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What is Mass treatment with azithromycin is indicated if prevalence of follicular trachomatous inflammation (TF) In 1-9 years population is more than: and explain in detail?
Ans. d. 10% (Ref: Park 23/e p308; WHO Trachoma Control: A guide for programme managers, 2006; p21-22)Mass treatment with azithromycin is indicated if prevalence of follicular trachomatous inflammation (TF) in 1-9 year population is more than 10%.TrachomaCausative agent: Chlamydia trachomatis (immune types A, B, C)Sexually transmitted C. trachomatis (serotypes D, E, F, G, H, I, J, K) may cause a milder infection 'Inclusion conjunctivitis'Incubation period: 5-12 daysQMode of transmission:Direct or indirect contact with ocular discharges or fomitesQEye seeking fliesQVenereal transmissionQCharacteristic Features:MC infected age group: 2-5 years aged childrenCommunicability: Trachoma is a disease of low infectivityReservoir of infection: Children with active disease, chronically infected older children and adultsPredisposing factors: Direct sunlight, dust, smoke and irritants (such as kajal or surma)Field diagnosis of Trachoma:At least 2 of following diagnostic criteria in children 0-10 years ageQFollicles on upper tarsal conjunctivaLimbal follicles or their sequelae ( Herbert's PitsQ)Conjunctival scarring (Trichiasis, Entropion)Vascular pannusWHO Classification of TrachomaTIF (Trachomatous Inflammation Follicular)TII (Trachomatous Inflammation Intense)* Presence of >5 large follicles on upper tarsal conjunctivaQ* Obscuration of >50% of deep tarsal vessels of upper tarsal conjunctivaTreatment:Treatment of choke for Trachoma: Azithromycin 20 mg/ kg oral statQCurrent WHO Recommendations for Antibiotic Treatment of TrachomaDistrict level prevalence >10% in 1-9 years old children* Mass treatment with AzithromycinQDistrict level prevalence 5-10% in 1-9 years old children* Targeted treatment with Azithromycin (the identification and treatment of all members of any family in whom one or more members have follicular trachoma)District level prevalence < 5% in 1-9 years old children* Azithromycin distribution may not be necessaryMass Treatment for TrachomaIndication of mass treatment in Trachoma: >10 % prevalence of severe and moderate Trachoma in children < 10 years of age (New Guidelines-WHO)QTreatment: 1% tetracycline ointment BD for 5 consecutive days each month or OD for 10 days each month for 6 consecutive months, or for 60 consecutive daysQSAFE StrategyQ (WHO)Surgery: for Trichiasis and EntropionQAntibiotic use: Azithromycin is drug of choiceFacial cleanlinessEnvironmental improvementQ