Doyne Lecture: trachoma, is it history?

Abstract

Trachoma has been known since pre-Pharaonic times and this infectious cause of blindness is targeted by the World Health Organization (WHO) for elimination by 2020. During the 19th century, trachoma was a major political problem in European countries as an important cause of disability in both soldiers and among the urban poor in the slums created by the Industrial Revolution. Even 100 years ago, trachoma was a major problem worldwide. Trachoma has now been eliminated from most developed regions, but the disease still affects some 150 million people in 56 developing countries. This paper reviews our current understanding of trachoma and the key strategies for the elimination of trachoma as a major blinding disease.

Trachoma: is the end in sight?

“…It is possible to detect intracytoplasmic inclusions of Chlamydia by Giemsa staining, as well as using culture and sensitivity testing with the use of tissue culture [2]. Modern molecular methods, including fluorescent-labeled monoclonal antibodies and PCR, are available and may be more accurate [14].…”

“…The active stage is characterized by inflammation, and the late or cicatricial stage is characterized by tarsal scarring, trichiasis and corneal scarring. Inflammation is not always present in cicatricial disease and C. trachomatis is rarely cultured [2].…”

“…Ocular C. trachomatis infection is associated with poor personal and population hygiene and is related to the society's level of development [2]. It is endemic to 55 countries, all of which (apart from Australia) are developing nations.…”

“…Families with young children are also at increased risk. This is believed to be because the majority of primary C. trachomatis infection occurs in the under fives, with infants harboring the highest numbers of bacteria, acting as a nidus for infection ( Figure 2) [2,8]. Females are more commonly affected, most likely due to their greater contact with children [11].…”

Tracoma: de lo básico a lo clínico

“…Chlamydia spp., es una bacteria gramnegativa que actúa como patógeno intracelular obligado; su pared posee lipopolisacáridos y proteínas inmunogénicos, pero no tiene peptidoglicano incorporado, pese a contar con los genes necesarios para producirlo, ni ácido murámico (21)(22)(23).…”