Eliminate blinding trachoma from Nepal by the year 2014
According to WHO, the trachoma elimination criteria has set for the prevalence of TF is less than 5% in children in 1-9 years old and prevalence of TT is less than 1 per 1000 population in all ages group. NTP will follow these set criteria and implement S & A components in the area until the elimination goal has been achieved.
Strategy:
The WHO recommends that the SAFE strategy be adopted in order to eliminate blinding trachoma:
Surgery to correct advanced stages of the disease
Antibiotics to treat active infection
Face washing to reduce disease transmission
Environmental change to increase access to clean water and improved sanitation to eliminate disease altogether
Strategic Direction
q Implement WHO recommended SAFE strategy in trachoma endemic areas of Nepal.
q Mapping out the disease burden through out the country and expand the program on priority basis.
q Deliver SAFE program through existing governmental and non-governmental organizations.
q Collaboration and partnership between the water supply and sanitation (WATSAN) organizations to implement face washing and environmental components.
q Facilitate in providing quality care services.
q Establish mechanisms for ongoing surveillance system.
Objectives
The main objectives of the program set for the end of 2014 are as follows:
Mobilize NNJS eye hospitals, primary eye care centers and other partners to clear the estimated TT backlog (23,000) by end of December 2014.
Assist, facilitate and mobilize Ministry of Health and population networks to distribute Zithromax in all trachoma endemic districts by December 2014.
Coordinate with INGOs, NGOs, Department of Water Supply and Sewerage and other F & E partners to make water supply and sanitation service available in needy areas.
What is Trachoma Disease?
Trachoma is one of the world's oldest infectious diseases; trachoma is a chronic and contagious infection that over time scars the upper eyelid, causing the eyelashes to scratch the cornea and eventually causes blindness. It is still affect large segments of the population in poorer areas. It is disease of social and economic concern. The disease attacks in the most productive years of person's life, affecting the economic well being of entire families and communities. Although surgical treatment is available in the later stages of disease, the real opportunity is in preventing recurrent infection.
History of Trachoma Disease in Nepal
Trachoma has been found to be clustered geographically in Nepal, with the highest prevalence rates in the far western regions of the country. Fifty percent of trachoma cases were found within a 100 km radius of Nepalgunj and 90 percent of cases within a 200 km radius of Bheri and Seti zones. In these two zones, trachoma prevalence was estimated at 26.6 percent, which is approximately three times greater than the national prevalence rate, 6.9 percent in 1981 survey, and the trichiasis rate was approximately 2 percent (with 80 percent of these cases found in women).
Prevalence rates of active trachoma were highest among children under ten years. Certain ethnic groups were also found to be largely affected - particularly among the Tharus, Ranatharus, Magars and Gurungs. Trachoma prevalence fluctuates seasonally with rates almost doubling in the pre-monsoon months of May and June.
Our Appeal to Interested Donor
The NNJS/NTP is implementing WHO recommended SAFE strategy in all trachoma endemic districts of Nepal. This program was initiated in 2002. In ten years of its existence, the program has distributed 3 rounds of Zithromax to 10.3 million people for trachoma in seventeen districts. TRA in 56 districts, population based prevalence surveys in 11 districts and end line survey in twelve districts have helped to quantify the disease burden. Eight districts are remained to be mapped and 5 districts remains to be carried out Impact Survey.
In Nepal, it was estimated that 42,000 people were suffering from advanced stages of the disease related to Trachoma and require sight-saving surgery, and nearly 29% (or 8.1 million) people were residing in trachoma endemic districts having a chance of disease transmission. In response to this large disease burden, Nepal Netra Jyoti Sangh launched National Trachoma Program (NTP) in 2002 and, in ten years, the program has achieved a great success in combating trachoma. Active trachoma prevalence has been reduced by 90 percent in the areas where SAFE has been implemented, and blinding trachoma has been prevented in 18000 people through trichiasis surgery. Indeed, trachoma is both treatable and preventable, and the SAFE strategy is an effective tool used to combat the disease. While numerable diseases afflict the third world, trachoma is one that can be easily eliminated with medicine and technology available today.
We have prepared a five-year (2010-2014) national strategic plan along with all governmental and non-governmental stakeholders and agreed the roles and responsibilities of each stakeholders and implementing SAFE program to date. As agreed, the NNJS, leader in eye care services is taking overall responsibilities to implement Surgery component with their human resources. The Ministry of Health and Population is taking overall responsibilities to distribute Zithromax by mobilizing their own existing governmental manpower and networks in trachoma endemic districts. Similarly, Department of Water Supply and Sewerage along with water and sanitation organizations implement face washing and environmental improvement components along with NTP in the same areas where SAFE strategy is implemented.
The organizational set-up, staff training and office establishment support have been already made by ITI's support to manage and deliver SAFE strategy in Nepal. From 2006, ITI is only committed to provide necessary Zithromax drug for trachoma treatment in the country. The Ministry of Health & Population and Research Triangular Institute (RTI) are supporting for the implementation of Antibiotics component which includes Zithromax distributors training, coordination, monitoring and supervision and carry out trachoma prevalence surveys and Impact Survey. We are looking for International support for SFE implementation to clear the estimated TT backlog of 23,000 and to carry out FE training program to health facility staff. This activity will help for not to spread trachoma again and it will also help to sustain the program in long term basis.
The total cost for entire project period for five years will be 1 million US$ which is US$ 250,000 for each calendar year. The support from international organizations like yours, Nepal can eliminate blinding trachoma in the next few years.
To find out how you can become a partner with NNJS/NTP to eliminate blinding trachoma please call Mr. Shekhar Sharma by telephone or in the following address.
Thank you.
National Trachoma Program, Nepal
PO Box: 23615
Tripreshwor, Kathmandu Nepal
Phone # 0977-1-4255605
Fax # 0977-1-4219316
Email: kath@nnjs.wlink.com.np shekhar@trachoma.org.np
Nepal had conducted one of the first scientific nationwide blindness surveys in 1980-81. The survey report was published as Epidemiology of Blindness in Nepal. It was a remarkable benchmark in the history of eye care programme of Nepal. This survey result lead to the paradigm shift in development of eye care service in Nepal. After three decades, another report of nationwide blindness survey has been published by Nepal Netra Jyoti Sangh (National Society for Comprehensive Eye Care) as “The Epidemiology of Blindness in Nepal: 2012”.
The book was unveiled by Secretary of Ministry of Health and Population on April 4, 2013 in the presence of different partners and major stakeholder of eye care services of Nepal. This book gives detail information on existing blindness scenario in the country, impact of eye care services with comparison to survey results of 1981.
We warmly congratulate our organization; Nepal Netra Jyoti Sangh being honored to receive "Healthcare Leadership Awards 2012", on the basis of Research and Feedback, Nepal Netra Jyoti Sangh has been selected by KRDWG's (Knowledge Resource Development & Welfare Group ) Expert Panel for Healthcare Leadership Awards 2012 in the Hospital category.
