Biology 402 Daniella DiNizo

What is Trachoma? Infectious eye disease Leading cause of blindness globally Disease of poverty Neglected tropical disease

History of Trachoma One of the earliest recorded eye afflictions Soldiers Immigrants through Ellis Island Disappeared from the industrial world Still plagues poorest regions of developing world

Epidemiology 84 million infected 8 million visually impaired 1995 – 15% of blindness; 2002 – 3.6% of blindness Most common among pre-school children

Causes Chlamydia trachomatis Associated factors Access to water Access to bathrooms Sanitation/ Hygiene Flies Overcrowding Poverty

Transmission Primary Person to person Direct contact with ocular, nasal, and respiratory secretions

Transmission Secondary Insect Vectors

The Eye

Stages 1 and 2 – Active Trachoma TF - Trachomatous inflammation follicular TI – Trachomatous inflammation intense

Infection – Stage 3 Trachomatous Scarring (TS) Scarring of the tarsal conjunctiva Eyelids turning inward may begin

Infection – Stage 4 Trachomatous trichiasis (TT) Ingrown eyelashes touching the cornea

Infection – Stage 5 Corneal opacity (CO) Clouding over of the cornea Blindness

Social Implications Global loss of productivity Women Cooking Water Family Effect on children Cycle of poverty

Treatment Azithromycin Tetracycline ointment Eyelid Surgery Resistance?

SAFE strategy – Surgery/ Antibiotics Surgery People with risk of blindness Reduce discomfort Improve vision Antibiotics For active infections Who?/ When?

SAFE Strategy - Facial Cleanliness/ Environmental Changes Facial Cleanliness Good facial hygiene Washing daily Environmental Changes Water Bathrooms Flies Interventions have not been as successful as expected

Future Directions Global Elminiation of blinding Trachoma by 2020 (GET2020) Emphasis on FE of SAFE strategy Research Global Awareness Without these steps Trachoma will continue to be a major cause of blindness in the developing world.

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