Trachoma

Trachoma is a bacterial infection that is the leading cause of preventable blindness in the world today. An estimated 8 million people suffer from visual impairment or blindness today, and another 84 million may be infected. Without massive investment in treatment programs, trachoma could blind up to 10 percent of the world's population in the coming decades.

Trachoma is caused by the bacterium Chlamydia trachomatis. It is easily transmitted by human-to-hu-man contact or by a type of fly that feed on the eye discharge of those already infected, which then carries it on to others. Infection usually starts during childhood, but blindness does not come until adulthood. Over the years, repeated periods of inflammation cause scar tissue to form on the inside of the eyelid. Eventually, the eyelashes turn inward—an exquisitely painful phase of the disease known as trichiasis. The sharp eyelashes scratch the cornea, causing severe visual impairment and blindness.

The disease was once prevalent throughout the world, but due to improvements in sanitation and standard of living, it has virtually disappeared from Europe and the United States. Today, it exists in Africa, Asia, Latin America, and parts of Australasia. It is endemic in at least 55 countries.

Infections tend to come in clusters, striking whole families or communities at the same time. Because blindness strikes in the prime of life, it is estimated that the disease costs US $29 billion in lost productivity each year. Women are three times more likely to contract trachoma than men, making it difficult for them to function in tribal societies, where a woman's worth can often be based on her ability to cook, to maintain a fire, or collect water from distant wells. Many are abandoned by their husbands, putting a burden on children or other family members to care for them.

The World Health Organization has developed a treatment protocol known as SAFE, an acronym drawn from four different community-based approaches to combating the disease: (1) surgery for trichiasis; (2) antibiotics for chlamydia trachomatis infections; (3) facial cleanliness; and (4) environmental improvement. Treatment is inexpensive, with surgery for trichiasis costing around $15 per person and antibiotics for ear-ly-stage infections around $10 per person. Implementation of SAFE is part of an initiative launched in 1997 called the Global Elimination of Blinding Trachoma by the Year 2020 (GET2020). It has shown tremendous progress in preventing the spread of the disease in pilot programs in Morocco and other countries.