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| | '''For patient information page click [[{{PAGENAME}} (patient information)|here]]''' |
| {{Trachoma}} | | {{Trachoma}} |
| {{CMG}} | | {{CMG}} |
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| {{SK}} Egyptian ophthalmia; granular conjunctivitis | | {{SK}} Egyptian ophthalmia; granular conjunctivitis |
| ==Overview==
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| '''Trachoma''' (Ancient Greek: "rough eye") is an infectious eye disease, and the leading cause of the world’s preventable blindness. Globally, 84 million people suffer from active infection and nearly 8 million people are visually impaired as a result of this disease. Globally this disease results in an estimated US $2.9 billion in lost productivity every year.
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| Trachoma is caused by the bacteria ''[[Chlamydia trachomatis]]'' and it is spread by direct contact with eye, nose, and throat [[secretions]] from affected individuals, or contact with fomites (inanimate objects), such as towels and/or washcloths, that have had similar contact with these secretions. Untreated, repeated trachoma infections result in a painful form of permanent blindness when the eyelids turn inward, causing the eyelashes to scratch the cornea. Children are the most susceptible to infection, but the effects are often not felt until adulthood.
| | ==[[Trachoma overview|Overview]]== |
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| Although trachoma was eliminated from much of the developed world in the last century, this disease persists in many parts of the developing world particularly in communities without adequate access to water and sanitation. In these communities, women are three time more likely than men to be blinded by the disease. Without intervention, trachoma keeps families shackled within a cycle of poverty, as the disease and its long-term effects are passed from one generation to the next.
| | ==[[Trachoma historical perspective|Historical Perspective]]== |
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| The World Health Organization (WHO) has set a goal of eliminating blinding trachoma as a public health concern by 2020. National governments in collaboration with numerous non-profit organizations implement trachoma control programs using the WHO-recommended SAFE strategy, which includes:
| | ==[[Trachoma classification|Classification]]== |
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| • Surgery to correct advanced stages of the disease;
| | ==[[Trachoma pathophysiology|Pathophysiology]]== |
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| • Antibiotics to treat active infection, using Zithromax donated by Pfizer Inc through the [http://www.trachoma.org International Trachoma Initiative];
| | ==[[Trachoma causes|Causes]]== |
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| • Facial cleanliness to reduce disease transmission;
| | ==[[Trachoma differential diagnosis|Differentiating Trachoma from other Diseases]]== |
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| • Environmental change to increase access to clean water and improved sanitation.
| | ==[[Trachoma epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Symptoms== | | ==[[Trachoma risk factors|Risk Factors]]== |
| The bacteria has an incubation period of 5 to 12 days, after which the affected individual experiences symptoms of [[conjunctivitis]], or irritation similar to "[[pink eye]]."
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| Further symptoms include:<br>
| | ==[[Trachoma screening|Screening]]== |
| *Eye [[mucopurulent discharge|discharge]]
| | ==[[Trachoma natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *Swollen eyelids
| | ==Diagnosis== |
| *[[Trichiasis]] (turned-in eyelashes)
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| *Swelling of [[lymph nodes]] in front of the ears
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| *Corneal scarring
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| *Further ear, nose and throat complications.
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| ==Prognosis==
| | [[Trachoma history and symptoms|History and Symptoms]] | |
| 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]]. [[Surgery]] may also be necessary to fix eyelid deformities.
| | [[Trachoma physical examination|Physical Examination]] | |
| | [[Trachoma laboratory findings|Laboratory Findings]] | |
| | [[Trachoma other diagnostic studies|Other Diagnostic Studies]] |
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| ==History== | | ==Treatment== |
| The disease is one of the earliest recorded eye afflictions, having been identified as early as 27 B.C. Today, most victims of trachoma live in underdeveloped and poverty-stricken countries in Africa, the Middle East, and Asia. Rare in the United States, the disease can be treated with [[antibiotics]] and prevented with adequate [[hygiene]] and education. According to the Centers for Disease Control, "No national or international surveillance [for trachoma] exists. Blindness due to trachoma has been eliminated from the United States. The last cases were found among American Indian populations and in Appalachia."<ref>http://www.cdc.gov/ncidod/dbmd/diseaseinfo/trachoma_t.htm</ref>
| | [[Trachoma medical therapy|Medical Therapy]] | [[Trachoma surgery|Surgery]] | [[Trachoma primary prevention|Primary Prevention]] | [[Trachoma secondary prevention|Secondary Prevention]] | [[Trachoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Trachoma future or investigational therapies|Future or Investigational Therapies]] |
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| In 1913, President Woodrow Wilson signed an act designating funds for the eradication of the disease.<ref>Allen SK, Semba RD. "The trachoma menace in the United States, 1897-1960." ''Surv Ophthalmol.'' 2002 Sep-Oct;47(5):500-9. PMID 12431697.</ref> By the late 1930s, a number of [[ophthalmologist]]s reported success in treating trachoma with [[sulfonamide]] antibiotics<ref>Thygeson P. [http://www.pubmedcentral.gov/picrender.fcgi?artid=1315791&blobtype=pdf "The Treatment of Trachoma with Sulfanilamide: A Report of 28 Cases."] ''Trans Am Ophthalmol Soc.'' 1939;37:395-403. PMID 16693194.</ref>. In 1948, Vincent Tabone (who was later to become the President of Malta) was entrusted with the supervision of a campaign in Malta to treat trachoma using sulfonamide tablets and drops. <ref>[http://staff.um.edu.mt/csav1/history/ophthalmology.pdf Ophthalmology in Malta, C. Savona Ventura, University of Malta, 2003]</ref>
| | ==Case Studies== |
| | | [[Trachoma case study one|Case #1]] |
| Although by the 1950s, trachoma had virtually disappeared from the industrialized world, thanks to improved sanitation and overall living conditions, it continues to plague the developing world. 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. Currently, 8 million people are visually impaired as a result of trachoma, and 84 million suffer from active infection.
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| The people that went through Ellis Island had to be checked for trachoma.
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| ==References==
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| <div class="references-small">
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| <references/>
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| </div>
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| ==Related Chapters== | | ==Related Chapters== |
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| {{Bacterial diseases}} | | {{Bacterial diseases}} |
| {{Eye pathology}} | | {{Eye pathology}} |
| | | {{WH}} |
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| [[Category:Blindness]] | | [[Category:Blindness]] |
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| [[Category:Neglected diseases]] | | [[Category:Neglected diseases]] |
| [[Category:Tropical disease]] | | [[Category:Tropical disease]] |
| [[Category:Infectious disease]]
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