Conclusions & Recommendations

TEC recommends countries to include above guidance in their supervisory tools to further the goal of no choking deaths from Zithromax®.

TEC recommends that ITI work with the Ethiopian study team to develop guidance for observing management of children during MDA to share with all endemic countries currently distributing Zithromax®.

TEC recommends that national programs review their trachoma MDA training materials to ensure that the correct dose of POS is given to all children who are eligible to receive it and that other measures to reduce risk of choking are followed during drug distribution, as described in the revised Zithromax® Management Guide.

TEC congratulates countries that have covered the increased activity costs (to purchase personal protective equipment and increases in per diem, lodging, and fuel costs) through domestic financing. TEC notes that securing domestic financing for this and other program activities is in line with guidance in the new WHO NTD Roadmap.

TEC congratulates the national programs that presented at TEC 23 (Nigeria, Côte d’Ivoire, and Ethiopia) and their partners for their rapid and comprehensive COVID-19 risk prevention during trachoma program activities. TEC encourages other countries to implement stringent COVID-19 risk prevention in their trachoma elimination efforts.

TEC recognizes the difficulty in interpreting the survey results in Korhogo, where baseline surveys were conducted at the same time as administrative redistricting resulting in a poor match of survey evaluation units and administrative districts. TEC approved the application for one round of MDA followed by impact surveys for the entirety of each of the new Korhogo districts (Korhogo 1, Korhogo 2, Dikodougou, Mbengue, Sinematiali). The TEC recommends to the NTD program of Côte d’Ivoire that impact surveys be conducted along the new administrative unit structures and not the previous survey evaluation units.

Given the lack of funding support for the Central African Republic trachoma program, TEC recommends to ITI to encourage the national program to submit a funding request to ESPEN for MDA.

The TEC Refugee/IDP Committee will think through these issues and bring thinking to the next TEC meeting for further consideration, particularly around the issue of data gathering in these populations. The Committee is now comprised of Chad, Robin, Stephanie, and David.

The TEC considered whether a survey in a fluid population provides any actionable information; and recognizes other methodologies that allow more flexibility and context-specific data capture may be needed. The experience of other programs working in similar situations may be instructive to the trachoma community in determining the necessary indicators to allow ITI to determine the point when MDA with Zithromax® is no longer needed.

TEC notes that there is continued difficulty in making evidence-based decisions in the context of refugees and internally-displaced persons (IDPs), which indicates the need for clarification of the decision-making guidelines