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Trachoma not Curable by Antibiotics Alone

A study conducted in Vietnam has indicated that antibiotic therapy against Trachoma is not effective in the long term. When children affected with trachoma //(second leading cause of blindness after cataract) were treated with azithromycin, it was seen that there was only a short-lived improvement. Dr. Deborah Dean, senior scientist at Children's Hospital Oakland Research Institute in California warned that once the last treatment was given, there was reinfection after 2 years.

The findings were reported in the Journal of the American Medical Association (Sept 27 issue).

The disease can affect the eyes and genitals and is caused by the Chlamydia Trachomatis bacterium. It occurs mostly in children, but constant reinfection causes the eyelids to invert. The eyelashes cause abrasions on the cornea producing scars leading to blindness.

The infection spreads through flies, and hand to eye contact. Unhygienic conditions in the poor villages of Asia and Africa have kept the bacteria on a rampage. Almost quarter of the older people who are affected will probably face blindness.

The WHO strategy to combat trachoma is four pronged.

They are-antibiotic therapy, surgery to prevent the inversion of eyelids, facial cleanliness and improvement of the environment.

The study was conducted on over 3000 people in Vietnam on two groups-one receiving the WHO treatment and the other treated only surgically. The researchers found to their surprise that reinfection was higher in the first group. They attribute this to the likelihood that though antibiotics may interrupt the infection, they may not build up the patient's immunity against reinfection.

The treatment being followed now includes the distribution of antibiotics to affected people. Dr.Dean however is positive that antibiotics alone will not be effective. She insists that long-term strategy has to factor in hygiene and most importantly, clean water.

Several groups are working on a vaccine, which could be ready in 5-10 years. Dr. Dean concludes that this would be the ideal solution.

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