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Dear Readers,
Trachoma is the world's leading cause of preventable blindness. This eye disease is closely associated with poverty and is often described as quiet and hidden. Quiet-as it manifests slowly making the person blind over a period of time. Hidden- because for those who develop trachoma do not often realize it till too late and very often it is taken as part of their life. It is usually found in rural communities where people live in overcrowded conditions with limited access to water and health care. However it threatens to blind nearly 10 percent of the worlds population unnecessarily. It is extremely gender biased with women being three times more likely to bear the burden of trachoma.

This issue of Sitenews seeks to highlight various dimensions of this disease. Resources are provided which highlight the magnitude of the problem. Being one of the oldest infectious disease known to man yet not been brought under control this needs to be understood and examined from different perspectives as it is not the clinical intervention which is a challenge in tackling this problem. The details of the clinical strategies for treatment have been well established including its diagnosis and management. However the barriers still remain at the providers and community level with both the groups not being able to come together to prevent this problem. Health education remains a very important strategy in the prevention. Global Elimination of Trachoma 2020 as well as the implementation for SAFE strategy has resulted in trachoma control programmes having a strong base.

The featured organization is International Trachoma Initiative which is doing extensive work in bringing this preventable disease under control.

Hope this issue will impart the resources which are worth to be read. Looking forward to come up with more resources in future.

We wish you an experience of learning that is very practical. Your feedback will let us know how we can improve. Please write in your feedback at eyesite@aravind.org. We look forward to your feedback.

We wish our readers an informative reading!

Happy Reading!

Regards,

Vision 2020 e-resource team
The Issue Features...
Trachoma
Vol. 4 No. 9 September 2007
•   Magnitude
•   Understanding Trachoma
•   Diagnosis & Management
•   Health Education
•   Global Elimination of Blinding Trachoma (Get 2020)
•   Trachoma Control Programmes
•   Featured Website
•   Talk To Us

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Trachoma affects about 84 million people of whom about 8 million are visually impaired. It was once endemic in most countries. It is responsible, at present, for more than 3% of the worlds blindness but the number keeps changing due to the effect of socio-economic development and current control programmes for this disease. In spite of this, trachoma continues to be hyperendemic in many of the poorest and most remote poor rural areas of Africa, Asia, Central and South America, Australia and the Middle East. The sequelae of active trachoma appear in young adulthood and in middle-aged persons. In hyperendemic areas active disease is most common in pre-school children with prevalence rates as high as 60-90%. It often strikes the most vulnerable members of communities - women and children. Adult women are at much greater risk of developing the blinding complication of trachoma than are adult men. This increased risk has been explained by the fact that women generally spend a greater time in close contact with small children, who are the main reservoir of infection.
  • MAPPING THE GLOBAL DISTRIBUTION OF TRACHOMA

  • Abstract:
    This article summarize and map the existing global population-based data on active trachoma and trichiasis.

  • TRACHOMA-RELATED VISUAL LOSS

  • Abstract:
    This article tells in detail about the emergence of Trachoma and also the prediction of Trachoma from the surveys conducted in Africa. It also clearly lists out the ration of population affected due to Trachoma related vision loss. It also tells in detail treatments for Trachoma.

  • THE BURDEN OF TRACHOMA IN THE RURAL NILE DELTA OF EGYPT: A SURVEY OF MENOFIYA GOVERNORATE

  • Abstract:
    This survey of trachoma was undertaken in Menofiya governorate to determine if Egypt should be identified as trachoma endemic and targeted for trachoma control efforts.

  • TRACHOMA RAPID ASSESSMENT: RATIONALE AND BASIC PRINCIPLES

  • Abstract
    This article tells in detail about rationale behind conducting the rapid assessment for Trachoma. It also describes about the Trachoma rapid assessment program, a rational, rapid and low cost method of identifying specific areas/communities liable to have a significant problem of blinding trachoma.

  • GUIDELINES FOR THE RAPID ASSESSMENT FOR BLINDING TRACHOMA

  • Abstract:
    This document introduces the concept and methodology of Rapid Assessment (RA) for those seeking to control and eliminate trachoma related problems through cost effective interventions. This document provides both a checklist of information needed and an approach for obtaining data that will enable the planners to identify the existence of Trachoma related problems and plan protection to provide solutions.

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Trachoma is one of the oldest infectious diseases known to mankind. It is caused by Chlamydia trachomatis a microorganism which spreads through contact with eye discharge from the infected person (on towels, handkerchiefs, fingers, etc.) and through transmission by eye-seeking flies. After years of repeated infection, the inside of the eyelid may be scarred so severely that the eyelid turns inward and the lashes rub on the eyeball, scarring the cornea (the front of the eye). If untreated, this condition leads to the formation of irreversible corneal opacities and blindness.
     Environmental risk factors are water shortage, flies, poor hygiene conditions, and crowded households. A prolonged exposure to infection throughout childhood and young adulthood appears to be necessary to produce the complications seen in later life. A single episode of acute Chlamydial conjunctivitis is not considered sight threatening as there is virtually no risk of prolonged inflammation or blinding complications.
  • TRACHOMA AND FLY CONTROL

  • Abstract:
    This article tells in detail about how and which flies spread trachoma. It also describes how the infections are caused due to flies and also suggests how these flies could be prevented by spraying insecticide and helps in reducing trachoma. It also highlights the result of study conducted in two villages where one is fly controlled and other not.

  • TRACHOMA AND WATER

  • Abstract
    This article lists out the reasons why one might expect improvements in water supply to reduce the transmission of trachoma in a community. However, the relationship between water supplies and trachoma is sometimes more complex than it might seem, and the proof that water supply improvement can help to reduce trachoma can sometimes be difficult. This article deals with relationship between water and trachoma.

  • FACE WASHING PROMOTION FOR PREVENTING ACTIVE TRACHOMA

  • Abstract
    The objective of this review is to assess the effects of face washing on the prevalence of active trachoma in endemic communities.

  • THE EVIDENCE BASE FOR TRACHOMA INTERVENTIONS

  • Abstract
    This article briefs about all four components of SAFE that is Surgery for trichiasis, Antibiotics for active trachoma, Face washing and Environmental interventions.

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A global initiative to eliminate trachoma as a blinding disease, entitled GET 2020 (Global Elimination of Trachoma), was launched under WHOs leadership in 1997. Through this initiative control activities are instituted through primary health care approaches that follow the evidence-based SAFE strategy. This consists of lid surgery (S), antibiotics to treat the community pool of infection (A), facial cleanliness (F); and environmental changes (E). VISION 2020 national plans that address trachoma are written in line with the GET2020 "SAFE" strategy and recommendations.
  • WHAT'S NEW IN AZITHROMYCIN?

  • Abstract
    This article tells in detail about the Azithromycin antibiotic that is used in the treatment of Trachoma. It also tells why the antibiotic azithromycin is used in the treatment of trachoma. It also highlights on various issues and queries like target group, distribution, dose, etc related to azithromycin.

  • AZITHROMYCIN FOR CONTROL OF TRACHOMA

  • Abstract
    This article describes about the new global initiative taken by WHO for the prevention of Trachoma by the year 2020. The initiative GET 2020 consists of a four-pronged strategy to reduce active trachoma through community-based antibiotic distribution and health education on face washing and environmental sanitation, and to reduce vision loss from trichiasis through provision of appropriate surgical services. It also describes in the detail about the usage of azithromycin antibiotic for treating trachoma in the communities.

  • DISTRIBUTION OF AZITHROMYCIN BY COMMUNITY HEALTH VOLUNTEERS IN GHANA

  • Abstract
    This is the report of an operational study conducted to test the feasibility of using community health volunteers (CHVs) to distribute azithromycin which was undertaken in the Daboya sub-district of Ghana's Northern Region.

  • WHATS NEW IN TRICHIASIS SURGERY?

  • Abstract
    This article describes in detail about the need for the Trichiasis surgery, the persons for whom this surgery could be done and where should the surgery to be done and how the surgical procedures could be improved.

  • TRICHIASIS SURGERY

  • Abstract
    This article describes in detail bout the Trichiasis and the surgical principles that have to be followed in the Trichiasis surgery. It also tells in detail about how the surgery helps as a safe strategy for the prevention of Trachoma. It highlights on the need for further research on the reasons for poor surgical uptake and follow up of surgical cases.

  • TRICHIASIS SURGERY FOR TRACHOMA THE BILAMELLAR TARSEN ROTATION PROCEDURE

  • Abstract
    The manual is guide to learn to identify the patients who require Trichiasis surgery. It also helps as a guideline for how to perform successfully the bilamellar tarsal rotation operation to correct Trichiasis and also helps to assess results and manage complications of the bilamellar tarsal rotation procedure.

  • TRAINING IN TRICHIASIS SURGERY

  • Abstract
    This article lists in detail about the Training procedures for treating Trachoma.

  • FINAL ASSESSMENT OF TRICHIASIS SURGEONS

  • Abstract
    The objectives of this manual are to list and describe the knowledge that must be demonstrated and the procedures that must be successfully completed before, during, and after, surgery in order for certification to be granted. It also provides a checklist of the knowledge and procedures to assess during observation of the surgical process and guidelines for scoring the checklist for purposes of certification.

  • ZITHROMAX INTHE CONTROL OF BLINDING TRACHOMA

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Health education helps individuals and groups of people learn to behave in a manner conducive to the promotion, maintenance or restoration of health. The ultimate aim of Health Education is Positive Behavioural Modification.
     Education for health begins with people as they are, with whatever interests they may have in improving their living conditions. Its aim is to develop in them a sense of responsibility for health conditions, as individuals and as members of families and communities. As far as eye care is concerned a lot of health education materials have to be developed for creating awareness about the eye diseases. We have provided you with the links of various health education materials that can be used by you to eliminate trachoma.
  • HEALTH PROMOTION FOR TRACHOMA CONTROL

  • Abstract
    This article tells in detail about the health promotion initiative to be taken for the trachoma control. It also describes in detail about the identified five key components for effective trachoma control communication. It emphasis on communication activities that have to be carried out for creating awareness in the community for trachoma and also tells how to effectively monitor and evaluate health promotional activities.

  • ACHIEVING COMMUNITY SUPPORT FOR TRACHOMA CONTROL

  • Abstract
    The purpose of this manual is to provide district health workers with guidelines for achieving community support for trachoma control activities. It also gives you some ideas on how to detect, treat and prevent the disease. Material from it can be adapted for training and involving others in trachoma control.

  • PREVENTING TRACHOMA - A GUIDE FOR ENVIRONMENTAL SANITATION AND IMPROVED HYGEINE

  • Abstract
    This manual forms part of the comprehensive safe strategy that has been developed for controlling trachoma through the action of a combination of determinants including Surgery, Antibiotic treatment, Facial cleanliness and Environmental change. It addresses the F and E components of preventive action for trachoma control, which focus on improving hygiene and the environment. This manual is intended for the communities where trachoma has been shown to represent a public health problem, which are mainly poorer rural or peri-urban communities.

  • THE ELIM CARE GROUPS: A COMMUNITY PROJECT FOR THE CONTROL OF TRACHOMA

  • Abstract
    This article tells in detail about the community project done by Elim Hospital for the control of Trachoma in Africa. It also describes how the eye care group approached the community groups and trained them to reach the community and create awareness among the people. It highlight the impact of Care Group activity on the improvement of health factors such as personal and environmental hygienic conditions and the prevalence of trachoma.

  • A GUIDE: TRACHOMA PREVENTION THROUGH SCHOOL HEALTH CURRICULUM

  • Abstract
    This guide describes about step-by-step methodology used for school health curriculum to reach the childrens affected with trachoma.

  • PRIMARY HEALTH CARE LEVEL MANAGEMENT OF TRACHOMA

  • Abstract
    This manual has been produced to assist trainers of health workers to teach a simplified assessment of trachoma. The manual is for use by the trainer to explain how to examine children and adults for signs of trachoma and how to use the simplified grading scheme.

  • JUMA AND TRACHOMA

  • Abstract
    This is a medical strip cartoon collection which can be used for creating Trachoma awareness.

  • ACHIEVING COMMUNITY SUPPORT FOR TRACHOMA CONTROL

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The Alliance for the Global Elimination of Blinding Trachoma by the year 2020 (GET 2020) supports and collaborates with WHO in carrying out essential activities such as epidemiological assessment, including rapid assessment and mapping, project implementation, coordination, and monitoring, disease surveillance, project evaluation and resource mobilization. It is open to all parties - governments, international organizations and nongovernmental organizations - which are willing and ready to contribute to international efforts.
  • TRACHOMA EPIDEMIOLOGIC SURVEY PROTOCOL

  • Abstract:
    This Trachoma epidemiologic survey protocol tells how to gather sufficient data for the preparation and the evaluation of Trachoma control component within a national programme for the prevention of blindness.

  • THE SAFE STRATEGY FOR THE ELIMINATION OF TRACHOMA BY 2020: WILL IT WORK?

  • Abstract
    The present article reviews the strengths and weaknesses of each component of the SAFE strategy for GET 2020, a comprehensive set of control measures Surgery for entropion/trichiasis, Antibiotics for infectious trachoma, Facial cleanliness to reduce transmission and Environmental improvements such as control of disease-spreading flies and access to clean water. Although significant hurdles remain to be overcome there is every reason to hope that GET 2020 will be successful.

  • TRACHOMA AND THE SAFE STRATEGY

  • Abstract
    This article tells in detail about the safe strategy suggested by the world health organization for the elimination of Trachoma. It also tells in detail about the International Trachoma initiatives taken for the prevention of Trachoma.

  • IMPLEMENTING THE SAFE STRATEGY FOR TRACHOMA CONTROL

  • Abstract
    The purpose of this manual is to provide program managers and planners with guidance for designing interventions for facial cleanliness and Environmental improvement in trachoma control programs. This manual shows how to learn about risk practices, offers toolbox for interventions, and explains how to communicate about a trachoma control program, and also provides steps for evaluating the trachoma control program.

  • TRACHOMA AT A GLANCE

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Trachoma can be controlled, and blindness and visual loss can be prevented by appropriate application of relatively simple and inexpensive measures. Trachoma-control programs must be aimed primarily at those severely affected communities where the disease leads to blindness. In planning and implementing control programs, consideration must be given to the simultaneous introduction of other specific measures for dealing with all causes of avoidable blindness. In recent years, knowledge about the causative agent of trachoma and about the epidemiologic patterns that determine the intensity of inflammation and the gravity of disease has increased substantially. This new information has led to a clearer definition of risk for the individual and for the community and has made it possible to distinguish communities with "blinding trachoma" from those with "non-blinding trachoma."
  • LESSONS FROM THE MOROCCAN NATIONAL TRACHOMA CONTROL PROGRAMME

  • Abstract
    This article tells in detail about the nationwide survey of the prevalence of visual impairment and its causes in Morocco. It also tells in detail how this Programme initiative has been evaluated and also key strengths of the programme for the elimination of Trachoma.

  • WHATS NEW IN TRACHOMA CONTROL?

  • Abstract
    This article enlightens us with the World Health Organization-recommended SAFE strategy, oral dose of the antibiotic azithromycin, and International Trachoma Initiative (ITI).

  • TRACHOMA CONTROL - A GUIDE FOR PROGRAMME MANAGERS

  • Abstract
    This guide has been written for managers of national and district trachoma control programmes. It sets out, step-by-step, what is needed to assess the magnitude and extent of the trachoma problem in the area and how to plan, implement, monitor and evaluate a programme to control, and ultimately eliminate trachoma.

  • DISTRICT BASED PLANNING

  • Abstract
    This article gives an overview of District based planning for vision 2020 and some experiences with integration of Trachoma into district based Vision2020 plans.

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International Trachoma Initiative
Founded in 1998 by the Edna McConnell Clark Foundation and Pfizer Inc, the International Trachoma Initiative is dedicated to the elimination of blinding trachoma, the world's leading cause of preventable blindness.

Working in countries where the World Health Organization has documented widespread disease, ITI collaborates with national ministries of health and other partners to identify regions where trachoma control will be targeted, develop a plan for implementing the SAFE strategy, and mobilize people and resources.

Through implementation of the SAFE strategy, ITI ensures that surgical services are available to patients with advanced disease, that antibiotics are distributed, that face washing is widely publicized, and that communities are working to improve access to clean water and sanitation.

Visit our website : www.trachoma.org

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