Trachoma – Now you see me…

Neglected Tropical Diseases, or NTDs, are a group of diseases responsible for the most common infections among people living in extreme poverty. While the majority of NTDs occur in tropical and subtropical undeveloped countries, they are by no means limited to those regions. Australia, for example, is a first world country that suffers considerably from NTDs; and of those NTDs, trachoma in particular is a huge health issue.  

 Trachoma, or sandy blight, is one of the leading causes of preventable blindness worldwide. Trachoma is caused by the bacteria Chlamydia trachomatis; the bacteria can create swelling under the inner eyelid, potentially leading to scarring. The scarring can cause the eyelashes to curl inward and scratch the surface of the eye, which if left untreated, will lead to irreversible blindness.

 Unfortunately, trachoma is also very highly infectious, and can be easily spread through infected nose or eye secretions. Unlike other bacterial infections, a single episode of trachoma produces few uncomfortable symptoms and can often be confused with a simple runny nose. However, the issue comes with repeated infections. Studies have shown that children living in rural areas can be infected up to 30 – 40 times in their childhoods, and each reinfection progressively leads to the scarring in their eyes getting worse and worse, eventually leading to blindness if left untreated.

 Luckily, trachoma is very treatable if proper care and preventive measures have been taken. The World Health Organization (WHO) suggests a SAFE strategy to combat trachoma. The surgical component (“S”) of the strategy involves using surgery to reduce eyelid swelling and scarring, thereby reducing the likelihood of blindness. Antibiotics (“A”) are the first line of defense for any trachoma infection and can be used to destroy the bacteria before any harm is done. Facial hygiene (“F”) and Environmental improvement (“E”) are concerned with preventing the spread of the disease through improving personal and environmental hygiene. This strategy has proven to be effective in trachoma treatments, countries like China, Morocco, Iran, and Mexico have eradicated trachoma using this guideline.

 Australia is the only first world country where trachoma is still an issue; in some areas of rural Australia, 4% of children are contracted with this crippling disease. However, there is good news in that the government is actively trying to combat this disease. Millions of dollars have been spent fighting trachoma and the rates of trachoma in rural communities have dropped enormously from 21% in 2008 to just above 5% in 2015. Trachoma, like all other NTDs, are very treatable given the proper resources have been allocated to combat them; we hope that in the near future, these diseases will receive the attention that they so deserve.          

References

Gambhir M, Basáñez M-G, Burton MJ, Solomon AW, Bailey RL, Holland MJ, et al. The Development of an Age-Structured Model for Trachoma Transmission Dynamics, Pathogenesis and Control. PLOS Neglected Tropical Diseases. 2009;3(6):e462.Available from: http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0000462

Rostami, S, Medscape [Internet] 2016 [cited 2017 Feb 20]. Available from: http://emedicine.medscape.com/article/1202088-treatment#d9

Cowling, C,Liu, B, Snelling, T, Ward, J, Kaldo, J & Wilson, P 2013. Australian trachoma surveillance annual report, 2013. Australian Government: The Department of Health. Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdi4002j.htm