Trachomasis

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Overview

Trachoma is the most common infectious cause of blindness worldwide. It afflicts some of the poorest regions of the globe, predominantly in Africa and Asia. The disease is initiated in early childhood by repeated infection of the ocular surface by Chlamydia trachomatis. This triggers recurrent chronic inflammatory episodes, leading to the development of conjunctival scarring. This scar tissue contracts, distorting the eyelids (entropion) causing contact between the eyelashes and the surface of the eye (trichiasis). This compromises the cornea and blinding opacification often ensues. The World Health Organization is leading a global effort to eliminate Blinding Trachoma, through the implementation of the SAFE strategy. This involves surgery for trichiasis, antibiotics for infection, facial cleanliness (hygiene promotion) and environmental improvements to reduce transmission of the organism. Where this programme has been fully implemented, it has met with some success. However, there are significant gaps in the evidence base and optimal management remains uncertain.

Symptoms

Mild itching and irritation of the eyes and eyelids.

Eye discharge containing mucus or pus.

Eyelid swelling.

Light sensitivity (photophobia)

Eye pain.

Eye redness.

Vision loss

Causes

Chlamydia infections spread through sexual contact, when vaginal fluid or semen containing the bacteria that causes chlamydia travels from one person to another. Sexual contact includes all kinds of sex, including sex that doesn’t involve penetration or ejaculation. There are lots of ways that the fluids from one person’s genitals can transmit the bacteria that causes chlamydia.

Intercourse. Bacteria pass from one person’s penis to their partner’s vagina or vice versa.

Anal sex. Bacteria passes from one person’s penis to their partner’s anus or vice versa.

Oral sex. Bacteria passes from one person’s mouth to their partner’s penis, vagina, or anus, or vice versa.

Sex involving toys. Bacteria pass from a toy with the bacteria to a person’s mouth, penis, vagina or anus.

Manual stimulation of the genitals or anus. Less commonly, infected vaginal fluid or semen can come in contact with a person’s eye, causing an infection called conjunctivitis. For example, this can happen if you touch the genitals of an infected person and then rub your eyes without washing your hands first.

Risk factors

Factors that increase your risk of contracting trachoma include:

Crowded living conditions. People living in close contact are at greater risk of spreading infection.

Poor sanitation. Poor sanitary conditions, inadequate access to water, and lack of hygiene, such as unclean faces or hands, help spread the disease.

Age. In areas where the disease is active, it's most common in children ages 4 to 6.

Sex. In some areas, women's rate of contracting the disease is two to six times higher than that of men. This may be attributed to the fact that women have more contact with children, who are the primary reservoir of infection.

Flies. People living in areas with problems controlling the fly population may be more susceptible to infection.

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Complications

If you don’t get treated for chlamydia, you run the risk of several health problems:

Women. If left untreated, a chlamydia infection can cause pelvic inflammatory disease, which can damage your fallopian tubes (the tubes that connect your ovaries to your uterus). It can even cause infertility (the inability to have children). An untreated chlamydia infection could also increase your risk of ectopic pregnancy (when the fertilized egg implants and develops outside your uterus). And chlamydia may cause premature births (giving birth too early). If mothers pass the infection to their children during childbirth, the newborn could have eye infections, blindness, or pneumonia.

Men. Chlamydia can cause an infection of the epididymis (the tube that carries sperm away from the testes) or proctitis -- inflammation of the rectum.

Both. Men and women can get a condition called nongonococcal urethritis (NGU) -- an infection of the urethra.

Pelvic inflammatory disease (PID). PID is an infection of the uterus and fallopian tubes that causes pelvic pain and fever. ...

Infection near the testicles (epididymitis). ...

Prostate gland infection. ...

Infections in newborns. ...

Ectopic pregnancy. ...

Infertility. ...

Reactive arthritis.

Prevention

The only way to avoid getting chlamydia is to abstain from having vaginal, anal or oral sex with someone who has a chlamydia infection. And be sure that sex toys that carry the bacteria don’t come in contact with your genitals.

It’s not always possible to know if a current or potential partner has chlamydia, though, especially since many people with chlamydia never notice symptoms. With prevention in mind, it’s a good idea to make safer sex practices a regular part of your sex life:

Use condoms during intercourse, anal sex and oral sex.

Use dental dams during oral sex or vagina-to-vagina contact.

Don’t share sex toys, but if you do, wash them after each use and cover toys used for penetration with a condom.

Have sex with only one partner, who only has sex with you.