in Islamic Republic of Iran

Trachoma_Elimination_pictureMinooshahr, Khuzestan province, Islamic Republic of Iran; ophthalmologic exam and surveillance visit in December 2017

17 September 2018 – Recently, the Islamic Republic of Iran prepared a dossier on the elimination of trachoma as a public health problem which provided information on the current epidemiological situation of trachoma in the country and the systems for identifying and managing patients with Chlamydia trachomatis.

Trachoma is the world’s leading infectious cause of blindness and one of 20 neglected tropical diseases that affect over one billion of the world’s poorest people.

Elimination of trachoma as a public health problem is defined as: 1) a prevalence of trachomatous trichiasis of less than 0.2% in adults aged over 15 years (approximately 1 case per 1000 people); and 2) a prevalence of less than 5% of trachomatous inflammation follicular in children aged 1–9 years.

The dossier was reviewed by an external Dossier Review Group convened by the World Health Organization (WHO) Regional Office for the Eastern Mediterranean. A patchwork of recent data, when taken together, presents a convincing case that the prevalence of trachoma is now below WHO thresholds for elimination as a public health problem. Antibiotics with anti-chlamydial activity are widely available. School health programmes on health promotion run by relevant government ministries are well established. Systems appear to be in place to maintain access to clean water and improved sanitation facilities at current levels or greater. Cross-border issues are reviewed in the dossier, and have been adequately considered.

Based on the evidence provided in the dossier about investment in and implementation the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) and the recommendation of the Dossier Review Group, WHO concludes that the Islamic Republic of Iran has achieved elimination of trachoma as a public health problem.

Dr Ghebreyesus mentioned in his message to His Excellency Dr Hassan Ghazizadeh Hashemi, The Minster of Health and Medical Education: "I would like to offer my warm congratulations to the Government of the Islamic Republic of Iran on achieving this landmark."

At this stage, WHO recommends continued surveillance for trachoma, awareness-raising within schools and communities, cross-border health checks, enhancing case finding and timely treatment for affected patients, and sharing the surveillance information with WHO.

Dossier document

Elimination of trachoma as a public health problem in Islamic Republic of Iran 2018 [pdf 4.3MB]