V 2020 – India: Why a survey on Trachoma?
Dr Praveen Vashist: According to the World Health Organisation (WHO) India is one of the endemic coun-tries for Trachoma. The last national survey was done in 1986 – 89. It is more than 25 years, a period in which a number of socio-developmental and trachoma specific SAFE initiatives have been taken to reduce the burden of the disease. It is time to conduct a mega survey to assess how these initiatives have impacted and to find out the current preva-lence and magnitude of trachoma in the country.

V 2020 – India: Has the disease not been eliminated from the country?
Dr Praveen Vashist: Though the burden of disease is reduced but there are still some high risk areas for trachoma. Dr RP Centre did a sur-vey in Nicobar Island of Andaman and Nicobar Island in 2010 and nearly 50% children were identified with active trachoma infection and trachomatous trichiasis was also ob-served in adults in all the ten villages surveyed, wherein trachoma control measures were suggested in form of mass Azithromycin treatment once in a year for three consecutive years. We conducted a repeat survey after three years in 2013 and found that the prevalence of active infection has come down to 6.8% amongst the surveyed children.In our Rapid Assessment of Trachoma (RAT) in urban slums of Delhi, we found active cases of trachoma in few slums although the magnitude of active trachoma infection was low.

V 2020 – India: For the current survey which are the states that you have selected?

Dr Praveen Vashist: We are conducting the tra-choma prevalence survey in 9 districts of 5 states which were part of the previous TRA survey in 2006 – 07. The 5 states are: Punjab, Haryana, Rajasthan, Gu-jarat and Uttarakhand. Uttar Pradesh was part of the 2006 – 07 survey, but Trachoma prevalence study has already been conducted by NPCB in this state.
The districts to be covered are:
Hoshiarpur (Punjab), Mahendergarh & Mewat (Haryana), Bikaner, Dholpur & Tonk(Rajasthan), Pauri Garhwal (Uttaranchal), and Kutch & Banas-kanta (Gujarat).

Additionally, 15 districts in 15 states will also be covered where a rapid as-sessment of trachoma will reflect the current status of trachoma in these regions.

V 2020 – India: What is the sam-pling frame/size for the survey?

Dr Praveen Vashist: For the Trachoma prevalence survey, we have selected 20 clusters randomly from each district. In each cluster minimum 100 children are examined: 1- 9 years for active infection and population of 10 years and above examined for trichiasis, corneal opacity including blindness.

V 2020 – India: Dr Praveen, you have led several surveys, including the one on trachoma in Andaman and Nicobar. So drawing from that experience what do you bring different to this survey?

Dr Praveen Vashist: In one word: quality. We are concerned about quality and are making all efforts to ensure that we maintain standards as per WHO guide-lines. We are also conducting microbiological investi-gations among the cases as well as equal number of controls. Direct Immunofluorescence analysis will be done using the MicroTrak Chlamydia trachomatis Specimen Kit procured from M/s Trinity Biotech, IreDirect Specimen Kit procured from M/s Trinity Biotech, Ireland in the dedicated trachoma lab of ocular microbiol-ogy unit of Dr. R.P.Centre.