Jerry is a ten-year-old poor boy living in a large family. He lives in a crowded place with fly infestation and does not have enough money to deal with it. Jerry’s conjunctiva is swollen and the doctor mentions that his eye has been infected with the bacteria Chlamydia trachomatis. The goal of this report is to understand the health issue of trachoma, its prevalence, causal factors, impact on society, and identification of the social services and programs to deal with it.
Trachoma is a foremost cause of blindness in the world caused by bacteria Chlamydia trachomatis, transmitted by flies and marked by roughening of the internal surface of the eyelids; spread by straight contact with eye, nose and throat secretions of the affected persons. Frequent trachoma infections lead to ‘entropion’, the eyelids turn inward and eyelashes scratches the cornea ensuing permanent blindness (Chidambaram J.D. et al, 2009). These happen in unfortunate areas with the absence of vital amenities such as water, toilets, etc. The bacterium has an incubation period of 5 to 12 days, with initial symptoms of eye swelling and conjunctivitis. Other symptoms may include eye discharge, trichiasis, and lymph node swelling near ears, increased heart rate, and resulting in corneal ulcer in the end. Lab tests are essential to establish the identification of the bacteria. Antibiotics such as azithromycin, erythromycin and doxycycline can prevent long-term complications, if used in the early stages of infection (Wright H. R. et al, 2008).
Trachoma is accountable for roughly 3% of the world’s sightlessness. Internationally, 8 million individuals are permanently visually incapacitated by the ailment. An additional 84 million surviving cases require treatment to prevent blindness (International Trachoma Initiative, 2011). The number keeps on fluctuating due to the consequence of socio-economic development and control programs of the disease. More prevalence of the disease is in the developing and poor nations of the world where the facilities of water and sanitation are adequately lacking. The vigorous trachoma appears in immature adulthood and in middle-aged persons. Women are more prone than males to the infection for their roles as caretakers of the children, who are the main reservoirs of infection. But the most susceptible are children because of their own problems of hygiene (PubMed Health, 2011). Thus trachoma continues to be hyper-endemic in rural areas of Africa, Asia, South and Central America, Australia and the Middle East. The impact of trachoma has been huge as it has become a sign of severe poverty for the affected areas. There can be no control of trachoma unless the cyclical shackles of poverty are broken.
Trachoma is aggressively present in areas of the world, where the living indices are low. The major causative factors towards trachoma have been poverty, overcrowding, lack of adequate water, lack of sanitation facilities, proximity to cattle and problem of cattle dung, where flies breed as they act as transmission agents for the bacterium; lack of medical facilities including well-trained staff for handling the disease and availability of recommended antibiotics for distribution in those areas (Taylor H. R. et al, 1989). Uses of traditional eye medicines have also been implicated in causing trachoma. Any socio-environmental health model must include all the above-mentioned factors for a detailed analysis and for the formulation of proper control policies.
Control of household fly density along with facial cleanliness and adequate measures for family protection is essential. Since May 2011, the World Health Organization (WHO) provides an online admittance to the statistics on trachoma pervasiveness and pertinent maps. The WHO recommends mass drug administration of greatly effective antibiotic azithromycin with biannual treatment in hyper-endemic areas and yearly in moderately affected areas (World Health Organization, 2011). The “SAFE” strategy has been in force for the control of trachoma: surgery for in-turned lashes, antibiotics for active disease, facial cleanliness, and environmental improvement. By means of the SAFE strategy, the WHO aims to control global trachoma by 2020. The occurrence and concentration of infection have been reported to drop noticeably by use of single-dose of antibiotic azithromycin with periodic use of tetracycline eye ointment for persons with the active disease (Mathew A. A. et al, 2009). Trachoma management is community-based and looks for public involvement through the primary healthcare approach. Morocco was the first country to use azithromycin for trachoma control and paved the way for its internationally recommended use as part of the SAFE strategy in the fight against the disease. The WHO partners asked for the implementation of the SAFE strategy in affected countries to eliminate trachoma through political and social will, and methodological capabilities (Kuper H. et al, 2003).
Trachoma is a transferable eye ailment of global incidence to be restricted only by means of eradicating the rampant causes and by adopting policies and programs that have the support of public, private and community spheres. The SAFE strategy recommended by WHO should be adopted worldwide to control the disease by 2020.
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