RTI International brings innovative solutions to eliminate trachoma in Mozambique

Additional collection of blood samples and eye swabs play a crucial role in controlling a public health problem that can cause blindness

RESEARCH TRIANGLE PARK, N.C. – The Government of Mozambique continues to make significant strides toward eliminating trachoma, a leading infectious cause of blindness, thanks to strong national leadership, support from the U.S. Agency for International Development’s (USAID) Act to End NTDs | East program, complemented by internal investment from RTI International, a nonprofit research institute and leading international development organization. 

Several districts in Mozambique face challenges as prevalence of trachomatous inflammation—follicular (TF), one of the early clinical signs of active trachoma, remains above the 5% elimination threshold, even after several years of mass drug administration (MDA) with azithromycin to prevent the spread of disease. TF is caused by a bacterial infection of the eye with Chlamydia trachomatis and refers to the presence of five or more follicles, which are small, round bumps, in the upper inner surface of the eyelid. These follicles result from the body’s immune response to the infection. 

In August 2022, Trachoma Impact Surveys (TIS) were conducted in four districts to better understand infection transmission dynamics. Traditionally, these surveys use clinical examination of the eyes to assess prevalence of the disease. However, this enhanced survey, known as TIS+, incorporated innovative testing including blood samples and eye swabs, for previous and current ocular Chlamydial infections alongside clinical examination. This is one of the first large-scale programmatic uses of this novel approach.  

Additional trachoma biomarkers for ocular Chlamydial infection provide a deeper understanding of community-level transmission of the disease, critical in these challenging settings. The findings published in Scientific Reports reveal that three districts had evidence of continued community-level transmission of ocular chlamydia thus further intervention with MDA was needed. 

Trachoma is one of the most prevalent neglected tropical diseases (NTDs) and caused by repeated ocular infections with the bacterium Chlamydia trachomatis, leading to blindness if untreated. The global effort to eliminate trachoma is centered around the World Health Organization’s SAFE strategy, which includes surgery, antibiotics, facial cleanliness and environmental improvements. 

“The progress made in Mozambique is a testament to the effectiveness of the SAFE strategy,” said Jeremiah Ngondi, Senior Trachoma Advisor for USAID’s Act to End NTDs | East program at RTI. “However, challenges remain in districts with persistent and recrudescent active trachoma. Adding these biomarkers is essential to help us maintain progress toward trachoma elimination.” 

The survey also highlights the importance of continuing MDA in districts with persistent transmission and emphasizes collaboration with stakeholders to improve access to water, sanitation and hygiene (WASH), which play a crucial role in controlling the spread of trachoma. 

Through the Act to End NTDs | East program, RTI remains committed to supporting the Government of Mozambique in its fight against NTDs and ensuring that no community is left behind in the effort to eliminate trachoma. 
 
Learn more about RTI’s work to control and eliminate NTDs around the globe