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At least 19 recordsLinked to original sources
PubMed1978

Childhood trachoma in a nonendemic area. Danish trachoma patients and their close contacts, 1963 to 1973.

During ten years of study of Chlamydia trachomatis eye infections, trachoma was diagnosed in 14 Danish patients with onset during childhood. Clinical findings in the eye were characteristic of classical trachoma. The infecting C trachomatis immunotype was identified in all but one case. At the time of diagnosis, seven patients were still children (6 to 10 years of age), three were teenagers, and four were adults. In five young girls the disease was extremely severe. Delay in proper diagnosis and adequate therapy contributed to the prolongation and severity of the disease. Failure to diagnose is attributed to widespread opinion and teaching of physicians in Western countries that trachoma eye disease has disappeared. Studies of family members and other contacts of the patients contributed to an understanding of the pathogenesis of this disease. The source of initial eye infection with C trachomatis organisms in these cases was thought to be the birth canal. It was further postulated that reinfection of the eyes of these children occurred either from a reservoir in their own or their mother's genital tract.

Adolescent↗
PubMed1975

Studies of trachoma in families on Taiwan.

This study was undertaken to clarify the natural history and pathogenesis of trachoma. A group of families who live in a formerly trachoma hyperendemic area of Southern Taiwan were placed under continuous surveillance. The development in recent years of the micro immunofluorescence test for trachoma antibody, along with improved cell culture isolation methods, have allowed this surveillance to include repeated effective laboratory studies in addition to clinical observations. After four years' study of one group of families and three years of another, a number of interesting findings have been obtained. Evidence is presented supporting our hypothesis that trachoma is a disease of immumopathology and results from repeated reinfections with the trachoma organisms. The clinical findings of papillae, especially those of an acute nature, has been the clinical finding most closely associated with the isolation of the organism and the demonstration of antibody. Evidence is presented that transmission of the organism is usually within the family group. Although only trachoma immunotypes B and C previously had been associated with trachoma infection on Taiwan, data is presented from one family in which type D infections occurred. While a series of new and reinfections with trachoma organisms were demonstrated in some of the families under observation, the majority of the families not only showed no new infections but showed spontaneous healing or disappearance of clinical and laboratory evidence of trachoma infection. This tendency of active trachoma infection to disappear from a family in the absence of transmission of the organism parallels the rapid fall and prevalence of active trachoma on Taiwan during the past decade.

Adolescent↗
PubMed1992

Trachoma in eastern province of Saudi Arabia.

Trachoma is one of the main cause of curable/preventable blindness in Saudi Arabia. First survey by NICHOL and al. 1955-65 in Eastern Province revealed prevalence rate of trachoma as 100% in Al Hasa, 98.0% in Qatif Oasis and 93.0% in Qatif town dwellers. Preliminary study by Ministry of Health, Eastern Province in 1986 revealed 3.74% of the population blind showing 10.1% due to trachoma. In 1986, Ministry of Health established Regional Prevention of Blindness & Ophthalmic Medical Education Committee, Eastern Province with six sub-divisions in Al Hasa, Qatif, Dammam, Al Khobar/Dhahran, Jubail and Hafr Al Batin. The whole health care divided in primary, secondary and tertiary level in 1987 and incorporated primary eye health care with primary health care. The Trachoma Center as a part of P.H.C. in Al Hasa was started in 1987 and a mass trachoma eradication programme by Trachoma Center was launched in 1988 along with improvement in socio-economic status/health facilities within last 10 years including development of structured P.H.C. system, leading to public awareness, prevention, treatment of bulk of active trachomas in this region particularly Al Hasa. This reduced the rate of prevalence of active trachoma to 1.5% in Al Hasa. Maximum active/inactive trachomas among the age above 55 years is 98.0% in Qatif region. Ministry of Health is in process of developing the Trachoma Center in Qatif region as well as comprehensive eye care by completing preliminary tertiary level care Eye Hospital in Dhahran to reduce the incidence of active trachoma below 0.5% within the next five years; thus achieve the goal of Prevention of Blindness in Saudi Arabia.

Blindness↗
PubMed1992

[Trachoma in the Sabou area (Burkina Faso). An epidemiological investigation].

Little is known about the epidemiology of trachoma in the Mossi plateau of Burkina Faso and the recent drought could have modified the transmission of the disease. A study population of 82,187 was surveyed using a cluster sample technique. A total of 1,841 people in 108 compounds were included in 18 villages. Data concerning trachoma were collected during six weeks of fieldwork in July 1991, during which local health workers were trained in trachoma and primary health care in ophthalmology. Active trachoma prevalence rises in infancy to reach a peak of about 13% (95% CI 3-23) in the 2 to 5 years old age groups, and then falls to less than 2% prevalence in 30 to 49 age group. Trachoma scarring is almost non-existent and trichiasis was not seen. Active disease was significantly more prevalent in female (prevalence ratio = 1.97, 95% CI: 1.34-2.90) and this difference was present from the age of 3 years. Active trachoma above the age of 30 was more likely to be intense than follicular (p < 0.001, Fisher's exact test). Because of a low prevalence of active disease and because trichiasis is absent, trachoma is not a major health problem in the Sabou area, Burkina Faso. Girls are more affected by active disease than boys and inflammatory trachoma in adults are usually intense in this setting.

Adolescent↗
PubMed1979

[Experimental trachoma].

During half a century, the agent of trachoma could be mainly demonstrated by inoculation to the conjunctiva of animals; by this mean the cycle of the agent could be revealed. There was a huge progress when T'ANG for these studies inoculated embryonated chicken eggs. However, experimentally infected animals are used at present time not only in trachome countries where do not exist laboratories: monkeys, guinea pigs, rabbits, rats and mice allow modern studies of chlamydial infection. Monkeys living in the countries where trachoma is endemic were selected because of their cheapness (orangoutan in Java, macaques in Northern Africa and in Taïwan, baboons in Africa). The monkeys selected by American workers are coming from South America. First pioneers (NICOLLE, CUENOD and NATAF, PAGES, JULIANELLE) have demonstrated the infectivity of animals and the place of the agent of trachoma on taxonomic point of view. As PAGES, we have demonstrated that infection could be regularly provoked when inoculating macaques; moreover a pannus could appear when adding hydrocortison drops or when infiltrating the cornea with tuberculin. Cultures of WEEKS bacilli were introduced in the eyes of trachomatous animals; we could observe an aggravation of the disease. If biology of trachoma is better known at present time, experimental trachoma is until now fundamentally important. It permits immunological studies especially for the purpose of vaccination; one can check terapeutical means for instance antibiotics; studies are performed to demonstrate cross immunizations or enhancement of defence (with levamisole). Experimental trachoma is hitherto and again for a long time commonly requested for the study of trachoma.

Animals↗
PubMed1975

Topical tetracycline and rifampicin therapy of endemic trachoma in Tunisia.

A controlled chemotherapy trial of trachoma was carried out in a Tunisian oasis among schoolchildren with active disease. We compared 1% tetracycline ointment (79 patients) or 1% rifampicin ointment (76 patients) with 5% boric acid ointment (79 patients). Medications were administered twice daily, six days a week, for ten weeks. Slit-lamp examinations by three ophthalmologists were made independently before treatment as well as five, 19, and 39 weeks after treatment. Bacteriologic cultures were taken during treatment as were smears to detect trachoma agent at each clinical examination. Five weeks after treatment, the intensity of conjunctival disease in the tetracycline and rifampicin groups was reduced significantly when compared with boric acid, but at 19 weeks this suppression was found only in the tetracycline group. Ocular bacterial pathogens were eliminated almost entirely in the two antibiotic groups during treatment. The initial prevalence of trachoma (29to 31%) was significantly reduced in the two antibiotic-treated groups at five weeks and 19 weeks after treatment. The prevalence of trachoma was equally low (7%) in all three groups following retreatment with tetracycline. Although both antibiotics were effective, rifampicin offered no advantage over tetracycline in this trial. Recurrent disease in this school-based treatment study probably was due to reinfection from younger siblings at home. While systematic, community-wide, antibiotic treatment programs are not always possible in countries where trachoma is endemic, limited antibiotic therapy programs should be continued in these areas to reduce the intensity and prevalence of trachoma, even though the disease cannot be eradicated.

Administration, Topical↗
PubMed1975

Studies on the role of the famiy unit in the transmission of trachoma.

Rates of trachoma infection of family members were compared for two groups of index cases; all were infants about 1 year old observed over a period of several months in a previous study. Group A infants were consistently infected with trachoma, and Group B infants were not infected with trachoma. On the average, 50% of Group A family members had active infection (as determined by trachoma inclusions in their conjunctival cells) and 80% of the siblings within 6 years of age to the index cases were infected. Only 9% of Group B family members had active trachoma, and 20% of the siblings within 6 years of age to the index case were infected. This study suggests intrafamilial spread of trachoma.

Antibodies, Viral↗
PubMed1992

[Feasibility of the new WHO Trachoma Grading System in China].

The New WHO Trachoma Grading System is found feasible in China by an epidemiological survey of trachoma using the two trachoma grading systems, the new WHO system and the Chinese conventional system, especially for large scale examination and treatment and for epidemiological survey. However, the New System regards the proportion of active trachoma amongst children under 10 years as the index of the scope and severity of the disease in a community, while the authors opine that the trachoma prevalence in teenagers, especially in middle school students, better reflects the situation of trachoma infection in a Chinese community.

Adolescent↗
PubMed1976

Severe endemic trachoma in Tunisia.

In two villages in southern Tunisia where trachoma was endemic 7 per cent and 14 per cent of adults respectively had visual acuity of 20/400 or less. In both villages active trachoma affected most children under the age of two, reached a peak in two- to five-year-olds, then declined to age 15. The chronic inflammatory disease in childhood appeared to produce irreversible scarring of the eyelids, and loss of vision occurred in adult life due to corneal scarring caused by inturned eye lashes and loss of tears (dry-eyed syndrome). Economic development in one village was associated with a decline in active, infectious disease. In the second village, whose traditional economy was unchanged, there was the same prevalence of active disease over a three-year period. Unless economic development or public health control programmes reduce the prevalence of severe and moderate trachoma children now affected will develop the same blinding lesions as their parents. With the increasing numbers of children who survive there will probably be a dramatic increase in the numbers of the blind from trachoma in 10 to 20 years. Since active inflammatory trachoma in childhood responds to tetracyclines, erythromycin, and sulphonamides the disease should be attacked in those undeveloped rural areas where it continues to lead to blindness.

Adolescent↗
PubMed1992

[Epidemiological surveillance of trachoma: evaluation and perspective].

World Health Organization (W.H.O.) carried out a survey recently. This survey consisted in a questionnaire to some of its Member States to try to define the importance and world distribution of trachoma. The answers which have been sent by ocular health advisers and/or persons in charge of national ophthalmological institutes showed a systemic lack of significant data to be used for planning or for epidemiological surveillance. Nevertheless, the analysis of this survey seems to lead to the conclusion that trachoma is not still the main cause of blindness in some countries who used to be famous because of an important endemicity. However, trachoma is still a real ocular health and public health problem in numerous other countries, mainly in rural areas and- or areas which are away from socio-sanitary development areas. To have a better quality concerning epidemiological data and to obtain an easier regularity in their collecting, W.H.O. Program for the Blindness Prevention proposed a simplified coding system of trachoma and its complications (S.S.C.T.C.). If this system was accepted by numerous countries it would allow: the use of a simple, reliable and cheap tool to collect epidemiological informations which would constitute an help to take decisions to be able to, give a second start to epidemiological surveillance of trachoma, to have a better idea of the localization of endemic centres of the disease and of this impact on population, to define the needs concerning collective and individual medical and surgical treatments.

Blindness↗
PubMed1992

[Trachoma in the province of Ouarzazate, Morocco].

A survey on the prevalence and severity of trachoma was carried out in the province of Ouarzazate, Morocco. In conformity with the guidelines proposed by the WHO Programme for the Prevention of Blindness, a random sample of 30 clusters was extracted from the general population of the province, according to probability proportional to size. Thus, the sample comprised 1200 individuals, of whom 1185 were examined. Participation in the survey was 98.8% and, overall, the sample is considered representative of the province. The simplified grading system proposed by WHO was used to register the data on trachoma and its complications. The global prevalence of trachoma was estimated at 40.8% (95% confidence interval (95% CI) = 30.2-51.4%) and that of active trachoma (follicular (TF), intense (TI), and mixed (TF + TI)) at 18% (95% CI = 12.8-23.2%). The trachomatous intensity indicator (presence of TI) for children under 10 years of age was 12.8% (95% CI = 6.8-18.8%). The severity of the infection is confirmed by prevalences of trichiasis-entropion of 2.2% (95% CI = 1.4-3.0%) and central corneal opacity of 3.3%. Corneal blindness is estimated at 1.6%. The epidemiological pattern of trachoma merits particular attention in the field of public health, particularly in the valley of Oued Drâa, where all the indicators are consistently higher than those elsewhere in the province.

Adolescent↗
PubMed1975

Immunity to chlamydial infections of the eye. IV. Immunity in owl monkeys to reinfection with trachoma.

In a study of trachoma in owl monkeys, it was found that owl monkeys are equally susceptible to low and high doses of trachoma and that resistance to reinfection persisted for six months in the majority of animals. Previous infections with a single trachoma type did not elicit greater resistance than previous infections with two types. Both serum antibodies and eye secretion titers correlated well with resistance to reinfection, but it is not as yet clear if either or both play a substantial role in immunity to trachoma.

Animals↗
PubMed1975

Trachoma in the Sudan. An epidemiological study.

The prevalence and distribution of trachoma in the Sudan has been studied. The morbidity rate of 83.2 per 1000 in the Northern Province decreases southwards until it reaches 0.94 in the extreme south (Equatoria Province). 2. In endemic areas infection starts very early--in the first year of life. 3. There is a marked difference between the prevalence of trachoma in towns and villages--71.3 per cent for the age group 1-4 years in villages, and 56.7 per cent for the same age group in the towns. This is probably due to better standards of living and hygiene in the towns. 4. Some relationship has been found between the rainfall, the relative humidity, and the incidence of trachoma, but this does not necessarily apply in other countries. 5. The factors that may explain the high prevalence of trachoma in the northern Sudan are: a. Mechanical trauma caused by frequent sandstorms. b. Irritation of the eyes by dust particles, leading to excessive watering and discharge, and rubbing with the fingers. c. The habit of frequent hand-shaking. d. Poor personal hygiene in pre-schoolchildren. e. Associated bacterial conjunctivitis. f. The presence of eye-seeking flies.

Adolescent↗
PubMed1975

Cytology as a guide to the presence of chlamydial inclusions in Giemsa-stained conjunctival smears in severe endemic trachoma.

Microscopical examination of 927 Giemsa-stained conjunctival smears from children with chronic trachoma in southern Tunisia showed 93 (10 per cent.) with typical trachoma (chlamydial) inclusions in epithelial cells. The accompanying cytological features were a useful indicator for inclusions. Inclusions were found only in slides with numerous polymorphonuclear neutrophils (PMNs) and separation of the epithelial cells. When these two features alone were present, 3 per cent. of the smears were inclusion-positive; when many lymphocytes were present also, 25 per cent. were inclusion positive; when other cytological features (plasma cells, macrophages, blastoid, and stem cells) were present as well, 70 per cent. of the smears were inclusion-positive. The occurrence of these sets of cytological features can be a useful guide for selecting smears for intensive examination for chlamydial inclusions. Immunofluorescent (FA) staining and Giemsa staining of 527 pairs of matched smears detected trachoma agent in 67 (13 per cent.); in thirty by both methods, in thirteen by Giemsa staining alone, and in 24 by FA alone. The examination of Giemsa-stained smears for chlamydial inclusions is a useful technique for the diagnosis of trachoma or inclusion conjunctivitis by laboratories that do not have the specialized facilities for the identification of these chlamydial infections by the technically more complex procedures of immunofluorescent staining or isolation in embryonated eggs or tissue cultures.

Bacteria↗
PubMed1979

Isolation of Chlamydia trachomatis from different areas of conjunctiva in relation to intensity of hyperendemic trachoma in school children in Southern Tunisia.

The simplified one-passage technique of culture in irradiated McCoy cells, in conjunction with certain other developments in technique, was used to isolate Chlamydia trachomatis from specimens collected from 78 children with trachoma in Douz, Southern Tunisia. The results show that C. trachomatis is not confined to the upper tarsal area of the conjunctiva in hyperendemic trachoma. The higher isolation rate and corresponding increase in the number of inclusions obtained from swabbings of the upper fornix and lower lid in addition to the conventional collection from the upper tarsus show the superiority of collecting specimens for culture from the whole conjunctiva. Specimens could be collected from the whole conjunctiva by using 1 swab for each eye and pooled for subsequent inoculation, so that the laboratory incurred no additional work. A close correlation was observed between isolation rate, together with the number of inclusions, obtained in cell culture, and intensity of inflammatory disease in hyperendemic trachoma. The sensitivity and practicability of this cultural test should provide a valuable laboratory index for use in epidemiological and therapeutic studies of trachoma.

Child↗
PubMed1975

[Electron microscopic study of trachoma].

The electron microscopic characteristics of the trachomatous conjunctiva and the trachoma agents and their evolution cycle are examined in a study on seven patients with Stage II trachoma, as classified by MacCallan, who had received no treatment. All the cellular epithelial structures remain intact despite the presence of pathological agents whose developmental cycle is entirely comparable to that observed "in vitro" in strain cultures. An imortant fact is the demonstration of macrophages in the sub-epithelial layers and of free pathological agents in the tarsal zone. The necrosis of the former may be responsible for the presence of the latter. A new hypothesis on the dynamics of trachoma infection is proposed together with its consequences in relationship to the forms of trachoma therapy.

Adolescent↗