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Trachoma in Croatia: How Did it Become a Thing of the Past?
Jelena Juri Mandic1,2, Maja Bakula1, Lorena Karla Sklebar1
1Department of Ophthalmology, University Hospital Centre Zagreb, Zagreb, Croatia.
Background:
Trachoma is a specific type of keratoconjunctivitis caused by bacteria Chlamydia trachomatis and characterized by conjunctival follicular and papillary hyperplasia, followed by conjunctival scarring, entropion, trichiasis and corneal ulcerations.
Objective:
The aim of this article is to describe the successful epidemiological programs and actions which led to eradication of trachoma in Croatia.
Methods:
Online literature search conducted with the purpose of identifying studies describing epidemiological methods of eradicating trachoma in Croatia.
Results:
In an effort to eradicate trachoma in Croatia, many medical and epidemiological actions were taken in the middle of the 20th century. At the time, throughout infected areas antitrachoma stations were founded, in form of an outpatient clinic office with a trained ophthalmologist and a nurse who would continuously treat and monitor trachoma patients. Special attention was given to screening and treatment of school-aged children and special programs were developed for their treatment. Many adults were treated in form of an intermittent treatment. Epidemiologists and ophthalmologists also organized regular screenings of the whole population in the infected areas. These screenings were conducted jointly with educational activities which consisted of simplified informative posters, brochures, flyers, and films.
Conclusion:
Success of trachoma treatment in Croatia in the middle of the 20th century was a result of a combination of a well-organized epidemiological programs and actions throughout the infected areas, which included educational programs, adequate treatment of local population and improvement of hygiene and living conditions. We hope that this historical review could help in planning and implementing the eradication of the most common infectious cause of blindness in low to mid income countries still nowadays.
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