The World Health Organisation (WHO) has validated Ghana as the first country in sub-Saharan Africa to eliminate Trachoma, the leading infectious cause of blindness worldwide.


Trachoma is a disease of public health importance in 41 countries in Africa and is responsible for the blindness or visual impairment of about 1.9 million people globally.


Currently, in 2018, 160 million people live in Trachoma-endemic areas and are at risk of trachoma blindness.


In Ghana, scientific studies carried out by the Ministry of Health (MoH) revealed that Trachoma was endemic in the Northern and Upper West Regions and recognized as a disease of public health significance.


Although blindness from Trachoma is not life-threatening, the physical, social and economic consequences for affected persons, usually aged 15 years and above, are grave.


In terms of economic cost, lost productivity from blindness and visual impairment is estimated at US$ 2.9-5.3 billion annually, increasing to US$ 8 billion when inwardly-turned eyelids and eyelashes are included.


Generally, blindness results in a worsening life experience of affected individuals and their families who are already among the poorest of the poor.


Delivering the key note address at the ceremony to celebrate Ghana’s feat, the Minister for Health, Kweku Agyeman-Manu, said in response to the study results of a Trachoma Rapid Assessment confirming the two Regions Trachoma-endemic, MoH and the Ghana Health (GHS), in partnership with WHO, International Trachoma Initiative, The Carter Center, United Nations Children’s Fund (UNICEF), World Vision Ghana and Water Aid, formulated a National Trachoma Programme in the year 2000, with the overall  objective of eliminating Trachoma by the year 2010.


Mr Agyeman-Manu said recognizing that inter-agency strength was required to achieve the objective of the programme, the Ministries of Education, Local Government and Rural Development, Sanitation and Water Resources, Gender and Social Protection were co-opted as partners while Sightsavers and the United States Agency for International Development (USAID) provided support.


He said due to the importance attached to the National Trachoma Programme, the MoH specifically mentioned Trachoma in its Programme of Work (2002-2006) and the Ghana Poverty Reduction Strategy Framework (2003-2005) as one of its priority diseases to be eliminated in order to reduce poverty due to blindness in the endemic areas.


He said the Ministry further developed a 5-year Strategy Plan—Ghana Free of Trachoma (2005-2009) that guided programme implementation.


Mr Agyemang-Manu said the elimination of Trachoma in the previously endemic areas meant that the miserable effects of blindness would be mitigated.


He, however, called for conscious efforts to sustain the gains made,especially for environmental cleanliness to keep diseases at bay.


Furthermore, he said, continuous awareness creation, sensitization and education was required on good hygiene and urged religious, traditional and community leaders to lead the process.


Mr Agyeman-Manu challenged GHS to continue to strengthen the health system through surveillance to track any incidental cases as well as communicate early to communities, the strategies put in place to take care of the incidental cases.


He attributed the success of the programme to hard work, strong leadership and ownership demonstrated at all levels of the health structure, adding that the role of the National Trachoma Task Force, Christophil Blinding Mission, Conrad N. Hilton Foundation, Community Water and Sanitation Agency and the implementation of the full SAFE strategy could not be ignored.


In a statement, Dr Anthony Nsiah-Asare, Director-General, GHS, said Ghana used the WHO-recommended SAFE strategy—Surgery to treat the blinding stage of the disease; Antibiotics to clear infection, Facial cleanliness and Environmental protection—to eliminate Trachoma in the Northern and Upper West Regions.


Dr Nsiah-Asare disclosed that as part of programme implementation, more than 5,354 safe water sources and about 14,000 household latrines were provided.


He said a post-intervention impact assessment in 2007-2008, after all endemic communities had received SAFE interventions, indicated that the prevalence of active Trachoma fell to 0.14 (2.87%)from a baseline of as high as 16.1 %, meaning Ghana had reached the ultimate intervention goal of reducing the disease in children aged 1-9 years.


He said between 2015 and 2016, a pre-validation surveillance survey was conducted to ascertain whether or not the elimination thresholds had been reached.


Dr Nsiah-Asare said the results of the survey indicated that all endemic districts had active trachoma less than 5% in children 1-9 years in all districts, while all districts, except Yendi had met the elimination criteria of 1 per thousand population.


He said having later conducted an active case search in Yendi and satisfied itself that Yendi also met the elimination criteria, a dossier on trachoma elimination was submitted to the WHO and the country was validated in May 2018.


Ghana ratified the WHO-recommended SAFE strategy as adopted in the World Health Assembly Resolution (WHA) 51.11 in 1998, targeting global elimination by the year 2020.


Ghana is also a member of the WHO Alliance for the Global Elimination of Trachoma by 2020 (GET 2020) which was launched in 1997.


The Alliance for GET2020 is a partnership which supports implementation of the SAFE strategy by member states and the strengthening of national capacity, through epidemiological surveys, monitoring, surveillance, project evaluation and resource mobilization.


The elimination of Trachoma in Ghana has, therefore, been achieved two clear years ahead of the elimination target year 2020.


Source: ISD (G.D. Zaney, Esq.)


Created: 15 August 2018
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