ITI is a program of The Task Force for Global Health.
Viet Nam is a socialist republic sharing borders with China, Laos and Cambodia and a member of the WHO Western Pacific Region. Major economic reforms of the past 30 years have brought about strong economic growth, moving Viet Nam from its position as one of the world’s poorest countries to classification as a lower middle-income country in 2010. The population has a higher education level and longer life expectancy than many countries with a similar per capita income. According to UNICEF, 98% of the population had access to improved drinking water and 78% had access to improved sanitation in 2015.
One third of the population remains economically vulnerable and extreme poverty persists among rural ethnic minority communities, particularly those living in remote mountainous regions in the center and near the border with China. The country’s highest rates of extreme poverty are in isolated communities located in steep mountainous terrain with very limited access to healthcare and other basic services.
The trachoma control program started in 1957 with the establishment of the National Institute of Trachoma, now known as the Vietnam National Institute of Ophthalmology (NIO). At that time, trachoma was a leading cause of blindness, with national prevalence of active trachoma and trichiasis estimated at 60% and 6.4%, respectively. In the early 1960s, one of Viet Nam’s leading trachoma experts, Professor Nguyen Xuan Nguyen, estimated that it would take Viet Nam 50 years to eliminate blinding trachoma. The intensive nationwide program included surgery campaigns, antibiotic treatment (with TEO), strong health and hygiene education and social mobilization. Districts and communes organized “Trichiasis Elimination Committees”. By 1975 the national prevalence of active trachoma was estimated at 17.5%.
Trachoma control activities were limited following national reunification in 1976, when MOH priorities shifted to life-threatening diseases and vaccination programs in the postwar recovery period. Progress continued, however, and by 1995 active trachoma and trichiasis prevalence were estimated to be 7.1% and 1.2%, respectively.
In 1999 Viet Nam endorsed the WHO Vision 2020 declaration and reactivated the National Trachoma Control Project, with support from ITI, HKI, FHF and the newly established MOH Steering Committee for Blindness Prevention. The Ministry of Health set the goal of eliminating blinding trachoma in Viet Nam by 2010 and launched SAFE implementation in 24 districts and 15 provinces, with distributions of donated Zithromax® from 2001 – 2007. Survey results in 2006 showed active trachoma prevalence below 5% in all 15 provinces. Trichiasis prevalence was estimated to exceed 1% in at least three provinces, and surgery became the primary focus of the program. The ITI Viet Nam office closed at the end of 2009.
CURRENT IMPLEMENTATION STATUS
In 2014, to assist in assessing progress towards elimination, USAID and GTMP collaborated with NIO to survey 24 districts thought to have previously been endemic. One cluster of Yen Minh district, Lung Ho commune, had usually high TF prevalence. Additional investigations of clinical signs and C. trachomatis DNA in Lung Ho in 2015 and 2016 indicated active disease warranting control.
In 2017, with USAID support through RTI Envision, the NIO will conduct Zithromax® MDA in Lung Ho commune and additional baseline surveys in the rest of Ha Giang province.
Zithromax® Shipments by Year