Sightsavers, Accra, Ghana.
Sightsavers, Banjul, The Gambia.
PLoS Negl Trop Dis. 2022 Mar 28;16(3):e0010282. doi: 10.1371/journal.pntd.0010282. eCollection 2022 Mar.
Trachoma is the leading infectious cause of blindness in the world and has been known to be a major public health problem in The Gambia for over 60 years. Nationwide blindness surveys, including trachoma, in 1986 and 1996 provided the foundation for a comprehensive plan to implement a trachoma elimination strategy. Impact and pre-validation surveillance surveys in 2011-13 demonstrated that active trachoma was below WHO threshold for elimination but trichiasis remained a public health problem. Trichiasis-only surveys in 2019 demonstrated that trichiasis was below WHO thresholds for elimination and in 2020 the Government of The Gambia completed and submitted its dossier for validation of elimination as a public health problem. Challenges that The Gambia faced on the pathway to elimination included effective use of data for decision making, poor trichiasis surgical outcomes, lack of access to antibiotic treatment for low prevalence districts, high attrition of ophthalmic nurses trained as trichiasis surgeons, unexpected active trachoma in madrassas, the misalignment of elimination of active trachoma and trichiasis, trichiasis in urban settings, and maintaining the quality of surgery post-elimination when trichiasis cases are rare. Elimination of trachoma does not end with the submission of an elimination dossier; The Gambia will need to sustain monitoring and support over the coming years.
沙眼是全球首要的传染性致盲病因，在冈比亚，沙眼作为一个主要的公共卫生问题已经存在了超过 60 年。1986 年和 1996 年进行的全国性盲症调查（包括沙眼）为实施消除沙眼战略的综合计划奠定了基础。2011-13 年的影响和预验证监测调查表明，活动性沙眼低于世界卫生组织消除标准，但倒睫仍然是一个公共卫生问题。2019 年进行的仅针对倒睫的调查表明，倒睫低于世界卫生组织消除标准，2020 年冈比亚政府完成并提交了消除倒睫作为公共卫生问题的验证文件。冈比亚在消除沙眼的道路上面临的挑战包括有效利用数据做出决策、倒睫手术效果不佳、低流行地区无法获得抗生素治疗、接受过培训的沙眼外科医生流失率高、宗教学校出现意外的活动性沙眼、活动性沙眼和倒睫的消除不一致、城市地区的倒睫以及在倒睫病例稀少时保持手术后的质量。消除沙眼并不意味着提交消除文件就结束了；冈比亚将需要在未来几年中持续监测和支持。
