What You Don't Know About Trachoma, a Neglected Tropical Disease
Trachoma is the world’s leading cause of blindness through infection.
Despite what its name may suggest, trachoma doesn’t infect the trachea (windpipe). The word trachoma actually comes from the Greek word for "rough," which is the exact feeling it inflicts on the eyes of those infected.
Trachoma is the world’s leading cause of blindness through infection. Left untreated, the disease causes the eyelid to fold inward on itself, allowing the eyelashes to painfully scrape the cornea, the clear covering in front of the eye. This causes inflammation and can eventually cause the cornea to cloud over. As a result, the disease can ultimately lead to blindness.
So, "rough" is an understatement, considering the life-altering trauma it exacts on the human eye.
It is estimated that 6 million people have been blinded by trachoma, and about 500 million more people are currently at risk, according to the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC).
The disease has become a public health issue in 41 countries, mainly affecting the most vulnerable areas of Africa.
Yaya Manneh, a 75-year-old community leader in Mariama Kunda village in The Gambia, experienced this disease firsthand.
“I must have had this eye condition for several years, and eventually the pain was so constant that I couldn’t continue my daily activities as head of the village,” he told Global Citizen in May. “It was so painful even just to blink.”
Trachoma is caused by the bacteria Chlamydia trachomatis, which is often spread through contact of an infected person’s eyes or nose discharge, or flies that have come in contact with other people who have been infected. It’s highly contagious and can spread through direct person-to-person contact, from touching hands, clothing, bedding, or towels, according to the CDC.
There’s currently no vaccine, but treatment is possible with a single oral dose of antibiotic. A person’s immune system can generally fight against one episode of the infection, but in communities that lack access to clean water and sanitation, repeated infections are frequent.
People who suffer through multiple infections often feel constant pain and can become intolerant to light because the corneal protective layer has become so scarred and scratched.
Those with severe cases like Manneh’s require a surgery that stops the eyelashes from scratching the eye and reduces the chance of recurring infection.
Manneh had surgery for his condition in 2017, thanks to an eye program facilitated through Sightsavers, an organization working to eliminate this disease.
Lamin Camara (left) is the ophthalmic nurse who operated on Yaya Manneh (right).
“I was in pain for a long time before I knew I could do anything about it,” Manneh said. “I see very well now and even have glasses that were given to me by the health center.”
In some of the poorest areas, trachoma infections can be prevalent in at least 60% of children under 5 years old. Women are also four times more at risk than men — likely because they are often in close contact with children.
This past June, 20 years after the World Health Assembly committed to tackling trachoma, Ghana became the first country in the WHO’s African Region to successfully eliminate it as a public health problem.
"Although there’s more work to do elsewhere, the validation of elimination in Ghana allows another previously heavily endemic country to celebrate significant success," WHO Director-General Dr. Tedros Adhanom Ghebreyesus said.
Ghana could be the first of many African Region countries to successfully eliminate this disease.
The WHO says prevention is possible, and it hopes to completely eliminate trachoma by 2020. The WHO strategy can be summed up in the acronym SAFE: Surgery (to treat advanced forms of trachoma); Antibiotics (to treat and prevent the infection); Facial cleanliness; and Environmental improvements, mainly in water, sanitation, and fly control.
For such a debilitating disease, it’s a promising sign that it is completely preventable, and — if caught early enough — curable.
The interview with Yaya Manneh was provided by Sightsavers. It has been translated and lightly edited for clarity.
"What You Don’t Know About X" is a new series focusing on neglected tropical diseases (NTDs). NTDs are a cluster of parasitic and bacterial diseases. While you may have heard of a few of them, it’s likely you know very little about their actual effects or why they are so often overlooked. This series looks to shed light on these devastating — and preventable — diseases.