��������

�������� is now trachoma-free. The World Health Organization recently sent a letter to the Kingdom, congratulating its government on totally eliminating the disease.
The story of this blinding menace in �������� highlights a challenging public health problem that required comprehensive socio-economic and infrastructure development, and high-quality healthcare and education for eradication.
Trachoma thrives in crowded families with poor hygiene and inadequate access to water and sanitation. Pre-school children and their mothers are particularly susceptible to the infection, and blindness in women occurs up to four times as often as men due to their close contact with infected children. The infection spreads directly from person to person via hand transfer of discharge from the nose or eyes or from sharing fabrics such as towels, clothes and bedding.
In trachoma-endemic areas, indirect spread also occurs through flies that are frequently seen clustering around the face and eyes of children where they feed on mucus and discharge.
Trachoma is a bacterial eye infection that results in redness, pain, mucous or pus-filled discharge and photophobia. After years of recurrent infections, a scarred eyelid pulls the eyelashes inward, which brush up and rub against the eye. As a result, damage to the cornea will manifest as visual opacities, which culminate with blindness or significant visual disability.

To bring the infection with trachoma down from almost 100 percent to zero percent in a few decades is a remarkable achievement for the government of �������� that illustrates the effectiveness of a systematic approach in addressing public health problems.

Dr. Hasan Massloom

Trachoma is the leading infectious cause of blindness worldwide. It belongs to a group of neglected tropical diseases that have a high prevalence among people in poverty. It is hyperendemic in the poorest and most rural areas of Africa, Central and South America, the Middle East and Asia.  More than 200 million people in 51 countries are at risk of losing their vision, and more than 2 million people are blind or visually impaired from trachoma. A 1955 survey revealed a prevalence rate of approximately 100 percent in the towns and villages in ��������’s Eastern Province. Up to 95 percent of Saudis treated at Saudi Aramco health clinics in Dhahran showed signs of trachoma infection, and 80 to 85 percent of them had impaired vision. Owen Oxley, a photographer for Aramco in the early 1950s, who provided pictures for Aramco’s weekly newspaper, the Sun and Flare, wrote in his memoirs that “many of the Saudi drivers drove so badly — because their vision was blurred by trachoma — that the company constructed extremely high curbs in Dhahran to keep trucks from barreling up on the sidewalk.” The fight against trachoma in �������� started in 1954 with extensive research by the Harvard School of Public Health and Aramco scientists, who produced a vaccine in the 1960s capable of reducing the disease’s attack rate. Until 1966, it was mistakenly believed that trachoma was caused by a virus because of the 600 to 1500-nanometer microbes and the inability to isolate it in a culture medium in laboratories.
The main approach was to focus on vaccine production, which was formerly believed to be the most effective method of mass prevention of the disease.
Dr. Snyder, dean of the Harvard School of Public Health and the director of Aramco trachoma research program in 1963, said: “Although improvements in living conditions may be expected to reduce the amount of blindness in an area, it is unlikely that economic advances will be made rapidly enough in the next few decades to have much influence on the enormous amount of infectious disease of the eye in the developing areas of the world.”  Although Dr. Snyder’s prediction about the speed of economic development and its impact on the reduction of blindness was conceivably true in most parts of the developing world, it failed to reckon with what happened in �������� over the next 20 to 30 years.

• Dr. Hasan Massloom is a board certified cardiothoracic surgeon and a member of the Shoura Council of ��������. Twitter: @massloom For full version, log on to www.arabnews.com/thespace