• Zahir ud Din Babar Army Field Hospital
  • Muhammad Saim Khan Combined Military Hospital, Multan
  • Bilal Murtaza Combined Military Hospital Okara
  • Rafiq Ahmad Khattak Army field hospital, KGNTH, Bannu
  • Shahrukh Shah Army field Hospital
  • Khurram Shahzad Army field hospital


Background: the objective of the study is to observe frequency of various clinical manifestations of trachoma in rural population. This observational study was conducted at Khalifa Gul Nawaz Teaching Hospital (KGNTH), Bannu, Pakistan from April 2016 to Jan 2017. Methods: Patients visiting for ocular complaints underwent initial screening that included demographic details and documentation of unaided as well as best corrected visual acuity (BCVA) which was followed by detailed slit lamp examination of anterior segment including eversion of upper lid for assessment of changes in upper tarsal conjunctivas by consultant ophthalmologist.  A total of 648 patients who had clinical presentation of trachoma were included in the study. Patients who had other forms of conjunctivitis, trichiasis, entropion, corneal opacification and vascularization due to causes other than trachoma were excluded. Patients were categorized according to age in three groups (Group 1–3) and according to stages of trachoma in five groups (TF, TI, TS, TT and TO). Results: Six hundred and forty-eight (648) were examined in this cross-sectional survey with a mean age of 14.3+14.2 years. Mean unaided visual acuity and BCVA of the patients was 0.12+.24 and 0.07+0.18 respectively. Groups-1 comprised of 86.7% of the patients and stage TF of trachoma was the most prevalent stage accounting for 70.06% of the patients. Conclusion: Trachoma is a serious community health problem with various clinical manifestations in different age groups. Awareness and educational programs are required to be conducted in schools and vocational training centers regarding its mode of transmission and control. Keywords:  Trachoma; Prevalence; Follicular conjunctivitis

Author Biographies

Zahir ud Din Babar, Army Field Hospital

Commanding Officer, Community Health Dept

Muhammad Saim Khan, Combined Military Hospital, Multan

Consultant Ophthalmology

Bilal Murtaza, Combined Military Hospital Okara

Consultant Ophthalmologist

Rafiq Ahmad Khattak, Army field hospital, KGNTH, Bannu

Director MTI (KGNTH)

Shahrukh Shah, Army field Hospital

Army field hospital, Medical officer

Khurram Shahzad, Army field hospital

Army field hospital , Medical officer


Mengistu K, Shegaze M, Woldemichael K, Gesesew H, Markos Y. Prevalence and factors associated with trachoma among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Ethiopia. Clin Ophthalmol 2016;10:1663–70.

WHO. World Health Organization Global Burden of Disease. Geneva: WHO Press; 2007.

Taborisky J. Historic and ethnologic factors in the distribution of trachoma. Am J Ophthalmol 1952;35(9):1305–11.

Larner AJ. Ophthalmological observations made during the mid-19th century European encounter with Africa. Arch Ophthalmol 2004;122(2):267–72.

Marr JS. When germs travel: six major epidemics that have invaded America since 1900 and the fears they have unleashed. Medscape Gen Med 2004;6(4):55.

Pizzarello L, Abiose A, Ffytche T, Duerksen R, Thulasiraj R, Taylor H, et al. VISION 2020: The Right to Sight: a global initiative to eliminate avoidable blindness. Arch Ophthalmol 2004;122(4):615–20.

Melese M, Alemayehu W, Bayu S, Girma T, Hailesellasie T, Khandekar R, et al. Low vision and blindness in adults in Gurage Zone, central Ethiopia. Br J Ophthalmol 2003;87(6):677–80.

Zerihun N, Mabey D. Blindness and low vision in Jimma Zone, Ethiopia: results of a population-based survey. Ophthalmic Epidemiol 1997;4(1):19–26.

Thylefors B. Trachoma–new opportunities to tackle an old problem. Br J Ophthalmol 1996;80(12):1033–4.

Thylefors B, Dawson CR, Jones BR, West SK, Taylor HR. A simple system for the assessment of trachoma and its complications. Bull World Health Organ 1987;65(4):477–83.

West SK, Muñoz B, Mkocha H, Hsieh YH, Lynch MC. Progression of active trachoma to scarring in a cohort of Tanzanian children. Ophthalmic Epidemiol 2001;8(2-3):137–44.

Solomon AW, Peeling RW, Foster A, Mabey DCW. Diagnosis and assessment of trachoma. Clin Microbiol Rev 2004;17(4):982–1011.

Taylor HR, Burton MJ, Haddad D, West S, Wright H. Trachoma. Lancet 2014;384(9960):2142–52.

Burton MJ, Holland MJ, Faal N, Aryee EA, Alexander ND, Bah M, et al. Which members of a community need antibiotics to control trachoma? Conjunctival Chlamydia trachomatis infection load in Gambian villages. Invest Ophthalmol Vis Sci 2003;44(10):4215–22.

WHO Alliance for the Global Elimination of Blinding Trachoma by the year 2020. Progress report on elimination of trachoma, 2013. Wkly Epidemiol Rec 2014;89(39):421–8.

Ngondi J, Matthews F, Reacher M, Onsarigo A, Matende I, Baba S, et al. Prevalence of risk factors and severity of active trachoma in southern Sudan: an ordinal analysis. Am J Trop Med Hyg 2007;77(1):126–32.

Yalew KN, Mekonnen MG, Jemaneh AA. Trachoma and its determi¬nants in Mojo and Lume districts of Ethiopia. Pan Afr Med J 2012;13(Suppl 1):8.

Mpyet C, Lass BD, Yahaya HB, Solomon AW. Prevalence and risk factors for trachoma in Kano state, Nigeria. PLoS One 2012;7(7):e40421.

West S, Muñoz B, Lynch M, Kayongoya A, Chilangwa Z, Mmbaga BB, et al. Impact of face-washing on trachoma in Kongwa, Tanzania. Lancet 1995;345(8943):155–8.

Cumberland P, Edwards T, Hailu G, Harding-Esch E, Andreasen A, Mabey D, et al. The impact of community level treatment and preventative interventions on trachoma prevalence in rural Ethiopia. Int J Epidemiol 2008;37(3):549–58.

Ashebir Y, Rai Sharma H, Alemu K, Kebede G. Latrine use among rural households in northern Ethiopia: a case study in Hawzien district, Tigray. Int J Environ Stud 2013;70(4):629–36.

Xue W, Lu L, Zhu J, He X, He J, Zhao R, et al. A Cross-Sectional Population-Based Survey of Trachoma among Migrant School Aged Children in Shanghai, China. Biomed Res Int 2016;2016:8692685.

Harding-Esch EM, Edwards T, Sillah A, Sarr-Sissoho I, Aryee EA, Snell P, et al. Risk factors for active trachoma in The Gambia. Trans R Soc Trop Med Hyg 2008;102(12):1255–62.