Women sharing eye makeup kits risk infection, blindness – Physician

Posted by admin Headlines, Health, Women Politics Saturday, September 23rd, 2023

Country Director of Sightsavers Nigeria, Dr Sunday Isiyaku, tells LARA ADEJORO why it is important for Nigeria to eliminate trachoma, said to be the world’s leading infectious cause of blindness

What is trachoma?

Trachoma is one of the oldest diseases known to humans. Bronze Age forceps for depilation, thought to have been used to remove affected people’s eyelashes, have been found in modern Iraq and the disease was common in Ancient Egypt with treatments discussed in the Ebers Papyrus written more than 3,500 years ago. Trachoma is the world’s leading infectious cause of blindness. It is the reason that about 1.9 million people around the world are blind or visually impaired. In advanced cases, after repeated infection, trachoma causes scarring of the inner surface of the eyelids making the eyelashes turn inward and scrape against the eye – this is called trachomatous trichiasis. People describe the pain as like having sand or thorns scratching their eyes. It also causes sensitivity to bright light so just going outdoors can be an agony. We often find people using homemade tweezers to pull out their eyelashes or even razor blades to cut them down. The good news is that trachoma is preventable and huge progress is being made around the world to eliminate it as a public health problem. A simple antibiotic can cure the infection and in advanced cases, there is straightforward surgery on the eyelid which can revert the eyelid to end the pain and stop any further loss of eyesight.

What are the triggers of the disease?

Trachoma is an infectious disease caused by a bacteria called chlamydia trachomatis. At the start, your eyes might be itchy or irritated and contain mucus or pus. This is uncomfortable, but more serious problems start when people get repeated infections. Each new infection causes more scarring under the eyelid which eventually turns the eyelashes inwards so that they scrape against the eyeball. Trachoma thrives in places without clean water and sanitation, where people have limited access to health care, and there are lots of flies around. Poor hygiene practices make the problem worse.

Who is mostly affected by the disease?

Anyone can get trachoma but it’s more common in women and children. Children are particularly vulnerable to trachoma infections because their immune systems are not fully mature yet, they tend to be in close contact with each other and may be less likely to pay attention to washing their hands and faces. Women are more likely to be affected because household responsibilities bring them in close contact with infected children or dirty fabric which might be carrying the bacteria. This puts women at greater risk of repeated infections and therefore the advanced, blinding disease. The World Health Organisation says that women are four times more likely to lose their sight to trachoma than men.

How does the infection spread?

Trachoma spreads primarily through direct contact with infected fluids from people’s eyes and noses and it spreads in three main ways. Firstly, flies that land on one person’s face can then carry the bacteria to someone else. Secondly, it can spread through direct contact, for example, if you touch someone’s hand after they’ve touched their infected face or nose. Finally, the infection can spread by touching items that are contaminated with the bacteria such as dirty towels, blankets, clothing, and handkerchiefs used for cleaning infected secretions. The disease can be easily passed from a mother to her child simply by wiping their face with a dirty scarf. Sharing eye makeup is a terrible idea because that is a very good way to catch the infection.

What is the prevalence rate of infection in Nigeria and how serious is it?

Around 3.5 million people in Nigeria are still at risk of losing their sight to trachoma. Generally, the disease is found in poorer and more remote areas. This has a lot to do with a lack of access to clean water, good sanitation, and health facilities, and a poor understanding of the importance of good hygiene. Things are improving. In 2018, Nigeria had the second-highest burden of trachoma in the world. But thanks to the joint effort of the Federal Ministry of Health, states, communities, and supporting partners, we are now fourth. Our work is supported by some very big international donors through the Accelerate Programme, including the Bill & Melinda Gates Foundation, the Children’s Investment Fund Foundation, The ELMA Foundation and Virgin Unite, and in the past from the Commonwealth Fund, the Department for International Development, and the Queen Elizabeth Diamond Jubilee Trust. With sustained effort, I believe we can eliminate the disease as a public health problem in a few years.

What are the complications of the disease?

The complications are horrible. As I said before, repeated trachoma infections cause scarring on the inside of the eyelid, which makes the eyelid turn inwards so the eyelashes touch and scratch the surface of the eye (the cornea). The scarring makes the cornea cloudy which causes visual impairment, and eventually blindness. Every blink of the eye causes severe pain, and this can be incapacitating. It can also make bright light painful, so infected people avoid going out in the daylight. There are also social implications. People may become isolated and feel like they can’t take part in activities in their community anymore. Globally, disabled people are up to twice as likely to live in poverty than people without disabilities. I always recall the case of a young boy called Muzi who had advanced trachoma. At seven, he was very young to have such a severe form of the disease. His father said that he was in so much pain and that he found it hard to even eat. Every time he went to school, the teachers sent him home. Fortunately, we were able to support Muzi with surgery on his eyelids and after this, he changed dramatically. He was no longer in pain all the time. He smiled and laughed. Although the damage to his sight could not be repaired, we were able to stop them from getting any worse and his father was eager to get him enrolled back in school.

But for many children with disabilities such as sight loss, a combination of stigma and discrimination means that they are regularly excluded from learning or even not seen as worth educating. We see children like Muzi unable to complete their education because their schools simply aren’t accessible or affordable for them. Part of my organisation’s work is fighting alongside people with disabilities so that they can claim their rights. No matter what their disability is, everyone should be able to participate fully in society.

-Punch