By Ama Achiaa Amankwah
Worldwide, about eighty million people are said to be blind through trachoma, according to data from the International trachoma Initiative (ITI). Eighty-four million is reported to be suffering from active infection, 75 percent of whom are women.
The disease, which is caused by the bacterium, Chlamydia trachomatis, is easily spread through casual and mother-to-child contact. It affects the inner upper eyelid.
According to estimates by the World Health Organization (WHO), 10 percent of the population in the world stands at risk of attracting Trachoma, thereby making the disease a major public health threat.
Currently, Trachoma is said to be prevalent in 56 countries, mostly in the developing world where sanitation is poor and access to potable water is largely constrained.
In Ghana, an estimated 2.6 million people are said to be at risk, with 12,000-recorded cases of trachoma-related blindness.
Infection is most prevalent in children aged one to five years.
Annually, about $3 billion productivity losses are recorded by developing countries such as Ghana from trachoma related blindness.
The Ghana Health Service, (GHS) in collaboration with other ministries and major health partners including the ITI, has thus begun implementing Ghana’s trachoma elimination efforts.
ITI is the key international organisation working to eliminate trachoma blindness worldwide. Founded in 1998 by the Edna McConnell Clark Foundation and a research-based pharmaceutical company, Pfizer, ITI has trachoma elimination programmes in 12 countries worldwide.
The global campaign strategy is dubbed, “SAFE”.
The SAFE, an acronym recommended by the WHO for trachoma control stands for “S” Surgery to treat complications that may cause blindness, “A” Antibiotics to treat active trachoma infections, “F” to encourage face washing to reduce disease transmission and “E” for environmental changes to improve sanitation and access to clean water.
Pfizer donated eight million Zithromax treatments to ITI’s global efforts in five years, which included over 1.3 million doses in Ghana.
The strategic plan for trachoma control in Ghana is dubbed, “Ghana Free of Blinding Trachoma”. The goal is to eliminate blinding trachoma from Ghana by the year 2010.
The disease is concentrated in the Northern and Upper West regions. Prevalence rates ranges from 2.8 to 16.1 percent. The five-year national strategic plan for the Trachoma programme began in 2005.
The surgical services strategy being implemented is the community-based approach whereby services are brought directly to the patients.
At the moment, nine districts in the two endemic regions whose prevalence rates of active trachoma are 10 percent and above are receiving district-wide antibiotic distributions. In the remaining seventeen districts, mass antibiotic treatment is being carried out in all communities with significant levels of active trachoma prevalence.
Districts and communities that have completed three rounds of antibiotic treatments and found to have prevalence rates no longer of public health significance will graduate.
From the year 2000 when the programme began, 3,177 people who were at the potentially blinding stage of the disease have been provided with surgery. Health education and promotion of face washing is encouraged among groups and individuals.
In addition, 5,546 household latrines have so far been provided to trachoma endemic communities.
Ghana has continued to have much success in the improved provision of water to affected areas. Approximately 2,134 safe water sources have been provided to trachoma endemic communities. There has been improvement in the provision of safe water, with the completion of two urban solar support water projects sponsored by ITI and executed by WaterAid for the Tamale metropolitan area.
The sanitation component concentrated on the identification, sensitization and mobilization of communities to construct and use household latrines in order to reduce the flies’ infestation and improve sanitation values.
This notwithstanding, there is a huge need for the provision of safe water and sanitation facilities in some of the trachoma endemic areas.
An important key to the success of Ghana’s trachoma programme analysts say has been the work of local health providers and educators.
At a press launch of a special media advocacy programme in Accra, President of ITI, Mr. Jacob Kumaresan, announced that Ghana is on track to eliminating blindness from trachoma. “As we went round, I observed that if services are taken to the people they will access them. Ghana will likely be one of the first African countries to eliminate blindness from trachoma since the mid-20th century and will be one of the first to do so worldwide.”
Health Minister, Major Rtd Courage Quashigah, noted that eye health is critical as any other aspect of health since the rate of blindness in a country can give an indication of that country’s level of development.
“Blindness culminates in unfortunate situations which incapacitate the victims to an extent that they cannot work. Even in cases where they do, it is far below capacity and this result in abject poverty.”
Therefore, he said as we strive to reduce poverty, it is imperative to prevent avoidable blindness and develop structures that can offer comprehensive eye health care to meet the vision 2020 global initiative.
Major Rtd Quashigah cited the lack of awareness to blindness prevention as a major challenge to eye care provision. He stated that environmental cleanliness is paramount to the prevention of blinding trachoma as it reduces the breeding of flies.
He emphasized that as government continues to support human resource development in training health personnel, awareness programmes must be given the utmost priority in the fight against preventable blindness.
“With the launch of the media advocacy on the prevention of trachoma we must act seriously to help eradicate it completely from our society.”
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