Trachoma

Question 1

What bacteria causes trachoma?

Answer 1

Chlamydia trachomatis

Question 2

How does trachoma cause blindness?

Answer 2

Infection leads to scarring of upper tarsal conjunctiva. Eyelashes turn in and scratch the cornea leading to ulceration and scarring.

Question 3

What are the risk factors for trachoma?

Answer 3

Lack of WASH
High level of flies
Sharing towels
Women (proximity to children)

Question 4

What are the grades of trachoma?

Answer 4

Trachomatous inflammation- follicular
Trachomatous inflammation- intense
Trachomatous scarring
Trachomatous trichiasis (eyelash rubs)
Corneal opacity

Question 5

How do you manage trachoma?

Answer 5

Single dose azithromycin or topical tetracycline

Surgery for entropion (will recur in 40%)

Question 6

What is the WHOs strategy for elimination of trachoma by 2030?

Answer 6

Surgery for entropion and trichiasis
Abx for infectious trachoma
Facial cleanliness to reduce transmission
Environmental improvements-control flies and access to clean water

12 countries eliminated trachoma

Question 7

What is the mass drug administration programme for trachoma?

Answer 7

Three round of MDA with azithromycin to districts with TF of 10% and over in 1-9yr olds
Azithromycin donated by manufacturers

Question 8

What is the definition of trachoma elimination in a community?

Answer 8

Trachoma trichiasis of <0.2% in over 15yr olds

Prevalence of TF in 1-9yr olds of <5% for 2yrs in the absence of MDA