Achieving elimination of trachoma as a public health problem in trichiasis-endemic districts requires a systematic approach to trichiasis case finding and outreach. In this study, we used programme monitoring data from seven countries for 2017–2019 to explore the efficiency of different community mobilisation approaches and uptake of trichiasis surgical services.
Countries that used broad-based community mobilisation strategies had large numbers of people presenting at outreach, but a small percentage of them had trichiasis (2.9%). In countries using house-to-house case finding, 37.5% of outreach attendees had trichiasis. Countries using house-to-house case finding also had proportionally more women attending outreach compared with countries using broad-based mobilisation. Among trichiasis cases offered surgery 86% accepted, which was similar for men and women.
In the settings of our study, the elimination of trichiasis as a public health problem, particularly in women, is more likely to reached by adopting a systematic approach with the community, and house-to-house case finding appears to be the best way to achieve this.