Water Sanitation Health

Water-related Diseases

Trachoma

The disease and how it affects people

Trachoma is an infection of the eyes that may result in blindness after repeated re-infections. It is the world's leading cause of preventable blindness and occurs where people live in overcrowded conditions with limited access to water and health care. Trachoma spreads easily from person to person and is frequently passed from child to child and from child to mother within the family.

Infection usually first occurs in childhood but people do not became blind until adulthood. The disease progresses over years as repeated infections cause scarring on the inside of the eyelid, earning it the name of the “quiet disease” The eyelashes eventually turn in. This causes rubbing on the cornea at the front of the eye. The cornea becomes scarred leading to severe vision loss and eventually blindness.

The cause

Trachoma is caused by an organism called Chlamydia trachomatis. Through the discharge from an infected child's eyes, trachoma is passed on by hands, on clothing, or by flies that land on the face of the infected child.

Distribution

Trachoma occurs worldwide and most often in poor rural communities in developing countries. Blinding trachoma is widespread in the Middle East, North and Sub-Sahara Africa, parts of the Indian subcontinent, Southern Asia and China. Pockets of blinding trachoma occur in Latin America, Australia (among native Australians) and the Pacific Islands.

Scope of the Problem

The World Health Organization (WHO) estimates that six million worldwide are blind due to trachoma and more than 150 million people are in need of treatment.

Interventions

Primary interventions advocated for preventing trachoma infection include improved sanitation, reduction of fly breeding sites and increased facial cleanliness (with clean water) among children at risk of disease. The scaring and visual change for trachoma can be reversed by a simple surgical procedure performed at village level which reverses the inturned eyelashes.

Good personal and environmental hygiene has been proven to be successful in combating trachoma. Encouraging the washing of children's faces, improved access to water, and proper disposal of human and animal waste has been shown to decrease the number of trachoma infections in communities.

Global Alliance for the Elimination of Trachoma by the year 2020 (GET 2020)

The WHO along with an alliance of interested parties has adopted the “SAFE” strategy to combat trachoma. The four components of the strategy include:

  • Surgery
  • Antibiotic treatment (Tetracycline eye ointment new antibiotic, azithromycin has been tested in a number of countries and initial results are very promising
  • Facial cleanliness
  • Environmental changes.

Prepared for World Water Day 2001. Reviewed by staff and experts from the Water, Sanitation and Health unit (WSH), World Health Organization (WHO).

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