The Islamic Republic of Iran has eliminated trachoma, the World Health Organization Regional Office for the Eastern Mediterranean (WHO EMRO) announced this week.
Trachoma is the world's leading infectious cause of blindness. It is the cause of visual impairment or blindness in 1.9million people and affects 157.7 million people globally.
The announcement follows the country's submission of a dossier, detailing the current epidemiological situation of trachoma in the country.
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.
An external Dossier Review Group convened by WHO EMRO reviewed and approved the dossier, citing effective government led health promotion and school health programmes as well as improved access to water, sanitation and hygiene in reducing the trachoma burden.
The Islamic Republic of Iran's approach to elimination has demonstrated the effectiveness of facial cleanliness and environmental improvements to reduce transmission
"Eliminating trachoma as a public health problem requires strong government leadership and a commitment to reaching all people in the population", said Scott McPherson, Vice Chair of the International Coalition for Trachoma Control. "The Islamic Republic of Iran's approach to elimination has demonstrated the effectiveness of facial cleanliness and environmental improvements to reduce transmission. ICTC congratulates Iran on its achievement to eliminate this neglected tropical disease."
Chair of the EMR Alliance for Trachoma Control, Babar Qureshi, also commented, "the EMR Alliance for Trachoma Control joins WHO-EMRO in congratulating the Islamic Republic of Iran in eliminating trachoma as a public health problem. It is a great milestone in the EMR region of having yet another country validated for the elimination of trachoma and a major achievement in the country which has worked many years to get to this point."
Trachoma was a major cause of visual impairment in Iran in the early decades of the 20th century. The first document concerning the distribution and epidemiology of trachoma dates back to 1959, in which 1,270 cases were reported in rural areas of the district of Malayer. Over recent decades, general hygiene and environmental health have improved nationally with epidemiologic studies and community observations showing that almost 95% of children in rural areas have clean faces. Based on national surveys, household access to an improved source of water in 2011 was 98% in urban areas (where more than two-thirds of Iranians live), and 90% in rural areas. Access to improved sanitation is estimated to be close to 100%. With effective systems to manage individuals with trichiasis, or conjunctivitis consistent with active trachoma, as well as improved facial cleanliness and environmental conditions, trachoma prevalence has reduced to below elimination thresholds
Iran is the third country in the WHO Eastern Mediterranean Region to achieve elimination and the eighth country to achieve elimination globally, following Oman (2012), Morocco (2016), Mexico (2015), Lao People's Democratic Republic (2017), Cambodia (2017), Nepal and Ghana (2018).
43 countries remain known to require SAFE strategy (surgery, antibiotics, facial cleanliness, environmental improvements), interventions to eliminate trachoma as a public health problem.