Sudan faces many obstacles in battle with trachoma epidemic
Trachoma Carter Center Video Screen Shot
The Greater Darfur region is not only in the middle of a serious yellow fever outbreak, but this area of Sudan also face an epidemic of the blinding bacterial disease, trachoma, according to an Al-Ayaam news report Dec. 23.
According to Federal Health Minister Dr. Tabita Boutros, there are at least 700,000 cases of trachoma in Sudan. However, problems in the Greater Darfur area have inhibited medicine and proper treatment to those ailing from the disease.
A deteriorating security situation, poor distribution of human resources, and lack of infrastructure, food, and drinking water in rural areas have all proven obstacles in the elimination of the disease in the region.
Trachoma is a horribly disabling disease that is virtually unknown to many Americans. It is responsible for an estimated 7-8 million cases of permanent blindness particularly in the Middle East and Africa.
The organism that causes trachoma is Chlamydia trachomatis serovars A-C. These types are different from the types of Chlamydia that commonly cause the sexually transmitted infection that is so prevalent here in the United States.
According to the World Health Organization, trachoma is hyperendemic in many of the poorest and most remote rural areas in 57 countries of Africa, Asia, Central and South America, Australia, and the Middle East. Roughly half of the global burden of active trachoma is concentrated in 5 countries (Ethiopia, India, Nigeria, Uganda and Sudan), and that of trichiasis in 4 countries (China, Ethiopia, Nigeria and Uganda). Overall, Africa is the most affected continent: 27.8 million cases of active trachoma (68.5 percent of all cases globally) and 3.8 million cases of trichiasis (46.6 percent of all cases globally) occur in 28/46 countries in the African region.
This is definitely a disease of the poor with poverty, poor personal hygiene and crowded living conditions being a few of the main factors contributing to its spread. It is also more commonly found in areas where the climate is dusty and dry.
The infectious agent is transmitted person to person through contact with eye or nasal discharges on fingers and indirectly through the use of contaminated items such as towels, pillows and clothes items like a mother’s shawl.
Flies are also a carrier of the contaminated discharge from person to person after feeding on the eye discharge of an infected person. In Africa and the Middle East, a specific specie of fly, Musca sorbens, is responsible for much of the spread.
Initially the infection resemble “pink eye” where there is inflammation of the eye, pain and sensitivity to light. Also the eye produces a watery discharge and the infection and inflammation resolves itself. The severity of trachoma is the result of frequent reinfection of the eye which over time causes scarring on the inner upper eyelid.
The resulting network of scarring over time causes an in-turning of the eyelashes (trichiasis) and entropian.
This results in a chronic abrasion of the cornea from the contact from the eyelashes. The scratching of the cornea also results in additional eye infections which in combination cause the cornea to turn opaque and blindness is the final result.
This endemic childhood disease is seen in up to 90 percent of children in rural areas of the countries listed above. Women, due to taking care of children are at least 3 times more likely to get infected than men.
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