Bacterial diseases had a great impact on the health of the human population in the world since the dawn of time. Especially in times of great war, it is able to spread through unsanitary and unclean conditions to other hosts, infecting them. Trachoma, a bacterial disease that blinds its hosts, is no different. With time and study within this disease, it is possible to spread the therapy used to prevent and stop the spread of this disease.
This article describes the etymology of the bacteria, the impact it had on the world, its classification, and the therapies available to treat the disease. Mohammadpour, Abrishami, Masoumi, and Hashemi, all from Tehran, Iran, recognized the significance and impact the disease can have, if allowed to have hosts. They were able to use the World Health Organization reports to understand the disease more and explain in depth ways to treat Trachoma.
Trachoma comes from the Greek word for “roughness” because it inflames the conjunctiva and cornea of the eye. It comes from the bacterium Chlamydia trachomatis. The disease was first noted before 8000 B.C. in Central Asia. Eventually, the disease spread to Europe and Africa, infecting people all the way from Rome to Egypt. During the Napoleonic Wars, trachoma became extremely prevalent in Europe, infecting thousands of French and British soldiers, leaving many blinded. The British, not fully knowing how to treat the disease, tried to prevent its spread with proper cleanliness, quarantine, and “improvement in the living conditions of soldiers.” From there, the disease made its way to the United States, which later classified it as a dangerous contagious disease. Before World War II, because of trachoma’s distribution around the world, the World Health Organization and La Ligue Contre Le Trachome united to find a cure for trachoma. In the mid-19th Century, trachoma treatment developed and they began to study both oral and topical tetracyclines. Topical tetracyclines had fewer side effects, so it was used as the method of treatment until the end of the 20th century. By beginning of the 21st century, trachoma had become a preventable epidemy.
With the development of the treatment of trachoma improving steadily in the 20th century, more has been learned about the agent, Chlamydia trachomatis, and best ways to both prevent and manage the spread of trachoma. C. trachomatis’ serotypes A, B, and C can all lead to the trachoma infection. The chlamydial infection can lead to inflammation, which is characterized by the presence of lymphocytic, monocytic, plasma cells and macrophages infiltrates to the ocular surface. With there being three different serotypes of the trachoma infection, the World Health Organization (WHO) created a grading system to simplify clinical manifestations. There are five categories: trachomatous inflammation-intense (TI), trachomatous scarring (TS), trichiasis (TT), corneal opacity (CO), and follicular trachoma (FT). As the conditions grow worse, the therapy for curing a patient become more severe, with the worse case being surgery.
According to WHO, there are four ways to prevent and manage the spread of trachoma. Combining to make the acronym “SAFE”, the treatment methods are surgery, antibiotics, facial cleanliness, and environmental improvements. The surgery is used to reverse the in-turned eyelashes to prevent blindness. It is a relatively simple procedure that most community and healthcare centers can provide. Unfortunately, this method has a high recurrence rate, so it is important for people to follow the other three methods in the acronym. The WHO also calls for communities which trachoma affects more than 10% of infants ages 1-9 to use antibiotics. Antibiotics are used to reduce the infection burden on a community. Topical tetracycline can be used as an ointment daily for at least six weeks, or as an alternative, annual Azithromycin tablets or liquids, the drug of choice for treatment of trachoma, can be given to infants. Pfizer, manufacturer of Azithromycin (Zithromax) is committed to fighting trachoma and is providing this drug free of charge. It has donated more than 500 million Zithromax treatments. This all, however, can be avoided just by facial cleanliness, washing dirty faces and preventing flies from landing on the eyes, and improving the environment by providing better access to clean water and improving sanitary and living conditions of inhabitants.