Trachoma in Kenya:

Population: 37 million
Human Development Rank: 148 of 177
Target year for elimination:  2020
# Districts in country:  80
# Trachoma-endemic districts:  18
# Districts Graduated: 0

Burden of Trachoma (estimated):
Trichiasis Backlog: 46,000
TT Prevalence:  3.6%
Prevalence TF (Children 1-9 years of age):  20.6%
Population at risk of infection:  6,000,000
 




National Program for Trachoma Control:
First MDA took place in 2007
Eye Care Coordinator:  Dr. M. Gichangi
AMREF Representative:  Dr. Festus Ilako

Burden of active disease (TF) and trichiasis (TT) in 4 project trachoma endemic districts, Kenya, 2004

     











The map that follows on the next page shows the location of the 18 suspected trachoma endemic districts. A survey has been carried out in six districts (numbered). The prevalence of TF is above 10% in four out of the 6 districts (labelled in italics). The prevalence of TT is above 1% in all six districts, as shown in the above Table.

The partners for the implementation of the trachoma control program in the Kajiado district are: The Ministry of Health, AMREF and Sight Savers International (SSI).  The detailed implementation plan (DIP) for Narok was conducted in November 2006 while that for Samburu, Kajiado and Laikipia, where a baseline population survey for trachoma was conducted in June 2007 (within the framework of the EU funding for trachoma control in Kenya (2007-2009) was conducted in February 2007.  AMREF has already recruited a Program Manager and the project manager for Kajiado while completing the recruitment of managers for Laikipai while the project manager for Narok was recruited by Operations Eyesight Universal.

SAFE Strategy:

• Surgery (S) -- At present surgical services are carried out on a very limited scale in West Pokot, Meru North, Narok, Kajiado, Samburu and Baringo where there is a surgeon in the district eye unit.   There is a need to train additional surgeons and equip them with surgical kits in order to accelerate surgical service uptake in both static and outreach programs. Kenya Trachoma Control Program intends to clear a backlog of 21,789 TT cases by 2009
• Antibiotics (A)– The consignment of Zithromax® that was received in November 2006 was cleared out of customs only at the beginning May 2007 and was stored in KEMSA (Central Medical Stores) in Nairobi and was dispatched to Narok, Samburu, Kajiado and Laikipia in June-August 2007 in view of a mass Zithromax® treatment campaign that is currently underway (September – October 2007).  Kaijado is currently distributing, but the remaining three districts will distribute during Q1 2008.
• Face washing (F)-- Lack of health education, water and hygiene in the endemic districts are the main challenges. School health programs are used for health education and school children wash faces at school using leaky tins. Chiefs’ barazas and churches are also used for health education. Partners such as AMREF work through community programs and social groups to encourage face washing with the available water. 
• Environmental improvement (E) --  includes improved access to water, improved personal and community hygiene and sanitation, as well as increased use of toilets, all leading to the reduction in the vectors for transmission (flies). The government through the Ministry of Natural Resources and other partners are working to increase the quantity and quality of water supply to communities through provision of boreholes, community and household storage tanks.  Construction and use of household pit latrines is also encouraged through community education and demonstration.

            Program monitoring:
            The Ministry of Health, together with the Trachoma Task Force (TTF), will provide program supervision in all the districts. The Trachoma Task Force is currently comprised of the Division of Ophthalmology, AMREF, SSI, CBM, KSB and the University of Nairobi.  It is expected that the Ministries of Education and Water will be included soon as well.  Quarterly meetings with district team leaders and annual meetings with stakeholders will be held to review the progress collectively. The stakeholders include the TTF in addition to DFID, the WHO and UNICEF.  A reporting system is in place and reporting tools will be provided.  Furthermore, the National Task Force will be reconstituted and revived to incorporate the ministries of planning and finance and further the agenda within public private partnerships.