Eliminating blindness the safe way

By promoting better hygiene, health education, and antibiotic use, blindness caused by trachoma could be drastically reduced, according to an Article in this week's issue of The Lancet.

Trachoma is an infectious eye disease affecting around 84 million people. It is one of the leading causes of preventable blindness worldwide. The bacterium Chlamydia trachomatis causes trachoma by triggering inflammation and scarring the eyelid. Trachoma is rife in overcrowded and poverty stricken areas of the developing world, where it is easily spread from person to person due to lack of water and poor sanitation.

Jeremiah Ngondi (The Carter Center consultant based at the University of Cambridge, UK) and colleagues conducted a 3-year study of a trachoma control programme in southern Sudan. The strategy, known as SAFE (surgery, antibiotics, facial cleanliness and environmental change), was implemented in the region in 2001. This community-based approach was designed to fight trachoma by treating the infection with antibiotics and surgery, improving hygiene through the promotion of face and hand washing, and aiding communities to build toilets and access clean water. Researchers assessed almost 4000 children aged between 1-9 years in four separate districts, for signs of trachoma and unclean faces. After 3 years, in two of the sites in which SAFE uptake was high, the prevalence of active trachoma had decreased by 92% and 91%. In one of the remaining districts, where the uptake of SAFE was low, only 2% reduction in the prevalence of active trachoma was seen.

Dr Ngondi concludes:"Our study shows that SAFE works and that dramatic results can be achieved with the SAFE strategy in trachoma endemic areas. The study raises several potential areas of future research: the SAFE strategy was designed for trachoma control but will have collateral health benefits on other communicable diseases such as diarrhoea, pneumonia, and malaria." (Quote by e-mail; does not appear in published paper)

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EMBARGO: 00:01H (London time) Friday August 11, 2006. In North America the embargo lifts at 18:30H ET Thursday August 10, 2006.

Also in this week's Lancet is a trial conducted by Sheila West (Johns Hopkins University, USA) and colleagues, which assessed whether trachoma rates could be reduced further by using insecticides to control fly populations, on top of antibiotic treatment for the infection itself. As flies act as a vector for trachoma, insecticides are thought to limit the spread of infection. However, the researchers found that fly control after mass antibiotic treatment did not have any added benefit.

See also accompanying Editorial.

Contact: Emily Staub, Assistant Director, Office of Public Information, The Carter Center, Atlanta, GA, USA. T) +1-404-420-5126 / +1-678-595-0341 EMILY.STAUB@EMORY.EDU


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