Video:Trachoma

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Description

Trachoma is an infectious disease caused by bacterium Chlamydia trachomatis.[1] The infection causes a roughening of the inner surface of the eyelids.[1] This roughening can lead to pain in the eyes and breakdown of the outer surface or cornea of the eyes.[1] Untreated, repeated infections can result in permanent blindness, as the eyelids turn inward with altered eyelashes position, causing them to rub on the eye.[2]Globally, about 80 million people have an active infection.[3]

Presentation

The bacterium has an incubation period of 6 to 12 days, after which the affected individual experiences symptoms of conjunctivitis, or irritation similar to "pink eye". Blinding endemic trachoma results from multiple episodes of reinfection that maintains the intense inflammation in the conjunctiva. Without reinfection, the inflammation gradually subsides.[4][5]

Complications

The later structural changes of trachoma are referred to as "cicatricial trachoma".Among the possible complications are : Trichiasis, Dry eye syndrome, Distichiasis, and corneal neovascularization.[6][5]

Cause

Trachoma is caused by Chlamydia trachomatis, serotypes (serovars) A, B, and C.[7]

Diagnosis

In terms of the evaluation of Trachoma we find that it depends on the individual's medical history and the signs observed while doing a slit-lamp exam.[5] [8]

Differential diagnosis

The differential diagnosis for Trachoma is as follows:viral conjunctivitis, bacterial conjunctivitis, Atopic keratoconjunctivitis and Giant papillary conjunctivitis.[5]

Management

The WHO-recommended SAFE strategy includes: surgery to correct advanced stages of the disease, antibiotics to treat active infection, using azithromycin, facial cleanliness to reduce disease transmission and environmental change to increase access to clean water and improved sanitation.[9][10]

Epidemiology

As of 2011, about 21 million people are actively affected by trachoma, with around 2 (point) 2 million people being permanently blind or have severe visual impairment from trachoma. An additional 7 (point) 3 million people are reported to have trichiasis.[11] 51 countries are currently classified as endemic for blinding trachoma.[12]

WHO elimination

In 1996, the WHO launched its Alliance for the Global Elimination of Trachoma, and in 2006, the WHO officially set 2020 as the target to eliminate trachoma as a public-health problem.[13] The International Coalition for Trachoma Control has produced maps and a strategic plan called 2020 INSight that lays out actions and milestones to achieve global elimination of blinding trachoma by 2020.[14]As of 2018, Cambodia, Ghana, Iran, Laos, Mexico, Nepal, Morocco, and Oman have been certified as having eliminated trachoma as a public-health problem; China, Gambia, Iran, Iraq, and Myanmar make that claim, but have not sought certification.[15]

History

The disease is one of the earliest known eye afflictions, having been identified in Egypt as early as 15 B.C.[4]Its presence was also recorded in ancient China and Mesopotamia. Trachoma became a problem as people moved into crowded settlements or towns where hygiene was poor. It became a particular problem in Europe after the Egyptian Campaign (1798 to 1802) and the Napoleonic Wars (1798 to 1815), trachoma was rampant in the army barracks of Europe and spread to those living in towns as troops returned home. Stringent control measures were introduced, and by the early 20th century, trachoma was essentially controlled in Europe. [16][4][17]

Society

The economic burden of trachoma is significant, particularly with regard to covering treatment costs and productivity losses as a result of increased visual impairment, and in some cases, permanent blindness.[1]The global estimated cost of trachoma is reported between 2 (point) 9 and 5 (point) 3 billion U.S. dollars each year.[1] By including the cost for trichiasis treatment, the estimated overall cost for the disease increases to about 8 billion U.S. dollars.[1]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 "Blinding Trachoma Fact sheet N°382". World Health Organization. November 2013. Archived from the original on 14 March 2014. Retrieved 14 March 2014.
  2. ↑ Vaz, Francis; Mehta, Nischcay; Hamilton, Robin D. (2020). "27. Ear, nose and throat and eye disease". In Feather, Adam; Randall, David; Waterhouse, Mona (eds.). Kumar and Clark's Clinical Medicine (10th ed.). Elsevier. p. 917. ISBN 978-0-7020-7870-5. Retrieved 2022-04-24.
  3. ↑ Fenwick, A (Mar 2012). "The global burden of neglected tropical diseases". Public Health. 126 (3): 233–6. doi:10.1016/j.puhe.2011.11.015. PMID 22325616.
  4. ↑ 4.0 4.1 4.2 Taylor, Hugh (2008). Trachoma: A Blinding Scourge from the Bronze Age to the Twenty-first Century. Centre for Eye Research Australia. ISBN 978-0-9757695-9-1.
  5. ↑ 5.0 5.1 5.2 5.3 Ahmad, Bilal; Zeppieri, Marco; Patel, Bhupendra C. (2024). "Trachoma". StatPearls. StatPearls Publishing. Archived from the original on 18 April 2024. Retrieved 6 November 2024.
  6. ↑ "Trachoma - EyeWiki". eyewiki.org.
  7. ↑ Mackern-Oberti, J. P.; Motrich, R. N. D. O.; Breser, M. A. L.; Sánchez, L. R.; Cuffini, C.; Rivero, V. E. (2013). "Chlamydia trachomatis infection of the male genital tract: An update". Journal of Reproductive Immunology. 100 (1): 37–53. doi:10.1016/j.jri.2013.05.002. PMID 23870458.
  8. ↑ "What Is Trachoma?". American Academy of Ophthalmology. 12 February 2024. Retrieved 9 November 2024.
  9. ↑ "WHO congratulates Benin and Mali for eliminating trachoma as a public health problem". www.who.int. Archived from the original on 29 July 2024. Retrieved 13 November 2024.
  10. ↑ "Trachoma - PAHO/WHO | Pan American Health Organization". www.paho.org. 11 October 2024. Archived from the original on 1 November 2021. Retrieved 13 November 2024.
  11. ↑ Taylor, Hugh R; Burton, Matthew J; Haddad, Danny; West, Sheila; Wright, Heathcote (December 2014). "Trachoma". The Lancet. 384 (9960): 2142–2152. doi:10.1016/s0140-6736(13)62182-0. ISSN 0140-6736. PMID 25043452.
  12. ↑ "Epidemiological situation". World Health Organization. Archived from the original on 19 October 2018. Retrieved 2018-11-01.
  13. ↑ "WHO | Blinding trachoma: Progress towards global elimination by 2020". 2006-04-10. Archived from the original on 2015-07-08. Retrieved 2015-08-05.
  14. ↑ "Global strategy lays out concrete action plan to eliminate blinding trachoma by 2020". International Coalition for Trachoma Control. July 2011. Archived from the original on 8 November 2014. Retrieved 8 November 2014.
  15. ↑ McNeil, Donald G. Jr. (16 July 2018). "Now in Sight: Success Against an Infection That Blinds". The New York Times. Archived from the original on 23 July 2018. Retrieved 2018-09-03.
  16. ↑ Mohammadpour, Mehrdad; Abrishami, Mojtaba; Masoumi, Ahmad; Hashemi, Hassan (December 2016). "Trachoma: Past, present and future". Journal of Current Ophthalmology. 28 (4): 165–169. doi:10.1016/j.joco.2016.08.011.
  17. ↑ Taylor, H. R. (November 2009). "Doyne Lecture: trachoma, is it history?". Eye. 23 (11): 2007–2022. doi:10.1038/eye.2008.432. ISSN 1476-5454. Archived from the original on 22 December 2023. Retrieved 19 November 2024.
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