Fight on Blinding Infection Expands

KIPWISI, Tanzania-Julia Msongo is led from a thatched mud hut through a dusty front yard onto a traditional three-legged stool and admits that her husband of more than 20 years and four children are ``just voices in the darkness.''

The 54-year Kipwisi villager is among 6 million people worldwide robbed of eyesight by the world's leading cause of preventable blindness trachoma.

Impoverished children wipe their red, sticky eyes and spread a blinding infection to their parents. Flies are attracted to the sticky discharge and runny noses and may pass the bacteria from person to person.

For Msongo, blindness came early - a result of successive infections that retracted the inner eyelid, causing the in-turning of the eye lashes so they scratch the cornea. Lack of corrective surgery scarred the soft corneal tissue, leading to severe vision loss and eventual blindness.

``Infections are painful as if the inner eyelid is made of sandpaper,'' said 61-year Paulo Matonya, who lost about 75 percent of his eyesight. ``The disease has reduced objects to blurred shadows that only become clear at very close range,'' he said while feeling his way down a dusty village road with a cane.

However, there is good news for 540 million people at risk of developing the disease and an additional 150 million -75 percent of them children-currently infected.

In a groundbreaking advance, the New York City-based International Trachoma Initiative announced Monday that its combination of hygiene and antibiotics has cut the disease's prevalence by more than half in the projects since they started last year.

The ITI's findings from a project involving 2 million people in remote regions of Tanzania and Morocco will be presented this week to the World Health Organization, which aims to eliminate trachoma by 2020.

``It's very good news,'' said Serge Resnikoff, WHO's head of prevention of deafness and blindness. But ``now that we know the road, we also know that the road will be long.''

Key to the program were free doses of Zythromax, an expensive antibiotic so powerful that patients need just one dose a year. The ITI also taught villagers that a mere three handfuls of scarce clean water can wash the germs off their faces.

``I would have had my sight had I known what I know now - that a simple face wash and enhancement of community hygiene by digging pit latrines could have saved my gift of sight,'' said Matonya.

The program has reduced the prevalence of the disease by between 50 and 80 percent among 250,000 people living in central Tanzania, said Dr. Peter Kilima, ITI's representative in the East African country.

Boosted by the success, the ITI program will embark on a major new expansion, fueled by more than $170 million in new support, to reach 30 million people at risk of trachoma-related blindness worldwide.

International pharmaceutical company Pfizer Inc. will contribute $140 million in donated Zythromax - approximately 10 million doses - and $6 million in funding for ITI over three years.

A charity that researches rare or neglected diseases, the Edna McConnell Clark Foundation, will contribute $6 million over three years. The Bill and Melinda Gates Foundation will contribute $20 million over five years.

With this support, ITI will target millions of people in Ghana, Mali, Morocco, Tanzania, Vietnam and Sudan. It hopes to eliminate trachoma by the year 2020 and says it may reach the goal much earlier in Tanzania.

Trachoma once was a worldwide scourge. Napoleon's troops encountered it in Egypt in 1798. It blinded early Americans and was one of the most common causes for rejecting would-be immigrants at Ellis Island - old photographs show the letter ``E,'' for ``infected eyes,'' scrawled on their collars.

With improved sanitation, trachoma was eliminated from North America and Europe. But the disease is most common where the economy is weak, the climate dry and dusty and access to water is difficult.

Source:RODRIQUE NGOWI, Associated Press Writer

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