Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease.
BACKGROUND:Sight loss from trachoma is the end result of a scarring disease process starting in early childhood and characterised by repeated episodes of conjunctival inflammation (active trachoma). Subsequently, the conjunctiva becomes scarred, causing the eyelashes to turn inwards and scratch the...
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ftdoajarticles:oai:doaj.org/article:34d19f8cbcf64dc292a17cb90c8219ba 2023-05-15T15:11:41+02:00 Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. Athumani M Ramadhani Tamsyn Derrick Martin J Holland Matthew J Burton 2016-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0004859 https://doaj.org/article/34d19f8cbcf64dc292a17cb90c8219ba EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4970760?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004859 https://doaj.org/article/34d19f8cbcf64dc292a17cb90c8219ba PLoS Neglected Tropical Diseases, Vol 10, Iss 8, p e0004859 (2016) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2016 ftdoajarticles https://doi.org/10.1371/journal.pntd.0004859 2022-12-31T03:12:05Z BACKGROUND:Sight loss from trachoma is the end result of a scarring disease process starting in early childhood and characterised by repeated episodes of conjunctival inflammation (active trachoma). Subsequently, the conjunctiva becomes scarred, causing the eyelashes to turn inwards and scratch the cornea (trichiasis), damaging the corneal surface and leading to corneal opacification and visual impairment. It is thought that this process is initiated and driven by repeated infection with Chlamydia trachomatis. We review published longitudinal studies to re-examine the disease process, its progression rates and risk factors. METHODOLOGY/PRINCIPAL FINDINGS:We searched PubMed for studies presenting incidence and progression data for the different stages of trachoma natural history. We only included studies reporting longitudinal data and identified 11 publications meeting this criterion. The studies were very heterogeneous in design, disease stage, duration, size and location, precluding meta-analysis. Severe conjunctival inflammation was consistently associated with incident and progressive scarring in five studies in which this was examined. One study reported an association between C. trachomatis infection and incident scarring. No studies have yet demonstrated an association between C. trachomatis infection and progressive scarring. Several studies conducted in regions with low prevalence active disease and C. trachomatis infection found evidence of on-going scarring progression. CONCLUSIONS/SIGNIFICANCE:Overall, there are few longitudinal studies that provide estimates of progression rates and risk factors, reflecting the challenges of conducting such studies. Our understanding of this disease process and the long-term impact of control measures is partial. Intense conjunctival inflammation was consistently associated with scarring, however, direct evidence demonstrating an association between C. trachomatis and progression is limited. This suggests that on-going chlamydial reinfection may not be mandatory for ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 10 8 e0004859 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Athumani M Ramadhani Tamsyn Derrick Martin J Holland Matthew J Burton Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Sight loss from trachoma is the end result of a scarring disease process starting in early childhood and characterised by repeated episodes of conjunctival inflammation (active trachoma). Subsequently, the conjunctiva becomes scarred, causing the eyelashes to turn inwards and scratch the cornea (trichiasis), damaging the corneal surface and leading to corneal opacification and visual impairment. It is thought that this process is initiated and driven by repeated infection with Chlamydia trachomatis. We review published longitudinal studies to re-examine the disease process, its progression rates and risk factors. METHODOLOGY/PRINCIPAL FINDINGS:We searched PubMed for studies presenting incidence and progression data for the different stages of trachoma natural history. We only included studies reporting longitudinal data and identified 11 publications meeting this criterion. The studies were very heterogeneous in design, disease stage, duration, size and location, precluding meta-analysis. Severe conjunctival inflammation was consistently associated with incident and progressive scarring in five studies in which this was examined. One study reported an association between C. trachomatis infection and incident scarring. No studies have yet demonstrated an association between C. trachomatis infection and progressive scarring. Several studies conducted in regions with low prevalence active disease and C. trachomatis infection found evidence of on-going scarring progression. CONCLUSIONS/SIGNIFICANCE:Overall, there are few longitudinal studies that provide estimates of progression rates and risk factors, reflecting the challenges of conducting such studies. Our understanding of this disease process and the long-term impact of control measures is partial. Intense conjunctival inflammation was consistently associated with scarring, however, direct evidence demonstrating an association between C. trachomatis and progression is limited. This suggests that on-going chlamydial reinfection may not be mandatory for ... |
format |
Article in Journal/Newspaper |
author |
Athumani M Ramadhani Tamsyn Derrick Martin J Holland Matthew J Burton |
author_facet |
Athumani M Ramadhani Tamsyn Derrick Martin J Holland Matthew J Burton |
author_sort |
Athumani M Ramadhani |
title |
Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. |
title_short |
Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. |
title_full |
Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. |
title_fullStr |
Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. |
title_full_unstemmed |
Blinding Trachoma: Systematic Review of Rates and Risk Factors for Progressive Disease. |
title_sort |
blinding trachoma: systematic review of rates and risk factors for progressive disease. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pntd.0004859 https://doaj.org/article/34d19f8cbcf64dc292a17cb90c8219ba |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 10, Iss 8, p e0004859 (2016) |
op_relation |
http://europepmc.org/articles/PMC4970760?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004859 https://doaj.org/article/34d19f8cbcf64dc292a17cb90c8219ba |
op_doi |
https://doi.org/10.1371/journal.pntd.0004859 |
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PLOS Neglected Tropical Diseases |
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8 |
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e0004859 |
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