By NewsDesk  @infectiousdiseasenews

The World Health Organization (WHO) announced this week that great progress has occurred in the battle against the bacterial neglected tropical disease, trachoma. Major data presented at the WHO Alliance for the Global Elimination of Trachoma by 2020 reveals the following:

  • The number of people at risk of trachoma has fallen from 1.5 billion in 2002 to just over 142 million in 2019, a reduction of 91 percent.
  • The number of people requiring surgery for trachomatous trichiasis – the late, blinding stage of trachoma – has dropped from 7.6 million in 2002 to 2.5 million in 2019, a reduction of 68 percent.
An outdoor examination of a woman’s right eye, looking for symptoms of trachoma/CDC

Eliminating trachoma contributes to the ocular health and quality of life of the poorest,  most disadvantaged people worldwide and thereby moves us a step closer to achieving universal health coverage,” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “Ridding the world of this painful, debilitating disease is being made possible through generous donations of the antibiotic azithromycin, sustained contributions from a network of dedicated funding agencies and partners, and the efforts of hundreds of thousands of front-line workers who work tirelessly to engage communities and deliver interventions.”

The organism that causes trachoma is Chlamydia trachomatis serovars A-C. These types are different from the types of Chlamydia that commonly cause the sexually transmitted infection that is so prevalent here in the United States.

Not only is trachoma a health issue in Africa and the Middle East,  but it is also endemic on the Indian subcontinent, Southeast Asia and China. Pockets of trachoma are seen in Latin America and Australia.

This is definitely a disease of the poor with poverty, poor personal hygiene and crowded living conditions being a few of the main factors contributing to its spread. It is also more commonly found in areas where the climate is dusty and dry.

The infectious agent is transmitted person to person through contact with eye or nasal discharges on fingers and indirectly through the use of contaminated items such as towels, pillows and clothes items like a mother’s shawl.

Flies are also a carrier of the contaminated discharge from person to person after feeding on the eye discharge of an infected person. In Africa and the Middle East, a specific specie of fly, Musca sorbens, is responsible for much of the spread.

Initially the infection resemble “pink eye” where there is inflammation of the eye, pain and sensitivity to light. Also the eye produces a watery discharge and the infection and inflammation resolves itself. The severity of trachoma is the result of frequent reinfection of the eye which over time causes scarring on the inner upper eyelid.

The resulting network of scarring over time causes an in-turning of the eyelashes (trichiasis) and entropian.

This results in a chronic abrasion of the cornea from the contact from the eyelashes. The scratching of the cornea also results in additional eye infections which in combination cause the cornea to turn opaque and blindness is the final result.

The World Health Organization (WHO) has developed the S.A.F.E. strategy to control and prevent trachoma. It consists of lid surgery (S), antibiotics (A), teaching kids to keep their face clean and personal hygiene (F), better sanitation and waste disposal or the environmental factors (E).

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