A systematic review of historical and contemporary evidence of trachoma endemicity in the Pacific Islands

Abstract

IntroductionTrachoma is endemic in several Pacific Island countries. The aims of this study were to (a) identify future trachoma mapping needs in the Pacific and (b) to examine whether any temporal trends in trachoma prevalence could be ascertained from the historical literature on trachoma in the Pacific Islands.MethodsHuman studies of trachoma and eye care in the Pacific Islands were identified from a systematic search of PubMed, EMbase, Scopus and Web of Science databases. A published quality assessment system for disease prevalence studies was modified to assess studies for quality and transparency.ResultsFew general ophthalmic studies in the Pacific mention trachoma. In targeted studies of trachoma, cases have consistently been identified throughout the Pacific since the early twentieth century. The largest number of studies come from Papua New Guinea and Fiji, whereas some countries have no published data on trachoma. The majority of studies identified were published before the Alliance for the Global Elimination of Trachoma 2020 was convened, so lack the standardisation of population-based mapping which has been implemented in the past decade.ConclusionsPopulation-based trachoma prevalence estimates have been recently generated in Papua New Guinea, Solomon Islands, Vanuatu, Kiribati and Fiji. There is insufficient evidence to assess whether there has been temporal change in trachoma prevalence in these countries over the past century. Cases of trachoma have been identified in some countries (for example, Nauru and Samoa) which have no recent population-based mapping data, but may be at risk of trachoma endemcitiy. Deployment of appropriate mapping strategies is warranted to identify whether interventions are required.

Chlamydia trachomatis—An Emerging Old Entity?

“…Trachoma is a leading cause of blindness in the world today. Common features upon presentation include redness, itching and irritation of the eyes and eyelids [ 80 ]. Discharge, swelling, pain and photophobia are also exhibited.…”

“…Community-wide control interventions were developed, known as the ‘SAFE’ strategy: Surgery to treat those suffering from trachomatous trichiasis, massive drug administration (MDA) with Antibiotics, promotion of Facial cleanliness, and Environmental improvement to reduce prevalence and transmission of the causative agent [ 136 ]. After the implementation of the SAFE strategy, the population prevalence of trachomatous trichiasis and trachomatous follicular inflammation in 1 to 9-year-olds decreased to <0.1% and below 5%, respectively [ 80 , 137 ].…”

Community-level trachoma ecological associations and the use of geospatial analysis methods: A systematic review

“…The studies which examined a single country included in this review were predominantly from sub-Saharan Africa (19 of 27), with nine of those studies in Ethiopia. The Americas and the Pacific Islands include areas endemic for trachoma with potentially different associated factors but which are relatively under-studied [ 67 ]. Furthermore, specific country contexts such as baseline trachoma prevalence or historical treatment coverage were not included in this review as potential moderating factors to observed associations.…”

Conjunctival Scarring, Corneal Pannus, and Herbert’s Pits in Adolescent Children in Trachoma-endemic Populations of the Solomon Islands and Vanuatu

“…According to this hypothesis, the low TT prevalence indicates that recrudescence is so recent that those exposed to active (inflammatory) trachoma in childhood have not yet lived long enough to develop blinding sequelae. Although empirical data to support this hypothesis are lacking [ 17 ], it is important to understand whether the current TF prevalence in 1–9-year-olds is driving conjunctival scarring that might lead to future blindness. If it is, interventions against active trachoma are likely needed; if not, interventions are probably not indicated.…”