Perspectives of National Coordinators and Partners on the Work of the Global Trachoma Mapping Project

Abstract

Purpose: Neglected tropical diseases (NTDs) affect people living in the poorest regions of the world and their debilitating effects perpetuate the poverty cycle. Understanding the distribution of NTDs is crucial for effective intervention delivery. In 2012, the Global Trachoma Mapping Project (GTMP) was initiated to map >1800 suspected trachoma endemic districts by March 2015. This research was carried out to better understand the implementation experience and identify lessons which might inform the GTMP and similar initiatives. Methods: Using grounded theory methodology, semi-structured interviews were conducted with key informants from six countries with 63% of the global mapping backlog (Ethiopia, Malawi, Mozambique, Nigeria, Solomon Islands, and Yemen). Interviews were transcribed, coded, and findings separated into categories. Results: Three themes were identified during the research; planning and operations, technical implementation, and governance. The project was felt to be most successful in countries where the Ministry of Health was actively engaged in setting standards, ensuring capacity building for government staff, and guiding the training, data collection, analysis, and interpretation of data. Standardized tools, training platforms, and the use of electronic data capture increased confidence in the reliability of the survey data, informed quality improvement efforts within survey implementation, and the immediate release of results empowered end-user decision-makers. Regional collaboration between endemic countries bolstered program manager competence and confidence, while reinforcing partnerships essential to the success of the GTMP. Conclusions: We depict how innovative characteristics of the GTMP, and lessons learned from its implementation, can strengthen similar initiatives to map disease prevalence and risk factors. ARTICLE HISTORY

The Global Trachoma Mapping Project: A Catalyst for Progress Against Neglected Tropical Diseases

“…Disease prevalence maps are absolutely critical for planning effective interventions, 12 and the GTMP data prepare the ground for trachoma elimination interventions for people that need them around the world. That the GTMP was able to fulfill its trachoma mapping mandate on schedule and under budget, while (1) where requested, simultaneously collecting data on Guinea worm, rabies, yaws, the preventive chemotherapy neglected tropical diseases, and access to water and sanitation; (2) maintaining the highest standards of quality and comparability; and (3) ensuring health ministry leadership and ownership, 11,13 is an impressive accomplishment.…”

Prevalence of and risk factors for trachoma in Kwara state, Nigeria: Results of eight population-based surveys from the Global Trachoma Mapping Project

“…53 In any case, the prevalence of all-trichiasis in adults was <0.2% in each LGA, so this omission does not affect our conclusion that elimination thresholds have been surpassed in this population. GTMP approaches are recognized to be of high epidemiological quality, 54,55 and to provide an advance over the more individualized survey designs 56 implemented prior to the inception of the GTMP.…”

Impact of the Global Trachoma Mapping Project

“…GTMP enabled Ministries of Health to take ownership of the survey process, and became a catalyst for implementation, with trachoma interventions underway in all participating countries. 3,8 The rigorous GTMP methodology and the implementation of the surveys through handheld mobile devices was a tremendous capacity builder, training a cadre of health workers in epidemiologic assessment with applicability far beyond trachoma. Moreover, GTMP formed the foundation for Tropical Data, the successor to the GTMP that supports country efforts to perform impact assessments for trachoma.…”