Hygiene Promotion - IRC International Water and Sanitation Centre

Appendix 7. TrachomaSource: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/trachoma_t.htmTrachoma is a chronic eye infection that leads to permanent scars in the conjunctiva andcornea. Repeat active infections occur in children < 10 years of age. Subsequently,conjunctival scarring and inversion of the eyelashes so they irritate the cornea (trichiasis)develops as a result of earlier infections. Trichiasis predisposes to corneal ulceration andcorneal opacities resulting in decreased vision and blindness. WHO estimates thatapproximately 6 million cases of blindness due to trachoma and 11 million cases oftrichiasis occur yearly. Prevalence of active disease in children varies from 10-40% insome African countries to 3-10% in several Asian countries. The overall incidence isunknown.Repeat infections result in a chronic follicular conjunctivitis that leads to scarring in theconjunctiva and cornea. Ultimately, corneal opacification and blindnessoccurs.Transmission:Primary: person-to-person transmission by ocular and respiratory secretions.Secondary: insect vectors such as house flies. Active infection occurs in children < 10years, reinfection during childhood is common. Endemic disease is found in rural areaswith limited economic means and poor sanitation and water supplies.Trends: unknown. WHO has initiated a global campaign for the elimination of blindnessdue to trachoma, GET2020, that recommends a strategy including antibiotics, improvedpersonal and community hygiene and sanitation, and surgery to correct trichiasis.Campaign challenges include: establishing surveillance for endemic trachoma, determiningwhen mass treatment with antibiotics is necessary (i.e., retreatment), determining theeffectiveness of improved hygiene and sanitation at preventing a resurgence of endemicdisease, monitoring for adverse effects of mass treatment with antibiotics, and improvingsurgical outcomes. Additional challenges include: improving diagnosis of active disease,monitoring the emergence of antibiotic resistant C. trachomatis, and improving ourunderstanding of the transmission and reservoirs of C. trachomatis. This page lastreviewed July 2, 2002Source: US Government, Centers for Disease Control and Prevention, National Center forInfectious Diseases, Division of Bacterial and Mycotic Diseases.82 Hygiene promotion