Trachoma

TRACHOMA

28/9/2013

Group Members

• ABDELRAHMAN KHALIFA • MUNA MUSTAFA AHMED ELSHIEKH • SARA ELSIR ALHAG

Normal Conjunctiva

• Normal: the normal conjunctiva is pink, smooth, thin, and transparent. There are normally large deep-lying blood vessels that run vertically.

Where is Tarsal Conjunctiva ?

Definition

• Trachoma is a chronic conjunctivitis due to repeated infection with Chlamydia trachomatis, serotypes A, B, and C.

Patho- Phisiology

• Inflammation from active trachoma infection leads to tarsal plate scarring which causes the eyelashes to turn in. The lashes rub on the cornea, producing ulceration, scarring, and blindness.

Mode of Transmission

• Transmission: the disease occurs particularly in poor dry areas of the world in which there is inadequate water supply and poor community sanitation.

The classic trachoma

environment can be described as:

Dry

Dirty

Discharge

3 Fs for transmission

•Flies: flies go from individual to individual•Fingers: direct contact with ocular discharge•Family: within the family, child to child

Epidemiological features

• 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.

•

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.

Sudan

Trachoma Stages• Normal Conjunctiva• (as described earlier )

• Trachomatous inflammation follicular (TF): the presence of five or more follicles(round swellings that are paler than the surrounding conjunctiva) in the upper tarsal conjunctiva.

• Trachomatous inflammation intense (TI): Obvious inflammatory thickening of the tarsal conjunctiva that obscures more than half of the normal deep tarsal vessels.

Trachoma Stages cnt

• Trachomatous scarring (TS): the presence of scarring in the tarsal conjunctiva. Scars are easily visible as white lines, bands, or sheets in the tarsal conjunctiva.

• Trachomatous trichiasis (TT): at least one eyelash rubs on the eyeball.

• Corneal opacity (CO): easily visible corneal opacity over the pupil. The pupil margin is blurred viewed through the opacity.

preventive measures

• educate the public on the need for personal hygiene especially the risk of common use towels

• Improve basic sanitation; including availability and use of soap and water encourage washing the face. Avoid common use towels.

• Provide adequate case finding and treatment facilities; with emphasis on preschool children.

• Conduct epidemiological investigation s to determine important factor in the occurrence of the disease for specific situation

• B .Control of patient, contacts and the immediate environment.-

• Report to local health authority: case Report requite in some countries of low endemicity.

• Isolation: not practices in most areas where the disease occurs. For hospital ized patient, drainage and secretion precautions.

• Concurrent disinfection: of eye and nasal discharges and contaminated articles.

• Immunization of contact s :NOT applicable• Investigation of contact sand source of infection. Members of

family ,playmates and schoolmates .

• Specific treatment: in areas where the disease is severe and highly prevalent ,mass treatment of the whole population .especially children ,

• c- Epidemic measures: in regions of hyper endemic prevalence mass treatment campaigns have been successful in reducing severity and frequency ,when associated with education in personal hygiene, especially cleanliness of the face ,and improvement , particularly a good water supply .

• d .disaster implications:-Non • E .international measures:- WHO Collaborating center . WHO Alliance

for the Global elimination of trachoma• Early evaluations of ten national trachoma elimination campaigns

already show promising results for the first two interventions, namely eyelid surgery and administration of antibiotic treatment.1

WHO's SAFE strategy for the global elimination of trachoma

• S Surgery for entropion and trichiasis

• A Antibiotics for infectious trachoma

• F Facial cleanliness to reduce transmission

• E Environmental improvements such as control of disease-spreading flies and access to clean water

Reference

• Oxford Handbook of Tropical Medicine • http://www.google.co.za/imgres?imgurl=http:

//www.eyecarelist.com.....

• http://www.who.int/blindness/causes/trachoma_documents/en/