NTDs: Trachoma – blindness caused by chlamydia bacteria (yes that chlamydia)

This post is the 17th (and final) in a series highlighting the WHO’s list of 17 Neglected Tropical Diseases (now technically 18 as mycetoma was added to the list at the 69th World Health Assembly in May 2016). To read the previous posts in this series click here.

SAFE strategy to eliminate trachoma. Courtesy ITI.

SAFE strategy to eliminate trachoma. Courtesy ITI.

Yes, the same chlamydia bacteria that causes untold numbers of STIs (sexually transmitted infections) around the world, also causes the disease trachoma. Trachoma is caused by Chlamydia trachomatis and is the leading cause of blindness worldwide. That means that trachoma is responsible for the visual impairment or irreversible blindness of more than 1 million people in more than 50 countries. More than 200 million people live in trachoma endemic areas and are at risk of blindness from trachoma.

Trachoma infographic. Courtesy ITI.

Trachoma infographic, Courtesy ITI.

Trachoma is one of the oldest diseases known to humans. It used to also be endemic in Europe and the United States. Fun history fact, European immigrants arriving at Ellis Island in New York had their eyelids turned up to look for trachoma scarring. Most of the folks with active trachoma infection were sent back to their home countries. Trachoma was eliminated in Europe and the US, before antibiotics were discovered, because of improved sanitation and living standards.

Trachoma is spread from person to person through flies that like to land by the eyes, and contaminated hands and clothing or bedding. Trachoma most often occurs in areas with a lack of basic hygiene, clean water, and adequate sanitation. Repeated infections over time can scar the inside of the eyelid which can cause the eyelashes to turn in towards the eye, scratching and damaging the eye.

Trachoma life cycle. Courtesy The Carter Center.

Trachoma life cycle. Courtesy The Carter Center.

One positive is that trachoma infection is curable with antibiotics, but the scarring and eye damage is a little more permanent. Surgery can help reduce the impact of the eyelid scarring but preventing that scarring is obviously a better alternative. The Carter Center established a Trachoma Control Program in 1998 and partners with WHO to implement the SAFE strategy for trachoma control. SAFE is a multi-pronged approach to trachoma control including Surgery, Antibiotics, Facial cleanliness and Environmental improvement. Since 1998 the Carter Center has trained local staff to perform the eye surgeries, helped distribute antibiotics, provided villages with health education, and supported the building of better sanitation facilities. Here are a few stories from folks who have been helped by The Carter Center’s efforts.

As with almost all of the 18 NTDs, elevating the living standards of the affected communities will have a drastic impact on their disease burden. We must not forget that the NTDs, while they are neglected in terms of money and resources, are an unfortunate part of daily life for many people in the world. We should also remember that it doesn’t have to be that way. We can do better, and we must do better.

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