Largest Infectious Disease Survey Reaches 50th Country Milestone & 10 Million People

The Tropical Data project, formerly known as the Global Trachoma Mapping Project, hit a milestone this year as it began disease surveys in Sierra Leone, the 50th country to be mapped. In the last 9 years, the project has reached nearly 10 million people in the largest infectious disease survey ever conducted by using mobile applications to screen people for trachoma, a neglected tropical disease.

The partnership with ministries of health, the WHO, London School of Hygiene & Tropical Medicine (LSHTM), Sightsavers and The Task Force’s International Trachoma Initiative (ITI) has been an essential tool in the global effort to eliminate trachoma as a public health problem and to prevent 137 million people from going blind.

Hear below from three Sierra Leonians who have helped reach this milestone.* 

Abie Alice Davies, Ophthalmic Nurse and Tropical Data Trainer

“The survey work, when we are out in the community, we try to locate either the chiefs or the health centre and we ask their permission before doing the survey. And even when we reach to the household, we try to ask for the head of the household and we ask the consent and we ask how many householders in that house and we even asked individual consent before inverting the leads and looking for any trachoma or any other eye conditions.

Abie Alice Davies in the red shirt examines community members’ eyes during survey collection. Photos courtesy of Sightsavers.

We are asking about the water to know where they get water from and for their health. Some communities don’t even have water system, they only use the river to do the water, the laundering, the cooking, the drinking… so we asked that. And for future, maybe in future, if that community we selected to have something like a water tap or a jack pump, that why we are are asking all that… The link between water and trachoma is that because trachoma is as a result of uncleanliness. So, the link between water and trachoma, if there is water available in that particular area, we will be having frequent face wash, so that is the link. If there is no water, there is a risk of Trachoma. The challenges the survey is facing is sometimes to locate the right place. Because of misspelling of names or pronunciation and so to locate the right places, so that is more of the challenges. But when we are there, everything falls into place.

I feel very proud [to be part of this project], one as a person because I am doing it for the country… By the end of the survey, I hope that at least we would try to see if there is any trachoma in the country so that either it would be eliminated or if we notice some cases so that they would be treated. And apart from the trachoma if like the other things we noticed, maybe the poor water facility or the toilet facility, if at least some of those things would be addressed later.”

Alusine Koroma, Ophthalmic Community Health Officer and Tropical Data Grader

“I am the grader, and as far as the work is concerned, I am also the team lead for this particular team. I am responsible for doing the introduction to the community and also [raise awareness of trachoma] before we start the surveys. I am also in charge with the responsibility of examining the patient for trachoma.

“As far as this work is concerned there are challenges, because some of us are used to being in our health facilities, now we are moving to communities and most of them are very hard to reach.

Alusine Koroma in the grey polo shirt helps build awareness about trachoma in the communities where he works. Photos courtesy of Sightsavers.

“I am expecting a good impact [from the surveys] because looking at what we are doing, going to the hard-to-reach communities, trying to find these trachoma cases is very key and what we are expecting is a success. So, if there are cases at the end of the day we report that, ‘okay these are the cases that we saw, or there are no trachoma cases’, then trachoma will be eliminated in this country. That is especially what we are expecting.

“COVID-19 does not only impact Sierra Leone alone, but it has a lot of impact in terms of the world. We completed our [Tropical Data] training back in February 2020… and we were supposed to have started this [project] but because of COVID it was delayed. [Once we were able to carry out these surveys] we have to go again for another refresher training and a COVID test was done for every one of us. We were asked to wear facemasks and even these loupes we are using we were able to attach face shields on them. The participants are also wearing facemasks to protect themselves [from COVID] and we are using soap and water to wash our hands.”

Tuangay Gondoe, Sightsavers’ Programme Manager

“My name is Tuangay Gondoe, I work for Sightsavers, I’m the program manager for the country programme…My role in this survey actually at the moment right now is to support the team, in supervising them and monitoring their activities in some of the districts.

“This survey needs to be done, I think we’ve done it before, ten years ago to actually look at the prevalence of trachoma in Sierra Leone, because it is one of the NTDs – the neglected tropical diseases. And if we are talking about elimination all of these things should be eliminated in the community or in the country. So, in order for us to understand if we need to do treatment or not, we need to do a survey to see what the prevalence is like.

“The first and foremost we are working in five districts in the north, most of them are around the border areas, the reason being that you know, they would have a lot of nomadic settlements and cow/cattle rearing in this area and the flies also contribute to this kind of sickness. So, the five districts we have people working there and we would also need to look at thirty households per community. Every community you go into you check out for thirty households and then you interview those thirty households. And even if the thirty households there are about… let’s say for one household there are twenty people in on household, you interview all of those, if they are available.

Tuangay Gondoe in the yellow and white dress works with ITI’s implementing partner Sightsavers in Sierra Leone. Photos courtesy of Sightsavers.

“To a large extent Covid has impacted on this work, because it should have happened last year and it is only happening now. So, you can imagine, it is taken almost a year or two to plan and everything and still there is a hold up because of Covid, because of the close proximity between you and the person that you are talking about or you’re dealing with, you have to be ensured that you protect yourself and that person. And during the time, even when you have protective gears, you don’t want to push too close to anybody. You know, so that is one of the problems that we had with Covid. And even right now has it is, people are really very scared. We have to ensure that we do community mobilization first and they are aware that they are coming. Because of what happened during the Ebola.

“What has worked well is that the graders and the recorders they are very enthusiastic, they are putting a lot of effort into what they are doing, even when they get to a community and they have challenges… They try to ensure that in as much as it has happened this way, let’s find a solution. So, they turn back and do the right thing, you know. So, for me that is very good. They have the right attitude.

“We are looking at how we can always ensure that we are not gender biased, that is the first [reason it’s important to have female surveyors], and we give equal opportunity to both sexes… These are community people, they are rural people. They won’t feel at ease talking to a male about issues about their personal life or anything like that. So it is also good that we have female graders or recorders interacting with them, then they can get more information from them, because they feel at ease when they are talking to their kind.

“I think the people appreciate [these surveys] because the eye is a crucial part of the body and so people who understand that know that if you have problem with your eyes, you need to act as fast as possible to ensure that you treat it and see what you can do to ensure that it comes back to normal.”

The project is currently supported by the Tropical Data partners: Sightsavers, ITI, LSHTM, and RTI International, with support from the US Agency for International Development (USAID) Act to End Neglected Tropical Diseases East programme and the WHO. 

*These stories were curated by Sightsavers.

Header photo: Alusine Koroma in the grey polo shirt helps build awareness about trachoma in the communities where he works. Photos courtesy of Sightsavers.

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