Health Programs

Trachoma Control Program

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What is the SAFE strategy?

In its effort to eliminate blinding trachoma, the World Health Organization developed a series of interventions to control trachoma known by the acronym SAFE: Surgery, Antibiotics, Facial cleanliness, and Environmental improvement.

S Lid surgery for those at immediate risk of blindness
A– Antibiotics to treat individual cases and to reduce infection in a community
F  Facial cleanliness and hygiene promotion to reduce transmission
E  Environmental improvements such as provision of water and household sanitation


S - Surgery
Surgery reverses the in-turned eyelashes of people with severe trachoma. Lid surgery is a fairly simple procedure that can be offered in the community or at health centers. Offering community-based surgery is the best way to encourage people suffering with trichiasis to seek help. Lid surgery takes away the pain of lashes scraping against the eyes and prevents further damage, but does not restore sight that was already lost.


A - Antibiotics
Antibiotics are used to treat active trachoma and reduce infection in a community. Antibiotics may be given on a case-by-case basis or in mass drug administration to the community. The World Health Organization currently recommends mass drug administration if the prevalence of active trachoma among children aged 1 to 9 years exceeds 10 percent. Pfizer Inc. generously donates millions of doses of the antibiotic Zithromax ® for trachoma control.


F - Facial Cleanliness
Dirty faces are associated with active trachoma. Children with dirty faces are more likely to transmit trachoma if they have an active infection or to get trachoma if they are not infected. Discharge from the eyes and nose attracts flies that can bring the infection or carry it to other people. Wiping or rubbing dirty eyes with cloths, bed sheets, or a mother's shawl can contribute to the transmission of trachoma. With support from the Carter Center Trachoma Control Program, communities are educated on the importance of clean faces.


E - Environmental Improvement
Trachoma persists where people live in poverty with crowded living conditions and without water, sanitation, and proper waste disposal. Transmission of trachoma occurs where these conditions exist and should be expected to return after antibiotic treatment if the conditions are not changed. Improvements like construction of household pit latrines and hand-dug wells will bring about sustainable elimination of trachoma. 



Map illustrating the range of trachoma. The Range of Trachoma

Map illustrating the range of trachoma.
(Click to enlarge)


 














































































 

 

 

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Trachoma Control
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Poster illustrating the life cycle of trachoma.

The Life Cycle of Trachoma
(Click to enlarge)

A surgeon performs eyelid surgery on a patient with trichiasis, or advanced trachoma.
Carter Center Photos
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Lid surgery is available with the support of The Carter Center and its partners.


Pfizer Inc. donates Zithromax® to treat cases of trachoma and to reduce community infection.
(Click to enlarge)

Pfizer Inc. donates Zithromax® to treat cases of trachoma and to reduce community infection.


This Ethiopian girl demonstrates the importance of keeping your face clean.
(Click to enlarge)

This Ethiopian girl demonstrates the importance of keeping her face clean to prevent trachoma.


In Niger, pit latrine ownership is a source of pride for women and men.
(Click to enlarge)

In Niger, pit latrine ownership is a source of pride for women and men.