Situation and trends
Blinding trachoma is hyperendemic in many of the poorest and most remote rural areas in 57 countries of Africa, Asia, Central and South America, Australia and the Middle-East. Roughly half of the global burden of active trachoma is concentrated in 5 countries (Ethiopia, India, Nigeria, Uganda and Sudan), and that of trichiasis in 4 countries (China, Ethiopia, Nigeria and Uganda). Overall, Africa is the most affected continent: 27.8 million cases of active trachoma (68.5% of all cases globally) and 3.8 million cases of trichiasis (46.6% of all) occur in 28/46 countries in the African Region. The highest prevalences of active trachoma have been reported from Ethiopia and Sudan, where the infection often occurs in more than 50% of children younger than 10 years; trichiasis is found in up to 19% of adults. Implementation of the SAFE strategy will lead to the elimination of blinding trachoma by 2020. In 2008, about 60% of the population in need received preventive chemotherapy using antibiotics and about 45% received surgical care. Ghana, the Islamic Republic of Iran, Morocco and Oman have reported reaching their elimination targets.