This is pleasing: although reducing TF prevalence (and thereby reducing the risk of future trachomatous blindness by minimizing the deposition of conjunctival scar) is the desired outcome, the impact of MDA in Ethiopia has been more variable than elsewhere in Africa.20–22 Reasons for the relative success in Somali region could include good MDA coverage, low trachoma prevalence at baseline,6 or other factors. Here, TF is linked to inclusion conjunctivitis.