Trachoma
Trachoma is an infectious eye disease caused by the Chlamydia trachomatis bacteria, primarily affecting children in developing regions where access to clean water and hygiene practices are limited. Characterized by symptoms such as red, painful, and sticky eyes, trachoma can lead to severe complications, including the turning in of the eyelid and eventual blindness if left untreated. The disease spreads rapidly in crowded living conditions where flies and poor sanitation are prevalent, making it a significant public health concern in parts of Africa, Asia, the Middle East, and some areas of Central and South America.
Treatment typically involves the use of tetracycline eye ointment and promoting facial cleanliness to prevent reinfection. In more advanced cases, surgical procedures may be necessary to correct eyelid position. The World Health Organization (WHO) has initiated efforts, such as the Global Elimination of Trachoma by 2020 (GET 2020), aimed at reducing the prevalence of this disease through a strategy known as "SAFE," which encompasses surgery, antibiotics, clean faces, and environmental improvements. Despite the challenges posed by cultural perceptions and resource limitations, education and community involvement are crucial in the fight against trachoma to improve hygiene and health outcomes.
Trachoma
ANATOMY OR SYSTEM AFFECTED: Eyes
DEFINITION: An infectious disease of the eyes that causes blindness
CAUSES: Bacterial infection
SYMPTOMS: Red, painful, and sticky eyes; irritation to underside of eyelid; turning in of eyelid and eyelashes with corneal damage; eventual blindness
DURATION: Typically six weeks
TREATMENTS: Tetracycline eye ointment, face cleansing, surgery if prolonged
Causes and Symptoms
Trachoma is caused by the Chlamydia trachomatia bacteria. It is carried primarily by children throughout the developing world, where water is scarce and washing is difficult. Combined with a general lack of hygiene, blowing dust and smoke from cooking fires provide a perfect environment for Chlamydia trachomatia bacteria to take hold.
Flies from refuse areas crawl on faces of children who sleep in crowded conditions. The insects touch those children with the bacteria, then infect and reinfect others rapidly throughout an entire village. The eyes become red, painful, and sticky, causing irritation to the underside of the eyelid. Infection easily spreads as children touch the faces of their mothers and other children.
Left untreated, the eyelid and eyelashes turn in, damaging the cornea. The disease becomes more painful and injurious to adults as the eyelashes break off. This bristle-like effect lacerates the cornea and opaque scarring builds (a condition called trichiasis). Blindness is inevitable, usually by the age of forty to fifty.
Treatment and Therapy
Tetracycline eye ointment, twice a day for six weeks, gets rid of the infection. Face cleansing, especially for children, is the best way to prevent infection, along with environmental improvement and education. After the disease has advanced, the last hope is a surgical procedure to rotate the eyelid to its original position. The procedure is relatively simple. Nurses, medical assistants, and technicians can be trained to perform it at local clinics. Efforts to eliminate Musca sorbens, the aggressive flies in Africa and Asia, are also effective in controlling trachoma.
Perspective and Prospects
The World Health Organization (WHO) estimates that 1.9 million people are blind or visually impaired because of trachoma. Active infectious trachoma affects 150 million children. Areas most affected are Africa, Central and South America, Asia, the Middle East, and interior Australia.
In 1997, WHO launched a concerted effort to control trachomatous blindness by forming a consortium, the Global Elimination of Trachoma by 2020 (GET 2020). Strategy for GET 2020 is summarized by the acronym “SAFE,” which refers to the four field-tested activities for control of trachoma; surgery, antibiotics (tetracycline), clean faces, and environmental change. Trachoma control is one of the most affordable health interventions. In 2020 WHO set 2030 as its new target date to eliminate trachoma.
Education of the peoples involved is difficult. Because the disease is not fatal, they have little concern, accepting the disease as a fact of life. Mothers are being educated to find time to retrieve well water for washing their children’s faces even when drought and poverty make feeding their families a trial. Mothers are being taught to understand the relationship between dirt on children’s faces and the eye diseases making their own eyes red and sore. As such environmental improvement techniques are taught, villages are motivated to cooperate with worldwide and local agencies in the interest of curing trachoma.
Bibliography
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Hertle, Richard, David B. Schaffer, and Jill A. Foster, eds. Pediatric Eye Disease: Color Atlas and Synopsis. New York: McGraw, 2002. Print.
Johnson, Gordon J., et al., eds. The Epidemiology of Eye Disease. 3rd ed. London: Imperial College, 2012. Print.
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Schachterm, J., et al. “Azithromycin in Control of Trachoma.” The Lancet 354.9179 (1999): 630. Print.
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"Trachoma." MedlinePlus. National Library of Medicine, 22 Aug. 2022, medlineplus.gov/ency/article/001486.htm. Web. Accessed 8 Apr. 2024.
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