**5. Diagnosis**

Trachoma diagnosis is usually determined clinically using a x2.5 binocular magnifying loupe to examine the everted upper tarsal conjunctiva. In non-endemic areas, the laboratory methods of diagnosis are usually preferred [39].

However, the laboratory detection of c trachomatis is problematic. Firstly, it requires sophisticated equipment that are hard to acquire or even maintain in trachoma endemic communities. Secondly, the services of a specialist microbiologist or pathologist is often required in order to make accurate and consistent diagnosis of C trachomatis [40]. Thirdly and most importantly is the fact that clinical signs of trachoma are poorly correlated with actual evidence of infection demonstrable in the laboratory [41, 42].

For operational purposes, any modality of *C. trachomatis* diagnosis will have to be cheap and reliable and provide rapid results. It becomes apparent, therefore, that trachoma control programs overwhelmingly rely on clinical signs of trachoma for diagnosis [43–46].

Even though laboratory tests are not commonly used in the field of the diagnosis of *C. trachoma*, they are useful in non-endemic areas as well as in research laboratories. Frequently performed laboratory tests include the following:

