Interventions for the treatment of trachoma: an overview of Cochrane systematic reviews

Abstract

Trachoma is an infectious disease caused by the bacterium Chlamydia trachomatis. Infection with C. trachomatis produces characteristic changes to the inner surface of the eyelids, resulting in sequela that when left untreated, leads to vision impairment and blindness. Repeated trachoma infections can cause severe scarring of the inside of the eyelid and can cause the eyelashes to scratch the cornea (trichiasis). The objective of this overview was to synthesize the evidence from Cochrane systematic reviews regarding the treatment of trachoma, and to provide a brief and user-friendly front end for health professionals, researchers and policy makers. Face washing plus topical tetracycline eye ointment gave no additional protective benefit against active trachoma when compared with topical tetracycline eye ointment alone. Nor was any benefit conferred in the presence of severe trachoma. Primary health-care education was found to be effective in reducing the odds of active trachoma. Evidence of benefit from insecticide spray or provision of latrines away from living areas was inconclusive for active trachoma. Surgical interventions that involve full-thickness incision with tarsal rotation are more effective than alternate surgical procedures.