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Trachoma study in Sudan finds massive prevalence levels

26 Sep 2008

Paul Chinnock

Source: PLoS Neglected Tropical Diseases (see original article)

A woman suffering from trachoma is examined by a nurse.
Christian Blind Mission/Argum /Einberger.

One of the highest rates of trachoma ever documented has been reported from the southern Sudan following a survey conducted in Jonglei State by experts from the University of Cambridge (UK), the Carter Center (US) and Sudanese health officials.

A bacterial eye disease, trachoma is the leading cause of infectious blindness worldwide. At least one person in nearly every household in Ayod Country, Jonglei showed some signs of trachoma. In one household in three there was a person with severe blinding trachoma.

When trichiasis (ingrown eyelashes) due to trachoma is present in more than one percent of adults in a population, the situation is regarded a critical public health concern. In Ayod Country this threshold was exceeded 15-fold in adults and 3-fold in children, who are usually considered to be free of blinding trachoma.

The findings follow previous studies in southern Sudan which have also recorded high levels of blindness, with trachoma the leading cause.

Lack of clean water, inadequate treatment and other known trachoma risk factors were all present in the surveyed households. The region has also suffered as a result of many years of civil war. Nevertheless, none of this adequately explains why the disease is so tragically common in southern Sudan. The researchers say, ‘…we were unable to identify why trachoma is so severe in this location.’

Carter Center trachoma expert Jonathan King and his co-authors have called for immediate corrective eyelid surgery to ease the pain and compromised vision of the children affected, and to help secure their healthy future. ‘The sheer severity and magnitude of trachoma in Ayod is reason for international alarm,’ said Dr King.

With support from The Carter Center, Lions Clubs International Foundation, and Christian Blindness Mission, the Ayod County Health Department has built an eye clinic where it is providing surgical services. In addition, the State Ministry of Health is now implementing the WHO-recommended SAFE* strategy to stop the spread of infection and prevent trachoma.

* The World Health Organization recommends the SAFE strategy to stop transmission of trachoma and the vision damage that it causes through: surgery for people with severe trachoma; antibiotics to treat active infections; facial cleanliness to prevent future infections; and environmental sanitation improvements to limit the number of eye-seeking flies that spread the disease.