Fighting Disease:  Niger

Controlling Trachoma

The leading cause of preventable blindness in the world, trachoma is an excruciating bacterial disease endemic to the poorest countries of the world. Although not typically a fatal disease, severe trachoma is disabling, debilitating, and eventually leads to blindness. The Carter Center supports trachoma control in six African countries in partnership with trachoma-endemic communities, ministries of health, the Lions Clubs International Foundation, Pfizer Inc., and the Conrad N. Hilton Foundation. Learn more about the Carter Center's Trachoma Control Program >

For additional information and updates on the following health program, read the latest issue of Eye of the Eagle >

In late 1998, The Carter Center capitalized on its experience and knowledge gained from the Guinea Worm Eradication Program to work with the government of Niger and partner organizations to implement trachoma control. National trachoma prevalence surveys conducted in Niger from 1997-1999 found the burden of trachoma to be concentrated in the regions of Zinder, Diffa, and Maradi. High prevalence of trachoma in children and trichiasis in adults indicated that trachoma was indeed a public health problem in Niger.

In response to these data, the Nigerien ministries of health, education, water, and social development established a Trachoma Task Force, inviting The Carter Center and other partner organizations to serve as members.

From 1999-2008, the Center focused exclusively on health education and environmental sanitation activities. In late 2008, the Nigerien Ministry of Health and the National Prevention of Blindness Program requested partner organizations support national trachoma elimination, with a target date of 2015.  With support from the Conrad N. Hilton Foundation, The Carter Center expanded its support to cover additional SAFE strategy activities throughout Maradi, Diffa, and Zinder regions.

The Niger Trachoma Control Program supports trichiasis surgery through both health center-based care and outreach strategies. To achieve national elimination of trachoma and reduce the backlog of existing trichiasis cases, The Carter Center has provided support to the national program to deliver surgery to targeted districts. In 2010, a total of 5,267 Carter Center-supported trichiasis surgeries were conducted.

Distribution of azithromycin in Niger is community-based and is carried out door to door in the villages by community distributors. In 2010, The Carter Center supported the distribution of more than 1 million doses of the antibiotic Zithromax® (donated by Pfizer Inc) and nearly 33,000 doses of tetracycline eye ointment to fill a treatment gap identified by the national program. The Center also has provided the Ministry of Health with much-needed surgical supplies and consumables with support from the John P. Hussman Foundation.

The Carter Center delivers health education through a variety of approaches including: rural radio broadcasts and listening clubs, soap making, and training of religious and community leaders. National school health programs, initiated with the support of Helen Keller International, have contributed to disease prevention efforts by training schoolteachers about trachoma control so they can then educate their students. Today, approximately 452 primary schools in Carter Center areas participate in trachoma control education. To reach children not in the secular school systems, the program also trains traditional Koranic schoolteachers. Through 2010, a total of 634 villages currently benefit from Carter Center-supported ongoing health education.

The program uses mass media to broadcast messages on all four components of the SAFE strategy for trachoma control. To broaden the reach of the program's educational campaign throughout Niger, health education messages are produced and broadcast in local languages on community radio stations.  To reach people without access to radio, artists and health educators performed theatrical dramas in large villages and weekly markets and to promote better family hygiene, more than a thousand rural women have been trained in traditional soap preparation. Soap made locally is affordable in the poorest of villages and can even be used to generate income.

Household latrine promotion has been a cornerstone of the Carter Center Niger program. In 2010, through Carter Center support, 10,650 household latrines were built in Diffa, Maradi, and Zinder regions.

Despite this progress, major obstacles persist in trachoma prevention and treatment efforts. Lack of access to health facilities and health personnel, poor water quality in rural areas, food insecurity due to environmental problems from locusts and poor rains, and internal migration all continue to challenge program efforts.

The Carter Center is committed to working with the Niger Ministry of Health to control trachoma until this disease is no longer a public health problem for the nation.

Read the feature: Nigerien Soap Provides Income, Helps Prevent Blindness >

View trachoma education materials from Niger >

Learn more about the Trachoma Control Program in Niger (in search result format) >