Trachoma: the Blinding Disease

Trachoma, a contagious disease caused by the bacterium Chlamydia trachomatis, is the world’s leading infectious cause of blindness. The disease works by attacking the inner eyelids, drawing eyelashes inward and scratching the cornea with each blink of an eye. In the United States and for a majority of the developed world, trachoma was eradicated in the 20th century. However, around 80 million people worldwide are currently affected, and in endemic regions, 60-90% of young children suffer from active infections. The disease is spread through direct contact, and is caused by lack of clean water, inadequate sanitation facilities, and overly-populated regions. In developing countries, trachoma is a conspicuous symptom of poverty.

Trachoma is easily treated with antibiotics, such as azithromycin, and in more advanced cases, a routine surgery. With access to sanitary latrines, water, and improved infrastructure, trachoma is easily preventable. The World Health Organization (WHO) has recommended a protocol known as the SAFE strategy to aid endemic regions, SAFE standing for surgery, antibiotics, facial cleanliness, and environment. Furthermore, nation’s such as Laos, Cambodia, Nepal, Oman, and others have recently eradicated the infection through simple improvements in public health policy and access to sufficient medical care.

Unfortunately, the debilitating effects of such an easily preventable disease is representative of an underdeveloped and unequal healthcare system. Trachoma is recognized as a neglected tropical disease (NTD), a category of ailments that primarily impacts those who live in poverty. NTDs trap people who reside in impoverished regions in a perpetual cycle of destitution, holding those afflicted back from work and pursuing education. Approximately 1 billion people (one-sixth of the world population) suffer from NTDs and are burdened by the lasting social and economic effects. Additionally, on a global scale the economic cost of trachoma, in terms of productivity, has been estimated to be between 2.9-5.3 billion US dollars. However, treatment costs for a majority of NTDs and mass drug administration is around 50 US cents per person, per year. This begs the question; if treatment is inexpensive in comparison to the economic costs lost, why is one-sixth of the world population still afflicted?

NTDs are often met with intense social stigma and primarily afflict marginalized communities, making diseases, such as trachoma, exceedingly difficult to eradicate. However, by increasing public knowledge, both in afflicted areas and in the developed world, we can move towards seeking accessible treatments and preventing NTDs. Through organizations such as the Global Health Impact Project, which seeks to assess the efficacy and accessibility of medications used to treat NTDs, along with Malaria, HIV/AIDS and TB, we are able to reduce the global burden of disease by advocating for equal access to essential medicines.

References:

1. "Blinding Trachoma Fact sheet N°382". World Health Organization. November 2013. Mcneil, D. G. (2018, July 16). Now in Sight: Success Against an Infection That Blinds. Retrieved from https://www.nytimes.com/2018/07/16/health/trachoma-blindness-nepal.html
2. "CDC – Neglected Tropical Diseases – Diseases". www.cdc.gov.