Trachoma Treatment and Prevention
The World Health Organization has targeted trachoma for elimination by 2020 through an innovative, multi-faceted public health strategy known as S.A.F.E.:
- Surgery to correct the advanced, blinding stage of the disease (trichiasis),
- Antibiotics to treat active infection,
- Facial cleanliness and,
- Environmental improvements in the areas of water and sanitation to reduce disease transmission
The comprehensive SAFE strategy combines measures for the treatment of active infection and trichiasis (S&A) with preventive measures to reduce disease transmission (F&E). Implementation of the full SAFE strategy in endemic areas increases the effectiveness of trachoma programs. The F and E components of SAFE, which reduce disease transmission, are particularly critical to achieving sustainable elimination of trachoma.
The "F" in the SAFE strategy refers to facial cleanliness. Because trachoma is transmitted through close personal contact, it tends to occur in clusters, often infecting entire families and communities. Children, who are more likely to touch their eyes and have unclean faces that attract eye-seeking flies, are especially vulnerable to infection, as are women, the traditional caretakers of the home. Therefore, the promotion of good hygiene practices, such as hand washing and the washing of children's faces at least once a day with water, is a key step in breaking the cycle of trachoma transmission.
The "E" in the SAFE strategy refers to environmental change. Improvements in community and household sanitation, such as the provision of household latrines, help control fly populations and breeding grounds. Increased access to water facilitates good hygiene practices and is vital to achieving sustainable elimination of the disease. Separation of animal quarters from human living space, as well as safe handling of food and drinking water, are also important environmental measures that affected communities can take within a trachoma control program.