Revue internationale du trachome et de pathologie oculaire tropicale et subtropicale et de sante publique : organe de la Ligue contre le trachome avec la collaboration de l'International Organization against Trachoma et des organisation...最新文献

Senile cataract is the major cause of curable blindness in Tunisia (51%). Other factors than advanced age seem to play a role in senile cataract. The simultaneous of senile cataract with the trachoma makes the surgical operation problematic. In order to evaluate the frequency of such risk factors, we have realized a prospective study in two groups of patients recruited in 4 hospitals centers in Tunisia. The two groups of patients were homogenous regarding to age (more than 45 old year) sex and geographic origins. Cataract was present in the first group (287), but not in the second group (169) risk factors which were evidenced are: diabetes or abnormal glucose test tolerance, high systemic blood pressure, especially diastolic, low education and non professional occupation, family history of cataract. Evolutive trachoma was found in 5.1% of cases compared to only 0.6% in controls (p = 0.02). Trachoma sequela were found in the two groups. The importance of an evaluation of such risk factors in senile cataract is raised.

The clinical serological response to topical treatment of trachoma with Berberine an indigenous drug has been studied in 32 microbiologically confirmed cases. Efficacy of Berberine 0.2% when compared to sulfacetamide 20% was found to be superior in both the clinical course of trachoma and in achieving a fall in the serum antibody titers (P < 0.05) against chlamydia trachomatis in the treated patients.

In 1987, World Health Organization (W.H.O.) program for the Blindness Prevention proposed a simple system for coding and recording the various stages of Trachoma and its complications. Since this time, this system revealed to be a convenient and useful tool and was used in each epidemiological survey carried out together with Member States, either for blindness prevalence and causes studies as in Benin, Congo, Togo and Turkey, or for specific studies on Trachoma as in Vietnam, Morocco, Mali and in Kiribati. After a short presentation of the most significative results of these studies, the authors discuss on: 1--Details of practical use for this system in the field conditions, underlining particularly: training for future users; setting up of a study concerning reliability: this study has to be both easy an serious to allow an acceptable similarity between the observations of several examiners; some important points to calculate the size of the sample which has to be studied. 2--Main parameters and epidemiological signs which can be took on and invigilated thanks to this system.

Identification of conjunctival chlamydioses could be very difficult since this disease is extremely latent. Moreover previous instillation of topical antibiotic provokes a negativation of D.I.F. and of cultures. P.C.R. is very useful, it was demonstrative in 41 cases out of 47 cases; D.I.F. was positive only in 18 cases. P.C.R. is a very promising method to recognize chlamydiae; identification of different serovars is processing.

Some traditional plants known for their resistance to the desert weather, has been studied for their level in beta-carotene. They are called Spartima maritima and Panicum turgidum. We hope with these plants and others, elaborate some zootechnic project. It will be very useful for all the sahel zone from Atlantic to Pakistan.

Trachoma is one of the main cause of curable/preventable blindness in Saudi Arabia. First survey by NICHOL and al. 1955-65 in Eastern Province revealed prevalence rate of trachoma as 100% in Al Hasa, 98.0% in Qatif Oasis and 93.0% in Qatif town dwellers. Preliminary study by Ministry of Health, Eastern Province in 1986 revealed 3.74% of the population blind showing 10.1% due to trachoma. In 1986, Ministry of Health established Regional Prevention of Blindness & Ophthalmic Medical Education Committee, Eastern Province with six sub-divisions in Al Hasa, Qatif, Dammam, Al Khobar/Dhahran, Jubail and Hafr Al Batin. The whole health care divided in primary, secondary and tertiary level in 1987 and incorporated primary eye health care with primary health care. The Trachoma Center as a part of P.H.C. in Al Hasa was started in 1987 and a mass trachoma eradication programme by Trachoma Center was launched in 1988 along with improvement in socio-economic status/health facilities within last 10 years including development of structured P.H.C. system, leading to public awareness, prevention, treatment of bulk of active trachomas in this region particularly Al Hasa. This reduced the rate of prevalence of active trachoma to 1.5% in Al Hasa. Maximum active/inactive trachomas among the age above 55 years is 98.0% in Qatif region. Ministry of Health is in process of developing the Trachoma Center in Qatif region as well as comprehensive eye care by completing preliminary tertiary level care Eye Hospital in Dhahran to reduce the incidence of active trachoma below 0.5% within the next five years; thus achieve the goal of Prevention of Blindness in Saudi Arabia.

World Health Organization (W.H.O.) carried out a survey recently. This survey consisted in a questionnaire to some of its Member States to try to define the importance and world distribution of trachoma. The answers which have been sent by ocular health advisers and/or persons in charge of national ophthalmological institutes showed a systemic lack of significant data to be used for planning or for epidemiological surveillance. Nevertheless, the analysis of this survey seems to lead to the conclusion that trachoma is not still the main cause of blindness in some countries who used to be famous because of an important endemicity. However, trachoma is still a real ocular health and public health problem in numerous other countries, mainly in rural areas and- or areas which are away from socio-sanitary development areas. To have a better quality concerning epidemiological data and to obtain an easier regularity in their collecting, W.H.O. Program for the Blindness Prevention proposed a simplified coding system of trachoma and its complications (S.S.C.T.C.). If this system was accepted by numerous countries it would allow: the use of a simple, reliable and cheap tool to collect epidemiological informations which would constitute an help to take decisions to be able to, give a second start to epidemiological surveillance of trachoma, to have a better idea of the localization of endemic centres of the disease and of this impact on population, to define the needs concerning collective and individual medical and surgical treatments.

The authors study the main causes for blindness in the Western Province thanks to the hospital data from the only Ophthalmology service of this region. When checking the files of the 204 patients the main blindness causes are (in decreasing order): cataracts, glaucomas, optical nerve atrophy, uveitis, onchocerciasis.... This study also shows the absence of trachoma as a blindness cause in this tropical area. These data could be used to plan an ophthalmological cure strategy waiting for the put into service of a blindness prevalence survey in the field.