National Trachoma Program
Our Vision: Nepal free from blinding trachoma.
Our Goal: Eliminate blinding trachoma from Nepal by the year 2010
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 2009 are as follows:
- Mobilize NNJS eye hospitals, primary eye care centres and other partners to perform 39000 TT surgeries 90% of total estimated TT backlog (45000) by December 2009.
- Assist, facilitate and mobilize Ministry of Health and population networks to distribute 8.7 million doses of Zithromax to treat 2.7 million populations in trachoma endemic districts by December 2009.
- 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 implemented the first phase of its program in Nepal between 2002-2005. In four years of its existence, the program has screened nearly 1.5 million people for trachoma in nine districts. TRA in 17 districts, population surveys in 11 districts and end line survey in two districts have helped to quantify the disease burden. Much more work on identifying Nepal's trachoma burden remains to be completed.
In Nepal, for example, 45,000 people suffer from advanced stages of the disease related to Trachoma and require sight-saving surgery, and nearly 7 percent (or 2.7 million people) of the nation's population suffers from active infection. In response to this large disease burden, Nepal Netra Jyoti Sangh launched National Trachoma Program (NTP) in 2002 and, in just three years, the program has achieved great success in combating trachoma. For example, active trachoma prevalence has been reduced by 40 percent in the areas where SAFE has been implemented, and blinding trachoma has been prevented in 8000 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 prepared five-year (2005-2009) 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 own 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. In 2006, ITI is only committed to provide necessary Zithromax drug for trachoma treatment in the country. We are looking international support for SAFE implementation, which includes Zithromax distributors training, coordination, monitoring and supervision and carry out trachoma prevalence surveys to quantify disease burden through out the country in Nepal.
The total cost for entire project period (2006-2009) 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 five years.
To find out how you can become a partner with NNJS/NTP to eliminate blinding trachoma please call Mr. BB Thapa by telephone or in the following address.
Thank you.
BB Thapa
Program Director
National Trachoma Program, Nepal
PO Box: 23615
Tripreshwor, Kathmandu Nepal
Phone # 0977-1-4255605
Fax # 0977-1-4219316
Email: bbthapa@trachoma.org.np
kath@nnjs.wlink.com.np
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