TrachomaBiology 402

Daniella DiNizo

What is Trachoma?Infectious eye

disease

Leading cause of blindness globally

Disease of poverty

Neglected tropical disease

History of TrachomaOne of the earliest

recorded eye afflictions

SoldiersImmigrants through

Ellis IslandDisappeared from the

industrial worldStill plagues poorest

regions of developing world

Epidemiology84 million infected

8 million visually impaired

1995 – 15% of blindness; 2002 – 3.6% of blindness

Most common among pre-school children

CausesChlamydia

trachomatis

Associated factorsAccess to waterAccess to

bathroomsSanitation/ HygieneFliesOvercrowdingPoverty

TransmissionPrimary

Person to person Direct contact with

ocular, nasal, and respiratory

secretions

TransmissionSecondary

Insect Vectors

The Eye

Stages 1 and 2 – Active TrachomaTF - Trachomatous inflammation follicular

TI – Trachomatous inflammation intense

Infection – Stage 3Trachomatous

Scarring (TS)

Scarring of the tarsal conjunctiva

Eyelids turning inward may begin

Infection – Stage 4Trachomatous

trichiasis (TT)

Ingrown eyelashes touching the cornea

Infection – Stage 5Corneal opacity (CO)

Clouding over of the cornea

Blindness

Social ImplicationsGlobal loss of

productivity

WomenCookingWaterFamilyEffect on children

Cycle of poverty

TreatmentAzithromycinTetracycline

ointment

Eyelid Surgery

Resistance?

SAFE strategy – Surgery/ AntibioticsSurgery

People with risk of blindness

Reduce discomfort Improve vision

AntibioticsFor active infectionsWho?/ When?

SAFE Strategy - Facial Cleanliness/ Environmental Changes

Facial CleanlinessGood facial hygieneWashing daily

Environmental ChangesWaterBathroomsFlies

Interventions have not been as successful as expected

Future DirectionsGlobal Elminiation of blinding Trachoma by

2020 (GET2020)Emphasis on FE of SAFE strategy ResearchGlobal Awareness

Without these steps Trachoma will continue to be a major cause of blindness in the developing world.

http://www.typesofbacteria.co.uk/trachoma-blindness.html

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/trachoma_t.htm

http://images.google.com/imgres?imgurl=http://webpages.scu.edu/ftp/mrzhao/images/trachoma1.jpg&imgrefurl=http://webpages.scu.edu/ftp/mrzhao/trachomasplashpage.html&usg=__8o18TNsjnRZXUJMUzPNcaljqLCo=&h=385&w=575&sz=23&hl=en&start=2&sig2=im4vg70W2Flxzp1IAcnWaw&um=1&itbs=1&tbnid=zarPAH4CYV8c9M:&tbnh=90&tbnw=134&prev=/images%3Fq%3Dtrachoma%26um%3D1%26hl%3Den%26sa%3DN%26rls%3Dcom.microsoft:en-us:IE-SearchBox%26rlz%3D1I7GGLL_en%26tbs%3Disch:1&ei=go6vS9mDIYP48AbOpIGcBg

http://proctor.ucsf.edu/internationalstudies2.html

Images: http://www.ellisisland.se/engl

ish/ellisisland_immigration3.asp

http://gamapserver.who.int/mapLibrary/Files/Maps/global%20active%20may%202006.jpg

http://www.cartercenter.org/health/trachoma/index.html

http://www.pba.org/blogs/entries/category/from-georgia-to-ethiopia

http://webeye.ophth.uiowa.edu/eyeforum/atlas/pages/trachoma-trichiasis-and-tylosis-pachyblepharon.html

http://digitalrabbit.org/wordpress/category/waterborne-diseases/

http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=7111

http://medicalecology.org/water/trachoma/trachoma.htm#sect3