The use of simple epidemiological models in the evaluation of disease control programmes: a case study of trachoma.

One of the problems in the quantitative evaluation of disease control programmes is the definition of a "critical" index reflecting the effect of control measures on the various aspects of a polymorphic disease. Trachoma is an example of a polymorphic disease in which its activity, intensity, severity, etc., are affected by control measures, including their timing. A simple epidemiological model indicated that the "force of infection" is a sufficient parameter to describe changes in the disease picture following a control programme. Use was made of two trachoma prevalence sample surveys in the same communities, one carried out in 1960-61 and the other in 1968-69. Total trachoma age-prevalence histograms were constructed and simple catalytic curves fitted with the help of a computer programme developed for this purpose. A reduction in the force of infection in the cohort born after the institution of control measures was found. Its projection to the whole community indicated that the control programme had reduced the disease load to 20.1%, i.e., about two-fifths of its former level.