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Control of Trachoma in Ethiopia

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Trachoma is an infectious disease, which causes the inner surface of the eyelids to roughen. Ethiopia is the leading country with the risk of being infected with trachoma. In approximation, this is about 85% of the entire population. This percentage, mostly consist of rural dwellers due to congestion which leads to poor sanitation and inadequate water supply.  The greatest number of people, who are at the final stage of becoming blind, is found in Ethiopia. Most of the infectious blindness in Ethiopia is caused by trachoma, and this reflects to the greatest number in the world.Control of Trachoma in Ethiopia

Introduction

Trachoma is caused by Chlamydia trachomatis. Chlamydia trachomatis is an intracellular human pathogen. The pathogen has features of both a fungus and a bacterium. The disease is prevalent in areas which are densely populated which results to poor sanitation and inadequate water facilities. It is usually spread by direct body contact of the infected person. For example, contact with throat, eye or nose secretions of the affected person. In some cases, flies also play a significant role in the transmission of the disease. Failure to treat trachoma, or if the infection is repeated, leads to Entropion. This is a permanent blindness, which is very painful and it forces the eyelids to turn inwards. Consequently, the eye lashes starts to scratch the cornea. Combination of trachoma infection and bacterial pathogens leads to severe inflammation, which may lead, to blindness (SunitaAgarwal, AthiyaAgarwal and David Apple, 861). In most cases, children are at a higher risk of being infected as they easily get dirty. However, the effects often show at adulthood. Research has also revealed that women are more prone to trachoma infection than men. The best reason for this is due to the role they play in a family unit. They are the caregivers of children, who are prone to risk of infections.

Trachoma occurs in two stages. The first one is active trachoma. This is a conjunctiva inflammation which is seen in children. The white lumps are formed in the under surface of the upper eyelid. This infection is accompanied by watery discharge. The next stage is called cicatricial trachoma. This is as a result of scarring of the conjunctiva resulting to eyelid distortion (Herbert John and Snoeball Thomas, 200). There are two patterns of trachoma. The first pattern is blinding trachoma. This is found in areas with inadequate water supply, which leads to poor personal hygiene. The second pattern is non-blinding trachoma. It is found in areas with adequate and clean water supply. This implies that there is no repeated infection which leads to blindness.

Prevention

The way towards preventing trachoma lays through obstacles. This is because the measures taken should be sustained to avoid reinfection. For example, the antibiotics should be supplied continuously to the health centers, clean water should be easily accessible, and better personal hygiene should be maintained. However, due to unexplainable reasons, this has not been the case. Someone must be reluctant to his or her role. This is what has made it difficult to fight trachoma. Nevertheless, the Ethiopian national government, in collaboration with non-governmental organizations has implemented programs on the control of trachoma. In this, they use a strategy known as SAFE. SAFE is an acronym, with letters standing for surgery, antibiotics therapy and selection, facial cleanliness and environmental improvement respectively (GiambattistaBietti and Werner Georges, 192).

WHO recommends that each region should have a community based antibiotic treatment to the mass for children between one and nine years, if the prevalence of active trachoma is greater than 10 percent. This should be followed by annual treatment for three years. This will continue if the prevalence fails to go below five percent. Antibiotics selection is also a considerable precaution. Azithromycin, which is a single dose, is recommended to treat trachoma. It is quite expensive but is donated through the international donation program which is organized by Pfizer.

Environmental improvement is also a significant factor which should be considered in order to control trachoma infection. This includes betterment of water facilities, good use of toilets, flies control, health education and better ways of handling domesticated animals. These will significantly reduce the transmission of the disease.

The Carter Center is a non-profit making organization which contributed a lot in the control of trachoma in Ethiopia. It has partnered with other organizations like Lions Clubs International Foundation, The Hilton Foundation, International Trachoma Initiative, and the ministry of health. The Carter Center is helping to implement the SAFE strategy. For effective control, in 1998, the Center established a Trachoma Control Program. One of the main objectives of this program was to empower the public on proper health (Parker James, 202).  These education materials are designed depending on the level of education of the audience, age and the social group.

As a result, by 2010, it was reported that more than 10000 people benefited from the education. The Carter Center has also built latrines for the households. This has helped in reducing the flies’ breeding sites. The Center also helps in administering and distributing drugs, that is, azithromycin, which is donated by Pfizer Inc., to areas under the support of the Carter Center. Through the Control Program, many local health workers have been trained to correct deformed eyelids through surgical methods. The Trachoma Control Program has brought benefits worth praise of the public. These include proper sanitation and improved personal hygiene. In order to prevent the infection of new born babies, anti microbial drugs are put in their eyes (Pommerville Jeffrey, 431). In addition to the introduction of The Trachoma Control Program, people have also improved their lifestyles, which have also helped in reducing the disease.

The most crucial step to take towards prevention of trachoma is to maintain cleanliness. This is by ensuring that sanitation, personal hygiene and clean water are available. The connection of water to poor people makes it play a significant role in the transmission of trachoma. The poor have a limited access to clean water, and it is impossible to have good hygiene without clean water. The health of the children should be checked closely to avoid running nose and maintain a clean face. Health education programs should be also introduced in schools, to inform children on the need to observe on cleanliness.

Trachoma is among the oldest eye infections. The first case in Africa was identified in Egypt in 15 B.C. (Abd-El-Aziz, 2). It became a considerable problem when people started to settle in town. The areas became crowded and this resulted to poor sanitation. It was widely described by Arabic ophthalmic surgeons as a pain of the conjunctiva muscles. The disease later spread to army barracks and then to rural areas. In 19th century, it was a significant problem in Europe. Fortunately, the control measures taken in the 20th century managed to reduce the cases although few were reported up to mid 20th century.

Conclusion

The blinding disease need to be fought. Through the improved living conditions and the implementation of The Trachoma Control Program, trachoma was virtually eliminated from the developed countries by1950s. However, it remains a challenge to the poor developing countries (Icon Group international, 44). This is because sanitation and water facilities have to be improved and it is beyond the capability of these growing countries. The fight against trachoma will only be possible if these poor nations will get funds from the developed ones. It will be difficult to buy drugs to treat a hungry person. The developing countries’ government should also invest more on quality health and sanitation. The citizens should also adhere to the health education programs offered by the non-governmental organizations. It is a duty for everyone to play a part in this fight with disease. Let’s join to give vision to the world, let’s fight trachoma.

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