Country director of Sightsavers Nigeria, Dr. Sunday Isiyaku, discussed why it is important for the country to eliminate trachoma, the world’s leading infectious cause of blindness. Trachoma is one of the oldest diseases known to humans. According to him, bronze Age forceps for depilation, thought to have been used to remove affected people’s eyelashes, have been found in modern Iraq and the disease was common in Ancient Egypt with treatments discussed in the Ebers Papyrus written more than 3,500 years ago.
As the world’s leading infectious cause of blindness, it is responsible for the blindness or visual impairment of about 1.9 million people around the world. In advanced cases, after repeated infection, trachoma causes scarring of the inner surface of the eyelids making the eyelashes turn inward and scrape against the eye. This is known as trachomatous trichiasis. The pain is described as like having sand or thorns scratching their eyes. It also causes sensitivity to bright light so just going outdoors can be an agony. “We often find people using homemade tweezers to pull out their eyelashes or even razor blades to cut them down,” the director said.
Children and women are the most vulnerable to the disease.
Fortunately, the disease is preventable and huge progress is being made around the world to eliminate it as a public health problem. He said that a simple antibiotic can cure the infection and in advanced cases, there is straightforward surgery on the eyelid which can revert the eyelid to end the pain and stop any further loss of eyesight. The infection thrives in places without clean water and sanitation, where people have limited access to health care, and there are lots of flies around. Poor hygiene practices also make the problem worse.
Anyone can get trachoma, but it is more common in women and children. Children are particularly vulnerable to the infections because their immune systems are not fully mature yet, they tend to be in close contact with each other, and they may be less likely to pay attention to washing their hands and faces. Women are more likely to be affected because household responsibilities bring them in close contact with infected children or dirty fabric which might be carrying the bacteria. Thus, women are at greater risk of repeated infections and, by extension, blinding disease. According to the World Health Organization (WHO), women are four times more likely to lose their sight to trachoma than men.
It spreads from people to people through a number of ways.
Furthermore, it spreads primarily through direct contact with infected fluids from people’s eyes and noses and it spreads in three main ways. First, flies that land on one person’s face can then carry the bacteria to someone else. Also, it can spread through direct contact. For example, it could be from touching someone’s hand after they’ve touched their infected face or nose. Finally, the infection can spread by touching items that are contaminated with the bacteria, such as dirty towels, blankets, clothing, and handkerchiefs used for cleaning infected secretions.
The disease can be easily passed from a mother to her child simply by wiping their face with a dirty scarf. Importantly, sharing eye makeup is a terrible idea because that is a very good way to catch the infection. Around 3.5 million people in Nigeria are still at risk of losing their sight to the disease. Generally, it is found in poorer and more remote areas. Common symptoms of the infection include itching and irritation. In children and people with early stages of active infection, there will be discharge like pus from the eyes. In later stages, when the eyelashes are scratching against the eyeball, there is severe pain, which is made worse by bright light, a feeling like sand or thorns in the eye, and blurred vision. However, the only way to be certain is to seek help from a health professional.
How the disease can be prevented and treated.
According to WHO, the use of the SAFE strategy is recommended to prevent infection and blindness from it. SAFE stands for surgery, antibiotics, facial cleanliness, and environmental improvements. A straightforward surgical procedure on the eyelid is for people with the advanced disease, trichiasis. “We can’t reverse the damage that’s already occurred, but surgery ends the pain and stops any further damage or loss of sight,” Isiyaku noted. Antibiotics are distributed during community-wide drug campaigns called mass drug administrations (MDA). Community drug distributors, mostly volunteers, are trained to go house-to-house in their local area.
World Health Organization: Website