Trachoma
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Trachoma is a bacterial infection caused by Chlamydia trachomatis that affects over 21 million people worldwide, causing visual impairment and blindness. It is prevalent in poor, rural parts of Africa, Asia, the Middle East, and Central and South America. The infection is transmitted through contact with discharge from the eyes or nose of an infected person or through contact with flies that have come into contact with infected individuals. Prevention focuses on maintaining good hygiene and sanitation to reduce transmission, while treatment involves antibiotics or surgery depending on the severity and stage of infection.
Trachoma
- 1. Trachoma – the world’s problemTrachoma – the world’s problem
- 2. TrachomaTrachoma Affected more than 21 million people 2.2 million are visually impaired 1.2 million are blind Around 180 million people worldwide live in areas with high risk of trachoma Appears in young adulthood and in middle- aged persons Adult women are at much greater risk than adult men
- 3. It was once endemic in most countries Now is presents for more than 3% of the world’s blindness in poor rural areas of Africa, Asia, Central and South America , Australia and the Middle East
- 7. More Statistics (I)More Statistics (I) AroundAround 285 million285 million people are visuallypeople are visually impaired worldwideimpaired worldwide 39 million39 million are blind,are blind, 246246 have low visionhave low vision 80% of all visual impairment is avoidable (can80% of all visual impairment is avoidable (can be prevented or cured)be prevented or cured) GloballyGlobally 153 million153 million people over 5 years of agepeople over 5 years of age are visually impaired as a result of uncorrectedare visually impaired as a result of uncorrected refractive errorsrefractive errors
- 8. More Statistics (II)More Statistics (II) AboutAbout 65%65% of all people who are visuallyof all people who are visually impaired are agedimpaired are aged 5050 and older, while this ageand older, while this age group comprises aboutgroup comprises about 20% of the world’s20% of the world’s populationpopulation.. An estimatedAn estimated 19 million children19 million children are visuallyare visually impaired. Of these,impaired. Of these, 12 million children12 million children areare visually impaired due to refractive errors; 1.4visually impaired due to refractive errors; 1.4 million are blind.million are blind. (October 2011, WHO)(October 2011, WHO)
- 9. caused by thecaused by the Chlamydia trachomatisChlamydia trachomatis bacteriumbacterium
- 10. Chlamydia trachomatisChlamydia trachomatis obligate intracellular humanobligate intracellular human pathogen, is one of threepathogen, is one of three bacterial species in thebacterial species in the genusgenus ChlamydiaChlamydia gram-negative, coccoid bacterium that typicallygram-negative, coccoid bacterium that typically infects columnar epithelial cellsinfects columnar epithelial cells It exhibits a characteristic two-stageIt exhibits a characteristic two-stage developmental lifecycle consisting of spore-likedevelopmental lifecycle consisting of spore-like
- 12. Vectors - severalVectors - several synanthropicsynanthropic muscid flysmuscid flys
- 13. Three types of TrachomaThree types of Trachoma Acute trachomaAcute trachoma Recurring trachomaRecurring trachoma Chronic TrachomaChronic Trachoma
- 14. Acute trachomaAcute trachoma It is frequently found in children who areIt is frequently found in children who are dirty, dusty and unhealthy. It usually affectsdirty, dusty and unhealthy. It usually affects one eye and gradually spreads to both theone eye and gradually spreads to both the eyes.eyes. Recurring trachomaRecurring trachoma If poor hygiene persists the person getsIf poor hygiene persists the person gets affected again and againaffected again and again
- 15. Chronic TrachomaChronic Trachoma It causes inward turning of the eyelid suchIt causes inward turning of the eyelid such that the eye lashes rub against the cornea .that the eye lashes rub against the cornea . • Leads to blindness between the age of 30 to 40Leads to blindness between the age of 30 to 40 years if left untreated. If it does not lead toyears if left untreated. If it does not lead to blindness, it leads to scarring of the of the corneablindness, it leads to scarring of the of the cornea of the eye.of the eye.
- 16. General SymptomsGeneral Symptoms painful eyespainful eyes swollen eyelidsswollen eyelids slimy discharge from the eyesslimy discharge from the eyes inward protraction of the eyelashesinward protraction of the eyelashes itching of the eyes and earitching of the eyes and ear nose and throat infectionnose and throat infection
- 17. DetectionDetection AnAn rRNA-basedrRNA-based assay andassay and PCRPCR werewere performed on swab specimens taken from theperformed on swab specimens taken from the right upper tarsal conjunctiva of 240 childrenright upper tarsal conjunctiva of 240 children aged 1 to 5 years living among 16 endemicaged 1 to 5 years living among 16 endemic villages in the Gurage Zone, Ethiopia.villages in the Gurage Zone, Ethiopia. TheThe rRNA-basedrRNA-based test detected ocular C.test detected ocular C. trachomatis infection in 142 (59%) subjectstrachomatis infection in 142 (59%) subjects compared with 67 (28%) detected bycompared with 67 (28%) detected by PCRPCR
- 18. Conclusion:Conclusion: TheThe rRNA-basedrRNA-based test appears to havetest appears to have significantly greater sensitivity than PCR forsignificantly greater sensitivity than PCR for the detection of ocular C. trachomatisthe detection of ocular C. trachomatis infection in children in trachoma-endemicinfection in children in trachoma-endemic villages.villages.
- 19. PreventionPrevention Maintaining good hygiene and sanitation areMaintaining good hygiene and sanitation are essential to prevent this disease of theessential to prevent this disease of the developing countries which has beendeveloping countries which has been eradicated from the developed countries.eradicated from the developed countries.
- 20. Some steps:Some steps: 1)1) Avoid physical contact with a person suffering fromAvoid physical contact with a person suffering from trachomatrachoma 2)2) Personal cleanliness (especially face and hands)Personal cleanliness (especially face and hands) 3)3) Washing hands and face frequently in children who areWashing hands and face frequently in children who are already infected to prevent re-infectionalready infected to prevent re-infection 4)4) Keep separate towels, handkerchiefs and linens forKeep separate towels, handkerchiefs and linens for each member of the family.each member of the family. 5)5) Keep the food covered and use latrines and toilets forKeep the food covered and use latrines and toilets for defecation to prevent breeding of flies.defecation to prevent breeding of flies.
- 21. Treatment - antibioticsTreatment - antibiotics There isThere is no vaccine availableno vaccine available Antibiotics can prevent long-termAntibiotics can prevent long-term complications if used early in the infection.complications if used early in the infection. Antibiotics includeAntibiotics include erythromycin anderythromycin and doxycyclinedoxycycline..
- 22. AlsoAlso Other medications are aOther medications are a tetracyclinetetracycline eyeeye ointmentointment and anand an oral azithromycinoral azithromycin known asknown as ZithromaxZithromax.. Although the oral azithromycin has beenAlthough the oral azithromycin has been found to be more effective, one of the biggestfound to be more effective, one of the biggest issues is that it is more expensive than theissues is that it is more expensive than the ointment.ointment.
- 23. SurgerySurgery - given to those who are- given to those who are experiencing the more severe symptoms ofexperiencing the more severe symptoms of trachoma.trachoma. One surgery isOne surgery is eyelid rotation surgeryeyelid rotation surgery, where, where the doctor moves the eyelids away from thethe doctor moves the eyelids away from the corneas. This surgery is done in order tocorneas. This surgery is done in order to prevent scarring of the eyelid, and it generallyprevent scarring of the eyelid, and it generally is done on an outpatient basis.is done on an outpatient basis. Treatment-surgeryTreatment-surgery
- 24. AlsoAlso AlsoAlso cornea graftingcornea grafting can be performed, whichcan be performed, which is when the corneas are replaced in the eyesis when the corneas are replaced in the eyes from donor.from donor. • Cornea grafting is an expensive procedureCornea grafting is an expensive procedure that is often not available to those who needthat is often not available to those who need it. One of the biggest problems with thisit. One of the biggest problems with this procedure is there is always a chance thatprocedure is there is always a chance that corneas will be rejected.corneas will be rejected.