A diagnostic instrument to help field graders evaluate active trachoma

Abstract

The SAFE strategy (Surgery for trichiasis, mass treatment with Antibiotics to clear ocular Chlamydia trachomatis infection, and Facial cleanliness and Environmental improvement to reduce transmission) is being used to eliminate trachoma as a public health problem. Decisions on whether or not to implement the A, F, and E components of SAFE are made on the basis of the prevalence of trachomatous inflammation-follicular (TF) in 1-9-year-olds. TF has a precise definition: at least five follicles, each of which is at least 0.5-mm diameter, in the central part of the upper tarsal conjunctiva. Determining whether a follicle has a diameter ≥0.5mm is difficult using magnifying loupes alone. We have d..