Seeing an end to trachoma in Viet Nam
Have you ever been offered surgery by a health worker to correct the in-turned eyelashes in your eye? This is a question overheard many times during a recent survey in Viet Nam.
During the survey, a group of health workers visited local communities in four provinces of Viet Nam - Bac Giang, Hai Duong, Nam Dinh and Thai Binh – in search of signs of trachoma infection. While previous efforts assessed the prevalence of trachoma in these communities, this survey would make sure that those impacted by visual impairment from trachoma had access to surgical services they need.
“This survey was no small task”, said Dr Bui Van Xuan of Viet Nam National Eye Hospital (VNEH). “We visited 30 villages in each province, and 40 households per village. In total, we examined more than 13,011 adults in the four provinces. It takes considerable effort but was an important step to ensure that the Vietnamese people have access to the eye health services they need.”
Since 2010, the elimination of trachoma as a public health problem has been a national target in Viet Nam. These efforts have been incredibly successful. Today more than 25.5 million people are no longer at risk of the disease, the Vietnamese government is now on the verge of achieving this public health milestone and through this survey, health workers are took the final steps to ensure this neglected tropical disease is gone for good.
The recent surveys were conducted by staff from VNEH with support from Fred Hollows Foundation (FHF) and RTI International, through USAID’s Act to End NTDs | East program. Going door-to-door, the graders were on the lookout for one of the tell-tale signs of trachoma infection: inverted eyelashes and corneal opacity. Once turned inward, the eyelashes can rub against the eyes and scratch the cornea, resulting in visual impairment or blindness. This ‘blinding stage’ of trachoma infection is known as trachomatous trichiasis.
In the 1990s, trachoma was one of the leading causes of preventable blindness in Viet Nam. While efforts to eliminate the disease have shown tremendous progress, it is essential to ensure the continued provision of health services for those impacted by the disease. Led by the VNEH, surgical services have been provided over the years. As Viet Nam is preparing to submit documentation to the World Health Organization (WHO) for validation of elimination as a public health problem, this was one of the critical last steps.
By collecting data from the selected households and villages, the graders aimed to determine if the number of outstanding cases of trachomatous trichiasis in the provinces met the elimination threshold requirements set by WHO to confirm Viet Nam’s eligibility for trachoma elimination validation.
After examining the eyelids of 13,011 adults for trachoma infection, the graders found the number of outstanding trachoma cases in all four provinces to be under the elimination threshold. Thanks to their efforts and commitment to monitoring progress, the validation of trachoma elimination in Viet Nam is now closer than ever before.
“Positive results from these TT only survey significantly contributed to fill the gaps of Vietnam trachoma elimination dossier. When the dossier is approved by the WHO, it will elevate the standing of Vietnam’s health sector in general, and in particular its eye health care system,” said Dr Tran Minh Dat of the VNEH.