Le trachome : Une infection pédiatrique toujours d'actualité

Abstract

Trachoma is a chronic granular conjunctivitis due to Chlamydia trachomatis serotypes A to C. The primary infection arises in thechildhood while vision threatening complications occur in the adulthood. Vision decrease is mostly related to the opacification of the cornea which is due to the chronic friction of eyelashes on its surface (trichiasis), itself being a consequence of the conjunctival scarring secondary to relapsing infections. The trachoma rages in developing countries, not only in Africa but also and especially in Southeast Asia and in the region of the western Pacific. Even if the number of cases of trachoma in the world is now 6-fold lower than twenty years ago, still 83 millions of patients are affected by active trachoma, leading to the estimation that 490 millions of people should be treated in a curative or a preventive way. The fight against trachoma is based on the S.A.F.E. strategy, an acronym for surgery of trichiasis, antibiotics for patients and contact subjects, facial hygiene and environmental improvement. Concerning antibiotics, oral azithromycin is now considered as the gold standard for mass distribution against trachoma, but costs remain a major problem in developing countries. However, application of the four large-scale measures of the S.A.F.E. strategy should allow ending in the purpose fixed by the WHO organization, namely the Global Elimination of Trachoma by the year 2020.