Eritrea's blueprint for trachoma elimination

Abstract

Purpose: This overview highlights Eritrea's progress in trachoma elimination from 2006 to 2024, emphasizing the Surgery, Antibiotics, Facial Cleanliness and Environmental Improvement (SAFE) strategy, pillars of the Neglected Tropical Diseases (NTD) Roadmap, and geostatistical mapping's role in achieving elimination targets. Methods: Trachoma Impact Surveys (TIS) and Surveillance Surveys (TSS) monitored WHO-endorsed SAFE strategy interventions and progress, with model-based geo-statistics providing more precise prevalence estimates. Results: Eritrea has attained open defecation-free status in 93% of villages, performed 22,546 Trachomatous Trachiasis (TT) surgeries, and integrated surveillance data into the District Health Information System (DHIS2). TT prevalence among those 15 years and older has significantly decreased, with many areas below the World Health Organization (WHO) threshold of 0.2%. Eritrea reduced TF prevalence among children aged 1 to 9 years from over 10% in 2006 to less than 5% in 2022, and TT prevalence among adults aged 15 and older from 3% to below 0.2% in most regions. Conclusion: Eritrea's innovative approaches and strong partnerships provide a model for other countries facing NTDs. Reliable data have been crucial for targeting resources and monitoring progress toward trachoma elimination. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.