Trachoma: A chronic infection of the CONJUNCTIVA and CORNEA caused by CHLAMYDIA TRACHOMATIS.Azithromycin: A semi-synthetic macrolide antibiotic structurally related to ERYTHROMYCIN. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis.Chlamydia trachomatis: Type species of CHLAMYDIA causing a variety of ocular and urogenital diseases.Eyelashes: The hairs which project from the edges of the EYELIDS.Hygiene: The science dealing with the establishment and maintenance of health in the individual and the group. It includes the conditions and practices conducive to health. (Webster, 3d ed)Gambia: A republic in western Africa, constituting an enclave within SENEGAL extending on both sides of the Gambia River. Its capital is Banjul, formerly Bathurst.Sudan: A country in northeastern Africa. The capital is Khartoum.Blindness: The inability to see or the loss or absence of perception of visual stimuli. This condition may be the result of EYE DISEASES; OPTIC NERVE DISEASES; OPTIC CHIASM diseases; or BRAIN DISEASES affecting the VISUAL PATHWAYS or OCCIPITAL LOBE.Toilet Facilities: Facilities provided for human excretion, often with accompanying handwashing facilities.ConjunctivitisEyelid DiseasesConjunctiva: The mucous membrane that covers the posterior surface of the eyelids and the anterior pericorneal surface of the eyeball.Chlamydia: A genus of the family CHLAMYDIACEAE whose species cause a variety of diseases in vertebrates including humans, mice, and swine. Chlamydia species are gram-negative and produce glycogen. The type species is CHLAMYDIA TRACHOMATIS.Endemic Diseases: The constant presence of diseases or infectious agents within a given geographic area or population group. It may also refer to the usual prevalence of a given disease with such area or group. It includes holoendemic and hyperendemic diseases. A holoendemic disease is one for which a high prevalent level of infection begins early in life and affects most of the child population, leading to a state of equilibrium such that the adult population shows evidence of the disease much less commonly than do children (malaria in many communities is a holoendemic disease). A hyperendemic disease is one that is constantly present at a high incidence and/or prevalence rate and affects all groups equally. (Last, A Dictionary of Epidemiology, 3d ed, p53, 78, 80)Entropion: The turning inward (inversion) of the edge of the eyelid, with the tarsal cartilage turned inward toward the eyeball. (Dorland, 27th ed)Conjunctivitis, Inclusion: An infection of the eyes characterized by the presence in conjunctival epithelial cells of inclusion bodies indistinguishable from those of trachoma. It is acquired by infants during birth and by adults from swimming pools. The etiological agent is CHLAMYDIA TRACHOMATIS whose natural habitat appears to be the genito-urinary tract. Inclusion conjunctivitis is a less severe disease than trachoma and usually clears up spontaneously.Ethiopia: An independent state in eastern Africa. Ethiopia is located in the Horn of Africa and is bordered on the north and northeast by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west and southwest by Sudan. Its capital is Addis Ababa.NepalTanzania: A republic in eastern Africa, south of UGANDA and north of MOZAMBIQUE. Its capital is Dar es Salaam. It was formed in 1964 by a merger of the countries of TANGANYIKA and ZANZIBAR.Neglected Diseases: Diseases that are underfunded and have low name recognition but are major burdens in less developed countries. The World Health Organization has designated six tropical infectious diseases as being neglected in industrialized countries that are endemic in many developing countries (HELMINTHIASIS; LEPROSY; LYMPHATIC FILARIASIS; ONCHOCERCIASIS; SCHISTOSOMIASIS; and TRACHOMA).Conjunctival DiseasesLymphogranuloma Venereum: Subacute inflammation of the inguinal lymph glands caused by certain immunotypes of CHLAMYDIA TRACHOMATIS. It is a sexually transmitted disease in the U.S. but is more widespread in developing countries. It is distinguished from granuloma venereum (see GRANULOMA INGUINALE), which is caused by Calymmatobacterium granulomatis.Mali: A country in western Africa, east of MAURITANIA and south of ALGERIA. Its capital is Bamako. From 1904-1920 it was known as Upper Senegal-Niger; prior to 1958, as French Sudan; 1958-1960 as the Sudanese Republic and 1959-1960 it joined Senegal in the Mali Federation. It became an independent republic in 1960.Water Supply: Means or process of supplying water (as for a community) usually including reservoirs, tunnels, and pipelines and often the watershed from which the water is ultimately drawn. (Webster, 3d ed)Niger: A republic in western Africa, north of NIGERIA and west of CHAD. Its capital is Niamey.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Conjunctivitis, Bacterial: Purulent infections of the conjunctiva by several species of gram-negative, gram-positive, or acid-fast organisms. Some of the more commonly found genera causing conjunctival infections are Haemophilus, Streptococcus, Neisseria, and Chlamydia.Hair Diseases: Diseases affecting the orderly growth and persistence of hair.Sanitation: The development and establishment of environmental conditions favorable to the health of the public.Cicatrix: The fibrous tissue that replaces normal tissue during the process of WOUND HEALING.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.Maps as Topic: Representations, normally to scale and on a flat medium, of a selection of material or abstract features on the surface of the earth, the heavens, or celestial bodies.
International Coalition for Trachoma ControlChlamydia trachomatisEyelash: An eyelash or simply lash is one of the hairs that grows at the edge of the eyelid. Eyelashes protect the eye from debris and perform some of the same function as whiskers do on a cat or a mouse in the sense that they are sensitive to being touched, thus providing a warning that an object (such as an insect or dust mite) is near the eye (which then closes reflexively).Hygiene: Hygiene is a set of practices performed for the preservation of health.River Gambia National ParkTransport in South Sudan: == Highways ==Blind People's Association: The Blind People’s Association (BPA) is an organisation in India which promotes comprehensive rehabilitation of persons with all categories of disabilities through education, training, employment, community based rehabilitation, integrated education, research, publications, human resource development and other innovative means.Restroom Access Act: The Restroom Access Act, also known as Ally's Law, is legislation passed by several U.S.Ligneous conjunctivitis: Ligneous conjunctivitis is a rare form of chronic conjunctivitis characterized by recurrent, fibrin-rich pseudomembranous lesions of wood-like consistency that develop mainly on the underside of the eyelid (tarsal conjunctiva). It is generally a systemic disease which may involve the periodontal tissue, the upper and lower respiratory tract, kidneys, middle ear, and female genitalia.BlepharochalasisConjunctiva: The conjunctiva lines the inside of the eyelids and covers the sclera (white part of the eye). It is composed of non-keratinized, stratified columnar epithelium with goblet cells, and also stratified columnar epithelium.Theodor Bilharz Research Institute: The Theodor Bilharz Research Institute is located in Giza, Egypt.EntropionAddis Ababa Fistula HospitalManipal Teaching HospitalFederal institutions of Tanzania: This is a list of the federal institutions of Tanzania.KPC Medical College and HospitalConjunctivochalasisWilhelm Siegmund Frei: Wilhelm Siegmund Frei (September 5, 1885, Neustadt – January 27, 1943) was a German dermatologist best known for his contributions to Durand-Nicolas-Favre disease, a sexually transmitted disease found mainly in tropical and subtropical climates. He is also known for the Frei Test, which was developed in 1925 for the detection of lymphogranuloma venereum (LGV).Papa MaliPublic water systemHealth in Niger: Public Health in Niger suffers from a chronic lack of resources and a small number of health providers relative to population. Some medicines are in short supply or unavailable.Trimethoprim/polymyxinVellus hair: Vellus hair is short, fine, light-colored, and barely noticeable thin hair that develops on most of a person's body during childhood. Exceptions include the lips, the back of the ear, the palm of the hand, the sole of the foot, some external genital areas, the navel and scar tissue.Sanitation: Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes as well as the treatment and proper disposal of sewage or wastewater. Hazards can be either physical, microbiological, biological or chemical agents of disease.BacitracinLegend tripping: Legend tripping is a name recently bestowed by folklorists and anthropologists on an adolescent practice (containing elements of a rite of passage) in which a usually furtive nocturnal pilgrimage is made to a site which is alleged to have been the scene of some tragic, horrific, and possibly supernatural event or haunting. The practice has been documented most thoroughly to date in the United States.
(1/426) Current trends in trachoma in a previously hyperendemic area. The Trachoma Study Group.
In response to reports of an excessive number of cases of trachoma at the end of 1995 from the western parts of the North Indian state of Uttar Pradesh, 837 children in the age-group 1-10 years were examined in three villages from where the maximum number of cases hailed. Clinically, the prevalence of trachoma was found to be 8.5% (71). The prevalence was significantly higher in males as compared to females (p < 0.05); and was observed to increase with age. 85.9% (61) of the clinically diagnosed children were active infective cases. 54.9% (39) of the clinically diagnosed cases showed the presence of antigen in the upper tarsal conjunctival scraping from the affected eye, using the Chlamydia trachomatis direct specimen kit (Syva MicroTrak, UK). It was concluded that ophthalmologists must be reoriented to the clinical diagnosis of trachoma to prevent overdiagnosis. (+info)
(2/426) Trachoma: can trichiasis be treated with a sticking-plaster? A randomized clinical trial in China.
Trachoma is the most frequent cause of preventable blindness in the world. At the trichiasis/entropion stage, lid surgery is recommended, but many patients only use epilation, which does not prevent loss of vision. We developed a new treatment that should be more accessible than lid surgery and more effective than epilation: a sticking plaster that forces eyelashes back to their correct position. The first randomized controlled trial was conducted in Shanghai with 57 patients to compare the plaster method with epilation. After 3 months of follow-up, with no attrition, 67% of those treated by the new method presented a good clinical status, vs none of those treated by epilation (P < 0.001). The new treatment was well tolerated and lid function remained normal. Although our results show overwhelming benefit of this new, simple treatment for trachoma at the trichiasis stage, more research is needed at the primary health care level and in other settings to determine the potential use of the new method on a large scale and by nonspecialists. (+info)
(3/426) Reliability of clinical diagnosis in identifying infectious trachoma in a low-prevalence area of Nepal.
The WHO Alliance for Global Elimination of Trachoma by 2020 has increased the need to identify ocular chlamydial infections by clinical examination in areas of both high and low prevalence. The relationship between clinically active trachoma (as defined by clinical examination) and chlamydial infection is known for areas with hyperendemic trachoma, but not for areas with a low prevalence of the clinical disease. In the present study, we examined, photographed, and DNA tested the conjunctivae of children in the Surkhet district of mid-western Nepal, an area known to have a low prevalence of clinically active trachoma. Although 6% of the children aged 10 years and under were found to have clinically active trachoma, none were found to have chlamydia infection by the most sensitive DNA amplification tests available. A very low prevalence of clinically active trachoma is not necessarily evidence of the presence of chlamydial infection. Therefore, the WHO policy of not recommending an intensive trachoma control effort when the prevalence of clinically active trachoma is less than 10% in children is appropriate for this area of Nepal. (+info)
(4/426) Alterations in the conjunctival bacterial flora following a single dose of azithromycin in a trachoma endemic area.
BACKGROUND/AIMS: The World Health Organisation has recommended repeated mass treatment of children in trachoma endemic areas with oral azithromycin. While chlamydia, the causative agent of trachoma, remains universally sensitive to azithromycin, there is concern that large scale programmes may alter the bacterial flora and induce resistance in streptococcal species. In this study the effect of a single dose of azithromcyin on the prevalence, species distribution, and resistance of conjunctival bacterial flora was determined. METHODS: Baseline and 14 day follow up bacterial cultures were taken from the conjunctivae of 121 children who reside in a trachoma endemic area of Nepal. 91 children were treated with azithromycin at baseline and 31 children received deferred treatment at the 14 day follow up. RESULTS: Although the prevalence of bacterial pathogens decreased significantly with azithromycin treatment, a significant change in the distribution of specific bacterial pathogens could not be demonstrated. Streptococcal resistance to azithromycin was found significantly more frequently after treatment. No change in the prevalence, distribution, or resistance pattern was found in the untreated control group. CONCLUSION: Repeated mass treatment of trachoma endemic areas with oral azithromycin will have an effect on bacterial flora. However, further work needs to be done to determine if this will have any clinical relevance. (+info)
(5/426) Expression of gelatinase B in trachomatous conjunctivitis.
BACKGROUND/AIMS: Gelatinase B is a matrix metalloproteinase involved in extracellular matrix (ECM) breakdown often associated with scarring and other pathological disorders. It was investigated whether gelatinase B is involved in the pathogenesis of ECM degradation associated with trachomatous conjunctivitis. METHODS: Conjunctival biopsy specimens obtained from six patients with active trachoma, six patients with active vernal keratoconjunctivitis (VKC), and seven control subjects were studied. Immunohistochemical techniques and a specific monoclonal antibody against human gelatinase B were used, and a monoclonal antibody against macrophage CD68 to identify mononuclear cells with gelatinase B immunoreactivity. In addition, quantitative zymography was used to compare the activity of gelatinase B in conjunctival biopsy specimens from seven patients with active trachoma and seven control subjects. RESULTS: Gelatinase B was detected by immunohistochemistry only in polymorphonuclear cells located in the vascular lumens in three normal conjunctival biopsy specimens. In all trachoma specimens and in five VKC specimens, gelatinase B was localised in monocyte/macrophage cells, positive for the CD68 marker, and in polymorphonuclear cells. The majority of the latter cell type was located in intravascular spaces. Compared with VKC specimens, trachoma specimens showed significantly more immunoreactive gelatinase B monocyte/macrophage cells (52.3 (21.9) v 8.2 (6.4); p <0.001) and polymorphonuclear cells (23.2 (14.2) v 6.3 (5.4); p = 0. 013). Activated macrophages with giant cell morphology clearly stained with the gelatinase B specific monoclonal antibody were observed in trachoma specimens. Zymography revealed that gelatinase B levels in trachoma specimens were significantly higher than the levels found in normal conjunctiva (1739.6 (1078.3) v 609.3 (395.9) scanning units; p = 0.0127). CONCLUSIONS: The increased activity of gelatinase B and numbers of inflammatory cells containing gelatinase B in trachoma specimens suggest that this enzyme plays a part in the pathogenesis of conjunctival scarring in trachoma. (+info)
(6/426) Incidence of trichiasis in a cohort of women with and without scarring.
BACKGROUND: Blindness from trachoma is a significant problem for many underdeveloped countries. While active trachoma is common in children, trichiasis, the potentially blinding sequella, develops in adulthood and affects mainly women. Little is known about factors associated with the development of trichiasis. METHODS: The 7-year incidence of trichiasis and its association with ocular chlamydia infection was examined in a cohort of women from a hyperendemic area. A total of 4,932 women 18 years and older, living in 11 villages in Central Tanzania, were examined in 1989. A follow-up examination in 1996 was performed on all women with scars living in six of the 11 villages and on a random sample of women without scars from the same villages. Trachoma was graded clinically, chlamydia infection was ascertained at follow-up using polymerase chain reaction-enzyme immunoassay (PCR-EIA). RESULTS: A total 523 of the women with scars and 503 of the women without scars were re-examined. Forty-eight of the women with scars (incidence, 9.2%) and three of the women without scars (0.6%) developed trichiasis in the 7-year period. Prevalence of chlamydia infection was significantly higher in the group with scars (11.7% versus 7.1%). Trichiasis cases were more likely to be older, and to have chlamydia infection at follow-up odds ratio (95% confidence interval) 2.5 (1.1-5.7). CONCLUSION: The 7-year incidence rate in the population with scars was high, over 1% per year. Ocular chlamydia infection was more common in the group with scars at baseline and was also associated with being a trichiasis case, suggesting the importance of potentially long-term chlamydia infection in the progression to trichiasis. Antibiotic distribution programmes for trachoma control should include women with scars. (+info)
(7/426) Preventing trachoma through environmental sanitation: a review of the evidence base.
A review of the available evidence for the associations between environmental sanitation and transmission of trachoma was undertaken with a view to identifying preventive interventions. The WHO Global Alliance for the Elimination of Trachoma by the Year 2020 (GET2020) has adopted the "SAFE" strategy, consisting of four components: Surgery, Antibiotic treatment, promotion of Facial cleanliness and initiation of Environmental changes. This review of 19 studies selected from the 39 conducted in different parts of the world shows that there is clear evidence to support the recommendation of facial cleanliness and environmental improvements (i.e. the F and E components of the SAFE strategy) to prevent trachoma. Person-to-person contact and flies appear to constitute the major transmission pathways. Improvement of personal and community hygiene has great potential for a sustainable reduction in trachoma transmission. Controlled clinical trials are needed to estimate the relative contribution of various elements to the risk of transmission of trachoma and the effectiveness of different interventions. These could show the relative attributable risks and effectiveness of interventions to achieve improvement of personal hygiene and fly control by environmental improvements, alone or in combination, and with or without antibiotic treatment. (+info)
(8/426) Blinding and non-blinding trachoma: assessment of intensity of upper tarsal inflammatory disease and disabling lesions.
A simplified method of evaluating both the intensity of active inflammatory disease and the visually disabling lesions of trachoma is presented. Evaluation of the active disease is based on the scoring of clinical signs, lymphoid follicles, and papillary hypertrophy. The irreversible lesions of trachoma are classified as conjunctival scarring, trichiasis and/or entropion, and corneal scarring. (+info)