This document updates the 2009 ECDC guidance on chlamydia control in Europe. It was developed by a technical expert group which conducted a critical review of the scientific evidence on the epidemiology of
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chlamydia and the effectiveness of screening programmes.
The aim of this guidance is to support Member States to develop, implement or improve strategies for chlamydia control. This guidance describes the current evidence base behind the proposed options, highlights key gaps in knowledge, and suggests effective options for national chlamydia control strategies. It is directed primarily at policy advisors but should also be useful for programme managers and experts in sexual health.
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Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (
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chlamydia) and disease in lymph nodes.
This is photomicrograph of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
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Trachoma disease
Trachoma is a sequela following infection by the bacterium Chlamydia trachomatis (C. trachomatis). The disease is preventable, but still the cause of blindness in 1.9 million people world wide.
Este documento ha sido concebido para proporcionar un marco que respalde los estudios de prevalencia de las ITS en los niveles local y nacional. El propósito de estos estudios es conocer la carga de las infecciones por NG y CT, dos ITS prioritarias que dan lugar a resultados obstétricos y perinata
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les adversos.
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Trachoma, caused by particular serovars of Chlamydia trachomatis, is the leading
infectious cause of blindness. Infection is transmitted within ocular and nasal secretions that are passed from person to person on fingers, fomites (such as clothing)
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and eye-seeking flies (particularly Musca sorbens).
Ophthalmic infection is associated with an inflammatory conjunctivitis known as “active trachoma”. Repeated episodes of active trachoma can scar the eyelids. In some individuals this leads to trachomatous trichiasis (TT), in which one or more eyelashes on the upper
eyelid touch the eye. TT is extremely painful. It can be corrected surgically, but, if left untreated, may lead to corneal opacification, resulting in vision impairment and blindness.
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Despite the development of point-of-care diagnostic tests for syphilis, chlamydia, gonorrhoea, and trichomoniasis, none comply with all WHO criteria. This analysis overviews landscape analyses of point-of-care diagnostic technologies for
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Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and syphilis, available and in the pipeline. The target audience for the target product profiles is broad and includes clinicians, researchers working on diagnostics, laboratory experts, including, microbiologists and virologists, public health experts, epidemiologists, developers, and representatives for manufactures, including biotech engineers, policy-and decision-makers as well as representatives from regulatory bodies and agencies, donor agencies and international organizations.
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Trachoma is the leading infectious cause of blindness (2). It is characterized by repeated
conjunctival infection with particular strains of Chlamydia trachomatis. This scars the conjunctivae and,
in some cases, leads to trichiasis with or without
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entropion. The abrasive action of eyelashes can
damage the cornea. In 2018, trachoma affected the poorest residents of the poorest communities of 43
countries
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Guidelines on care, treatment and support for women living with HIV/AIDS and their children in resource-constrained settings
Integrated Management of pregnancy and childbirth
Since 1996, trachoma has been targeted for elimination as a public health problem worldwide. The active trachoma criterion for national elimination as a public health problem is a TF1–9 < 5%, sustained for at least two years in the absence of antibiotic mass drug administration (MDA), in each formerly endemic EU. Usi
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ng A, F and E, health ministries and their partners have made considerable progress towards achieving this criterion in formerly endemic EUs worldwide. In 2002, an estimated 1517 million people lived in EUs in which EU-wide implementation of the A, F and E components of SAFE were thought to be needed for the purposes of global elimination of trachoma as a public health problem; by June 2021, that number had fallen to 136.2 million, a 91% reduction. Approximately 85% of the 136.2 million people living in EUs needing A, F and E in June 2021 were in WHO’s African Region.
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Trachoma is one of the 17 WHO-defined Neglected Tropical Diseases
(NTDs) that affect over 1 billion of the world’s poorest and most
marginalized people. It is caused by the bacterium chlamydia trachomatis.
Countries, partners, and donors are committed to
the global elimination of blinding trachoma by 2020.
Achieving this public health milestone requires more
than funding; it requires health personnel with the
right mix of skills, and well supported and managed
health systems. Mass drug administra
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tion (MDA)
with Zithromax®, the Pfizer, Inc. donated antibiotic,
is a key component of the SAFE strategy, endorsed
by the World Health Organization. There is growing
recognition that improving all aspects of MDA, from
planning to training, recording to reporting, and
receipt of drug to distribution (the supply chain), will
be necessary if MDA programmes are going to reduce
the community burden of Chlamydia trachomatis, and
eliminate trachoma as a cause of blindness by 2020.
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The Fifty-first World Health Assembly adopted resolution WHA51.11 in 1998, which targets the
global elimination of trachoma as a public health problem by 2020 (1). The strategy recommended
to achieve that goal is encapsulated by the acronym “SAFE”, which represents: Surgery for
individuals wi
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th trachomatous trichiasis (TT; the late blinding stage of trachoma); and Antibiotics,
Facial cleanliness and Environmental improvement (2). The A, F and E interventions are delivered to
entire districts in which active (inflammatory) trachoma is common in order to treat ocular infection
with Chlamydia trachomatis, the causative organism of trachoma, and sustainably reduce its
transmission.
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