Control of trachoma and prevention of blindness in rural communities in Burma.

Trachoma was identified as the single most important cause of blindness in central Burma in a study carried out in 1961-1962. Control measures started in 1964 considerably reduced the degree of endemicity and severity of the disease in the areas treated. According to recent simplified criteria of evaluation, the prevalence of active trachoma has been reduced by more than 60% and that of active inflammatory disease of moderate and severe intensity from 7.4% to 1.8% of the active cases. A reduction in the risk of becoming infected is evident from changes that have occurred among the younger age groups.The experience acquired by the trachoma control project in central Burma-covering a population of more than 4 million in 8000 villages-emphasizes the importance of the active participation of the community and the role of local auxiliary personnel. Most of the activities, including surgical repair of trichiasis, are the responsibility of health assistants; their training includes, in addition to the recognition and treatment of patients requiring topical application of antibiotics or surgical repair of trichiasis, the screening and referral to the general practitioner or to the eye specialist of those needing more specialized attention.The results already obtained have made possible a gradual replacement of control activities by a surveillance programme, and their integration into the basic health services. The objectives of the trachoma control programme have been expanded to include the prevention and management of other causes of preventable or curable blindness, with special emphasis on eye injuries and glaucoma.