Distribution of azithromycin for the treatment of trachoma

Trachoma remains the world’s leading infectious cause of blindness and the leading cause of ocular morbidity. Despite this, there is increasing hope of eradicating trachoma as a blinding disease and ending the years of suffering caused by trachoma. Much of the world is now free from trachoma because of improved standards of housing and hygiene. In poorer regions, however, trachoma remains hyperendemic. These areas include parts of Africa, Asia, the Middle East, and also Aboriginal communities in Australia. The World Health Organisation (WHO) estimates that 146 million people worldwide are presently infected by trachoma.1 Over ten million adults suffer from trichiasis that without corrective surgery will render them unnecessarily blind. An additional six million others are presently blinded by trachomatous corneal scarring. The development of an integrated attack on trachoma by the WHO aims to prevent the development of further trachomatous blindness.2 Total eradication of the causative organism of trachoma, Chlamydia trachomatis , does not seem to be a necessarily achievable and desirable goal. Moreover, it would not prevent the progression to blindness of those people previously infected. Both in terms of feasibility and effectiveness, the eradication of trachomatous blindness is a more realistic and preferable goal. The “ SAFE strategy” developed by the WHO uses a combination of activities including S urgery for trichiasis, A ntibiotic treatment of active chlamydial infection, the promotion of F acial cleanliness, and improvement of E nvironmental conditions.2 The antibiotic component …