7/04/2007

What is Trachoma?

Trachoma is an infectious disease of the eye caused by the bacterium Chlamydia trachomatis. Those who are infected by trachoma do not instantly go blind—the disease manifests gradually. While children are highly susceptible to infection, the most severe effects emerge in adulthood, when scarring from repeated infections causes eyelashes to turn inward and scratch the cornea, leading slowly and painfully to complete blindness.

How does a person become infected with trachoma?
The bacteria that causes trachoma can be spread easily on an infected person’s hands or clothing, or may be carried by flies that have come into contact with discharge from the eyes or nose of an infected person. Because trachoma is transmitted through close personal contact, it tends to occur in clusters, often infecting entire families and communities.

Who is most at risk of contracting trachoma?
Trachoma affects rural populations with limited access to health care and clean water, and it disproportionately affects the most vulnerable members of these underserved populations—women and children. The primary hosts of the trachoma bacteria are children under the age of five. Due to the infectious nature of the disease, those who have the most contact with infected children are most likely to become infected themselves. Since women are traditionally the primary caregivers of children, they are frequently exposed to trachoma and are thus more vulnerable to infection and eventual blindness.

How prevalent is trachoma?
Currently, more than eight million people are visually impaired or irreversibly blind as a result of trachoma, and over 84 million people have active disease. The disease is particularly widespread in Africa, where 36 countries are trachoma endemic.

How can trachoma be eliminated?
Trachoma can be effectively eliminated through the WHO approved SAFE strategy:
· Surgery to correct advanced stages of the disease
· Antibiotics to treat active infection
· Face washing to reduce disease transmission
· Environmental change to increase access to clean water and improved sanitation to eliminate disease altogether
The SAFE strategy combines curative medicine, public health measures, and social development interventions to fight blinding trachoma. SAFE uses appropriate medicines and technologies that are readily adaptable to diverse cultures and populations. Communities in which the SAFE strategy is applied have shown progress in the elimination of trachoma.

Is trachoma elimination feasible?
Yes. Morocco is likely to be the first country to eliminate trachoma using the SAFE strategy. Through a vigilant and concerted effort over the past six years, Morocco has reduced its prevalence of active trachoma by 90 percent among children under ten years of age. Based on data illustrated in the graph below, there is strong evidence that Morocco will be successful in eliminating trachoma as a public health issue by the end of 2005. Morocco’s progress towards trachoma elimination stands as an encouraging challenge to other endemic countries and offers hope for the global elimination of blinding trachoma by 2020.

If trachoma is so prevalent, why have I never heard of it?
Despite the fact that it affects nearly 10 percent of the world’s population, few people have heard of trachoma. It is one of the oldest infectious diseases known to mankind, however, and references to it appear on papyrus scrolls dating back to he pharonic period of ancient Egypt. With improvements in living conditions, it has been eliminated in most developed nations. Due to poverty and lack of resources, however, the disease persists primarily in the developing world, where nearly one billion people remain at risk of blindness from trachoma. Because trachoma does not kill, and because it is mostly contained among the world’s most marginalized people, it receives little attention as a public health issue.
But trachoma is a serious threat to public health and human development. In addition to the tremendous personal suffering caused by the disease, it limits or eliminates its victims’ ability to work, resulting in productivity losses estimated at US$2.9 billion per year.

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