Chlamydial infection
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
In addition to its role in genital diseases, C. trachomatis infection of the eye (trachoma) is one of the world’s leading causes of preventable blindness. In 2002, the WHO reported that this infection accounts for about 3.6% (1.3 million) of total blindness worldwide. This disease is endemic in 56 countries including many in Africa, the Middle East and some parts of Asia, Latin America, and the Western Pacific. Trachoma is transmitted through contact with eye droplets from contaminated hands, clothing, and eye-seeking flies. The most affected populations are those living in poverty where resources are limited, hygiene is poor, and conditions permit facile transmission of the infection (5). C. trachomatis can also cause a systemic sexually transmitted disease, Lymphogranuloma venereum (LGV), which is characterized by genital ulceration and inguinal lymphadenopathy (buboes). This disease can progress and result in hemorrhagic proctocolitis, rectogenital scarring, and lymphedema. LGV is endemic in some areas of Africa, Asia, South America, and the Caribbean but is uncommon in industrialized countries (6).
Corneal Disorders
Ching-Yu Cheng, Tien Yin Wong in Ophthalmic Epidemiology, 2022
Trachoma is the most common cause of infectious blindness globally and is responsible for visual impairment in around 1.9 million people across 44 countries.21 Nearly 90% of these individuals live in sub-Saharan Africa. According to a global report published in 2017, the number of people suffering from blindness due to trachoma was 0.4 million.18 Trachoma is caused by Chlamydia trachomatis, which is a Gram-negative, obligate intracellular bacterium. The serotypes of C. trachomatis responsible for endemic trachoma include A, B, Ba, and C.22 Recurrent episodes of infection and inflammation cause ocular surface complications, conjunctival scarring, and consequent lid abnormalities like entropion, trichiasis, and corneal scarring, eventually leading to blindness. A 4-year cohort study from Tanzania reported the progression of trachoma-related conjunctival scarring in 23% of affected children.23 The scarring progression was strongly associated with papillary conjunctival inflammation. Another study from Ethiopia stressed the effects of trichiasis on the quality of life for adults suffering from trachomatous trichiasis.24 This study concluded that scarring and trichiasis had a profound effect on vision-related as well as health-related quality of life, even in individuals having normal vision.24
Chlamydia trachomatis
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward in Case Studies in Infectious Disease, 2010
Trachoma is the most serious of the eye infections caused by C. trachomatis. The word ‘trachoma’ in Greek means rough (trakhus) and reflects the roughened appearance of the conjuctiva. Repeated re-infection with the ocular serovars A, B, Ba, and C results in chronic keratoconjunctivitis. Following infection there is an incubation period of 5–12 days, after which the symptoms start to appear and include a mild conjunctivitis and eye discharge. Initial infection is often self-limiting and heals spontaneously. A repeated infection, however, leads to the development of chronic inflammation (see Section 2), characterized by swollen eyelids and swelling of lymph nodes in front of the ears. Years of re-infection and chronic inflammation may result in fibrosis and in scarring in the upper subtarsal conjunctiva. The progress of scarring over many years causes distortion of the lid margin and the lashes turn inwards and rub against the cornea. This is called trichiasis (Figure 4). If untreated, persistent trauma can result in ulceration of the cornea, corneal opacity, and blindness.
Chlamydia trachomatis: quest for an eye-opening vaccine breakthrough
Published in Expert Review of Vaccines, 2022
Vivek P Chavda, Anjali Pandya, Erica Kypreos, Vandana Patravale, Vasso Apostolopoulos
Trachoma symptoms include soreness of the eyes, itchy skin, eye and eyelid irritation, eye weeping, swelling of the eyelids, eye pain, and photophobia. It is critical to ascertain the period of these symptoms and acquire a history of travel to endemic areas (e.g. North Africa, the Middle East, and India). Vaginitis, cervicitis, or urethritis may occur concurrently. Trachoma is diagnosed primarily based on the patient’s history and clinical signs that can be seen on slit-lamp evaluation. While many diagnostic assays have been developed to diagnose the organism, no ‘gold standard’ exploration persists. Trachoma has a favorable prognosis wherein early detection and treatment are critical for preventing irreversible side effects and eye damage. In recent years, community-based SAFE strategy implementation has improved the prognosis for thousands of people at risk. A study conducted in Rural Sudan found that using this stratification resulted in massive declines in the pervasiveness of active disease [91].
Ocular Chlamydia trachomatis infection: elimination with mass drug administration
Published in Expert Review of Anti-infective Therapy, 2019
Meraf A. Wolle, Sheila K. West
In recognition of this public health problem, the World Health Assembly has targeted the year 2020 to eliminate blinding trachoma [1], and a multifaceted strategy (SAFE) is recommended including antibiotics for treatment of infection. For trachoma-endemic communities, mass treatment with antibiotics is provided annually for years. In this review, we present relevant details on C. trachomatis and the epidemiology of trachoma, followed by a description of the antibiotics typically used to treat ocular C. trachomatis infection. We then discuss the public health approach to the elimination of trachoma, specifically the use of mass drug administration. We describe the effectiveness of this approach, and the challenges of antibiotic treatment of communities, concluding with a discussion of the elimination of trachoma in the future.
Prevalence of trachoma in 13 Local Government Areas of Taraba State, Nigeria
Published in Ophthalmic Epidemiology, 2018
Murtala M. Umar, Caleb Mpyet, Nasiru Muhammad, Mohammed D. Adamu, Habila Muazu, Uwazoeke Onyebuchi, Adamani William, Sunday Isiyaku, Rebecca M. Flueckiger, Brian K. Chu, Rebecca Willis, Alexandre L. Pavluck, Nicholas Olobio, Ebenezer Apake, Francisca Olamiju, Anthony W. Solomon
The prevalence of TF was less than 5% in all but one (Ussa) of the 13 LGAs of Taraba State mapped in this series of surveys. Previous studies (conducted in 2009) reported TF prevalences of 5.0% in Gashaka and 6.1% in Donga9 which are LGAs that were not included in the present study. According to current recommendations, one round of high coverage antibiotic mass drug administration is indicated in Ussa LGA (and in Gashaka and Donga LGAs), in addition to implementation of the F & E components of the SAFE strategy; such an approach has proven highly effective in eliminating active trachoma elsewhere.22 While there have been no specific trachoma elimination activities in Taraba since the 2009 surveys were conducted, disease prevalence is unlikely to have remained exactly the same as recorded then. Where water supply and sanitation conditions, education and/or access to health care have improved, the prevalence of trachoma is likely to have fallen.23,24
Related Knowledge Centers
- Antibiotic
- Azithromycin
- Chlamydia Trachomatis
- Conjunctiva
- Cornea
- Tetracycline
- Visual Impairment
- Granulation Tissue
- Entropion
- Neglected Tropical Diseases