Speaker
Description
Background: Trachoma is a targeted disease to be eliminated as a public health problem 2030 through SAFE strategy (Surgery to correct TT, Antibiotics to reduce bacterial infection, Facial Cleanliness, and Environmental Improvement to reduce transmission). Despite 15 years of strategy implementation, there are 95 persistent and 13 recrudescent districts in the region. In addition, it has an estimated 75,929 cases waiting for Trachomatous trichiasis surgery. The barriers and facilitators of the SAFE strategy implementation was not well explored and we aimed to explore the barriers and facilitators of SAFE strategy in hyper endemic settings of Wagehimira zone in 2025.
Methods: a programmatic study design was conducted from January to February 2025. Program experts who were health extension workers, Neglected Tropical Diseases officers from districts health offices and zonal health departments, and non-governmental organization participated from Wagehimira. Thirteen key informants and nine focus group discussions were conducted. Open Cod 4.03 software was used and Thematic analysis was done.
Results: Four major themes and thirteen subthemes were identified. The awareness of Trachomatous trichiasis symptoms and confidence in surgical treatment improved, while geographic inaccessibility, fear, and insufficient post-operative follow-up continued to limit service uptake. The Mass Drug Administration was widely accepted and effective, though shortages of pediatric syrup persisted. There were slight improvements in sanitation, but open defecation, poor latrine quality, and inadequate waste management was common. Moreover, cultural norms and water scarcity made difficult to consistent hygiene practice. All of these results showed significant advancements, but they also highlighted ongoing deficiencies in hygiene infrastructure, community involvement, and service delivery to eliminate trachoma.
Conclusions and recommendations: Awareness and acceptance of Trachomatous trichiasis surgery and Mass drug administrations have improved, major challenges including limited surgical access, fear, pediatric drug shortages, and poor sanitation. Hence, strengthening logistical support for patients who had trachomatous trichiasis surgery and enhancing the capacity of integrated eye care workers are crucial. Strengthen Mass drug administration delivery, better water access, and culturally adaptable hygiene promotion and waste management should also be strengthened.
