Background: Trachoma is the world’s leading cause of preventable blindness and
occurs where people live in poor conditions with limited access to water and health
care. Prior to this study, it was considered an eliminated disease in Rwanda; however
its prevalence had not been recently assessed in the country.
Objectives: To determine the pattern of active trachoma, trichiasis and trachoma
related risk factors in Rwanda. The objective was also to produce by spatial analysis
a map of the distribution of trachoma based on the result of this TRA.
Design: A cross-sectional study, based on Trachoma Rapid Assessment (TRA), was
conducted from December 2007 to January 2008.
Setting: Nine selected districts of Rwanda.
Methods: Fifty children from 15 to 20 households per selected village were examined
and environmental data were collected from households. All children aged 1 to 9
years were examined for active trachoma and all persons aged 15 years or more for
Trachomatous Trichiasis (TT) and Corneal Opacity (CO).
Results: In total, 102 of the 1375 examined children had active trachoma and 20 of
the 96 adults examined had trichiasis. Gatsibo and Nyaruguru districts were the most
affected by active trachoma with a prevalence of 15.3% and 12.6% respectively.
A positive association was found between the presence of active trachoma and
the occurrence of children with unclean faces; however no correlation was found
between the presence of active trachoma and the absence of functional latrine or
the walking distance to the nearest water source. Kayonza and Gicumbi districts
had a higher number of trichiasis cases and 5.2% of these had developed corneal
opacity, with only one patient having undergone surgery.
Conclusion: Up to recently, trachoma was considered eliminated from Rwanda; but
this TRA showed that the rate of active trachoma, at least in Gatsibo and Nyaruguru
districts, is well above the threshold for treatment, according to the International
Trachoma Initiative and WHO. There is a need of a baseline survey in the two districts
to orientate on the strategies to be used for the control of trachoma so that Rwanda
can be a trachoma free country as proposed by the WHO vision 2020 initiative.