Trachoma

[2] Efforts to prevent the disease include improving access to clean water and treatment with antibiotics to decrease the number of people infected with the bacterium.

[2] Trachoma is a public health problem in 42 countries across Africa, Asia, the Middle East, and Central and South America.

[4] The bacterium has an incubation period of 5 to 10 days, after which the affected individual experiences symptoms of conjunctivitis, or irritation similar to "pink eye".

[8] Blinding endemic trachoma results from multiple episodes of reinfection that maintains the intense inflammation in the conjunctiva.

It is characterized by white lumps in the undersurface of the upper eyelid (conjunctival follicles or lymphoid germinal centers) and by nonspecific inflammation and thickening, often associated with papillae.

[12] Most commonly, children with active trachoma do not present with symptoms, as the low-grade irritation and ocular discharge are just accepted as normal, but further symptoms may include:[citation needed] The most important complication to look out for is a corneal ulcer, which is caused by intense rubbing of the affected eye, or trichiasis with a superimposed bacterial infection.

Children are the most susceptible to infection due to their tendency to get dirty easily, but the blinding effects or more severe symptoms are often not felt until adulthood.

Many factors are indirectly linked to the presence of trachoma including lack of water, absence of latrines or toilets, poverty in general, flies, close proximity to cattle, and crowding.

Trachomatous trichiasis (TT)—At least one ingrown eyelash touching the globe, or evidence of epilation (eyelash removal) Corneal opacity (CO)—Corneal opacity blurring part of the pupil margin Although trachoma was eliminated from much of the developed world in the 20th century (Australia being a notable exception), this disease persists in many parts of the developing world, particularly in communities without adequate access to water and sanitation.

[19] Environmental improvement: Modifications in water use, fly control, latrine use, health education, and proximity to domesticated animals have all been proposed to reduce transmission of C.

[21] WHO Guidelines recommend that a region should receive community-based, mass antibiotic treatment when the prevalence of active trachoma among one- to nine-year-old children is greater than 10%.

[citation needed] Azithromycin (single oral dose of 20 mg/kg) or topical tetracycline (1% eye ointment twice a day for six weeks).

[5] If not treated properly with oral antibiotics, the symptoms may escalate and cause blindness, which is the result of ulceration and consequent scarring of the cornea.

[27] As of June 2022, 125 million individuals live in trachoma endemic areas and are at risk of trachoma-related blindness, and the disease is a public health problem in 42 countries.

[28] In many of these communities, women are three times more likely than men to be blinded by the disease[citation needed], likely due to their roles as caregivers in the family.

[33] The program recommends the SAFE protocol for blindness prevention: Surgery for trichiasis, Antibiotics to clear infection, Facial cleanliness, and Environmental improvement to reduce transmission.

[34] Eradication of the bacterium that causes the disease is seen as impractical; the WHO definition of "eliminated as a public health problem" means less than 5% of children have any symptoms, and less than 0.1% of adults have vision loss.

After the Egyptian Campaign (1798–1802) and the Napoleonic Wars (1798–1815), trachoma was rampant in the army barracks of Europe and spread to those living in towns as troops returned home.

[9] Today, most victims of trachoma live in underdeveloped and poverty-stricken countries in Africa, the Middle East, and Asia.

[citation needed] In the United States, the Centers for Disease Control says, "No national or international surveillance [for trachoma] exists.

The last cases were found among Native American populations and in Appalachia, and those in the boxing, wrestling, and sawmill industries (prolonged exposure to combinations of sweat and sawdust often led to the disease).

Epidemiological studies were conducted in 1956–1963 by the Trachoma Control Pilot Project in India under the Indian Council for Medical Research.

[41] This potentially blinding disease remains endemic in the poorest regions of Africa, Asia, and the Middle East and in some parts of Latin America and Australia.

[45] The economic burden of trachoma is huge, particularly concerning covering treatment costs and productivity losses as a result of increased visual impairment, and in some cases, permanent blindness.

Ellis Island Public Health Service physicians examining new immigrants for trachoma in 1910
Disability-adjusted life year for trachoma per 100,000 inhabitants in 2004