Trachoma is a bacterial infection of the eye that spreads through contact with infected fluids or flies and causes blindness. It is caused by Chlamydia trachomatis and affects the conjunctiva. Repeated infections can cause scarring of the eyelid and turn the eyelashes inward where they scratch the cornea, causing blindness. The SAFE strategy of surgery, antibiotics, facial cleanliness, and environmental improvement was developed by WHO to treat and prevent trachoma. A study in Ethiopia found the top barriers to surgery for trichiasis were lack of time, financial constraints, no companion, and fear of surgery.

1. TRACHOMA
By Anna Melton
http://go-near.org/?p=172

2. Trachoma is the world’s leading
cause of preventable blindness

3. Trachoma is a contagious bacterial
infection in the eye which causes
blindness after multiple reinfections.

4. Trachomatous inflammation-follicular
http://www.who.int/blindness/causes/trachoma_documents/en/index.html

5. The bacteria infects the conjunctival covering which
leads to irritation and inflammation.

6. Normal conjunctival covering
Infected conjunctival covering
http://www.who.int/blindness/causes/trachoma_documents/en/index.html

7. Trachomatous inflammation-follicular and intense
http://www.who.int/blindness/causes/trachoma_documents/en/index.html

8. Trachomatous scarring
http://www.who.int/blindness/causes/trachoma_documents/en/index.html

9. Eventually, the eyelid will turn inward
causing the eyelashes to scar the cornea.

10. http://www.who.int/blindness/causes/trachoma_documents
/en/index.html
Trachomatous trichiasis

11. Trachoma is caused by the
bacterium Chlamydia trachomatis
http://www.microbelibrary.org/library/gram-stain/3089-examination-of-gram-stains-of-
cervical-and-urethral-discharges

12. 1.Elementary body
(EB) attaches to
surface of cell.
2. Elementary
body enters by
endocytosis.
3. Elementary
body enters
endosome.
4. Elementary
bodies reorganize
into reticulate
bodies (RB).
http://pathmicro.med.sc.edu/mayer/chlamyd.htm

13. 5. Reticulate
bodies (RB)
replicate.
6. Reticulate
bodies (RB)
reorganize into
Elementary bodies
(EB)
7. Both RB and
EB reside in
inclusion granule.
8. Reverse
endocytosis
http://pathmicro.med.sc.edu/mayer/chlamyd.htm

14. http://pathmicro.med.sc.edu/mayer/chl
amyd.htm
http://chlamydiae.com/twiki/bin/view/Cell
_Biology/GrowthCycle

15. Chlamydia trachomatis is spread through
direct contact with an infected person.
http://anglicansablaze.blogspot.com/

16. Flies also play a major role in the
spread of the disease.
http://bjo.bmj.com/content/88/6/750.full

17. Poor sanitation, dirty water, and lack of
hygiene are causes of trachoma.
http://sitemaker.umich.edu/aqua/home

18. Thus trachoma primarily affects
developing countries in Africa and Asia.
https://apps.who.int/pbd/trachoma/MAPS.htm

19. Trachoma binds a family to the cycle of poverty.
Child Mother
daughter must drop
out of school to
take care of family
Father
Unable to work
increasing financial
troubles
Will likely
develop blinding
trachoma as an
adult

20. Trachoma affects the eye in five stages that
can be diagnosed through an eye examination.
http://www.guardian.co.uk/global-development/2011/jan/06/prevent-
blindness-trachoma-poor-countries-2020

21. http://www.who.int/blindness/causes/trachom
a_documents/en/index.html

22. The early stages are easily treated by
one dose of Zithromax or by
topical application of Achromycin.
http://allpills.biz/order-zithromax-
online-en.html
http://www.sightsavers.org/blogs/insights/archana_patel/16594.html

23. Zithromax inhibits protein synthesis by
disrupting mRNA translation
http://pharmacologycorner.com/protein-synthesis-inhibitors-macrolides-mechanism-of-action-
animation-classification-of-agents/

24. Once the disease progresses to
Trichiasis, surgery is necessary.
http://www.who.int/blindness/causes/trachoma_documents/en/index.html

25. The SAFE strategy was
developed by WHO as an
approach to treatment and
prevention of trachoma.

26. Surgery
http://www.cbmuk.org.uk/our-work/campaign/nicodems-story-NTDs-trachoma

27. Antibiotics
www.sightsavers.org/images/content/17857

28. Facial Cleanliness
http://fieldnotes.unicefusa.org/2011/06/effort_to_eliminate_trachoma.html

29. Environmental
Improvement
http://fiaintl.org/fiaintl/myweb.php?hls=10021&id=7

30. WHO launched Global Elimination of
Trachoma 2020 (GET).
trachoma.org/global-strategy-2020-INSight
http://new.paho.org/hq/index.php?option=com_content&view=arti
cle&id=6668%3Aq16th-meeting-of-the-who-alliance-for-the-
global-elimination-of-blinding-trachoma-get-by-
2020q&catid=4451%3Ahsd0108m-neglected-d-trachoma-
meeting-&lang=en

31. Although surgery to reverse the effects of trichiasis is
free or low cost in developing countries, the number of
cases operated has grown less than anticipated.

32. Saul N. Rajak, et al. asked “Why Do
People Not Attend for Treatment for
Trachomatous Trichiasis in Ethiopia? A
Study of Barriers to Surgery”

33. The Top 5 List
1.Lack of Time
2.Financial Constraints
3.No-one to accompany
4.No symptoms
5.Fear of surgery

34. They concluded “that a locally delivered outreach
campaign providing free or low-cost surgery would
overcome or reduce the three most common
barriers…”
http://www.sightsavers.org/about_us/default.
ml
http://www.sightsavers.org/our_wo
rk/how_we_help/health/causes_of
_blindness/trachoma/16916.html

35. Sources
Rajak SN, Habtamu E, Weiss HA, Bedri A, Zerihun M, et al. (2012) Why Do People Not Attend for Treatment for
Trachomatous Trichiasis in Ethiopia? A Study of Barriers to Surgery. PLoS Negl Trop Dis 6(8): e 1766.
doi:10.1371/journal.pntd.0001766
Schlosser , K. (n.d.). Trachoma Matters. Retrieved from
http://trachoma.org/sites/default/files/guidesandmanuals/History%20of%20Trachoma%20by%20Katherine%20Schlosser.pdf
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Prevention and Blindness and Visual Impairment. (2010). Retrieved from http://www.who.int/blindness/en/
About Trachoma. (n.d.). Retrieved from http://www.trachomacoalition.org/about-trachoma
Priority eye diseases . (n.d.). Retrieved from http://www.who.int/blindness/causes/priority/en/index2.html
Weekly Epidemiological Record. (2012). Retrieved from http://www.who.int/wer/2012/wer8717.pdf
Water-related Diseases . (2001). Retrieved from http://www.who.int/water_sanitation_health/diseases/trachoma/en/
International Trachoma Initiative. (2011). BBC Trachoma Documentary. Retrieved from:
http://trachoma.org/features/multimedia/video/bbc-trachoma-documentary
Trachoma Grading Card . (n.d.). Retrieved from http://www.who.int/blindness/publications/trachoma_english.jpg