Work

Trachoma Decline and Widespread Use of Antimicrobial Drugs

Year: 2004

Type: article

Abstract: Trachoma is disappearing in many parts of the world, even in the absence of specific control programs.Following mass antimicrobial drug treatments for trachoma in western Nepal, the prevalence of trachoma declined far more rapidly than could be attributed to the control program alone.Pharmacy surveys in the same region found that children received more antichlamydial drugs from sources outside the trachoma program than they did from the program itself.We demonstrate that high background antimicrobial drug use may be responsible for much of the observed decline in trachoma and discuss its potential role in eliminating this infectious disease.T rachoma is disappearing in many parts of the world, even in the absence of specific control programs.It is a disease of the rural poor, and as living conditions have improved during the last century, a corresponding decline in trachoma has occurred (1-4).In Western Europe and the United States, trachoma virtually disappeared by the late 20th century.Other infectious diseases such as syphilis, chancroid, tuberculosis, and leprosy also began to subside in Europe and the United States during this time.This downward trend seems to have begun before, and continued into, the antimicrobial drug age.Therefore, many attribute this decline to socioeconomic factors, such as improved sanitation and social changes, and even to legislation to control venereal disease, rather than to antimicrobial drugs.Addressing the importance of antimicrobial agents in the disappearance of these infectious diseases retrospectively is difficult.In the case of trachoma, we have a unique opportunity to observe the effect of rising antimicrobial pressure in the community on a disease that is in decline but has not yet disappeared.

Source: Emerging infectious diseases

DOI: 10.3201/eid1011.040476