Purpose: Baseline surveys were conducted in Tigray region, Ethiopia, in 2013. Since then, rounds of azithromycin mass drug administration (MDA) have been delivered in-line with international guidance. The purpose of these surveys was to assess trachomatous inflammation-follicular (TF) prevalence following those treatments to enable the region to plan the next steps towards elimination of trachoma.
Methods: All surveys followed WHO recommendations for community-based cross-sectional survey design. Thirty-one woredas in six zones of Tigray region were surveyed. There were two survey series: all 31 woredas were surveyed in the first series, and 11 woredas were resurveyed in the second, due to having a TF prevalence between 5% and 9.9% in the first series.
Results: In the first series of 31 surveys, one woreda had an adjusted TF prevalence in 1-9-year-olds of <5.0%, 13 had a prevalence of 5.0-9.9% and 17 had a prevalence of 10.0-29.9%. In the second series of 11 surveys, the prevalence of TF was <5.0% in seven woredas and 5.0-9.9% in four woredas. The most recent adjusted prevalence of trachomatous trichiasis (TT) unknown to the health system in ≥15-year-olds was ≥.2% in 27 EUs. One-third of households visited had access to an improved drinking water source within a 30-minute return journey of their house, and 11% had an improved latrine.
Conclusion: Eight woredas met the criteria to stop MDA for 2 years before the re-survey. However, further rounds of MDA, additional efforts to improve water and sanitation access and ongoing strengthening of surgical services for TT are needed across Tigray.
Keywords: Ethiopia; Tigray; neglected tropical disease; trachoma; trachoma impact survey.