West Sheila K
Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Wilmer Room 129, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Prog Retin Eye Res. 2004 Jul;23(4):381-401. doi: 10.1016/j.preteyeres.2004.04.001.
Trachoma is the leading infectious cause of blindness worldwide. The World Health Organization (WHO) estimated that approximately 5.9 million persons are blind or have severe vision-loss as a result of trachoma, and another 10 million are at high risk. Trachoma preferentially affects the most deprived communities, and within these communities, women and children bear the brunt of the burden. In recent years, there has been a renewed focus on research and heightened enthusiasm for strengthening trachoma control programs in afflicted countries. WHO has convened an alliance of member countries, non-governmental organizations, and other partners for the Global Elimination of Blinding Trachoma by the year 2020, and endorsed the multi-faceted SAFE strategy for trachoma control. SAFE-Surgery, Antibiotics, Face-washing, and Environmental improvement-has incorporated sound research on elements likely to reduce trachoma, and trachomatis blindness, in endemic communities. This review summarizes current knowledge about trachoma and its causative agent, Chlamydia trachomatis, the epidemiology and risk factors for trachoma as a prelude to reviewing the SAFE strategy. While ongoing research to support the knowledge base for SAFE must continue to be a priority, the full implementation of SAFE is the best hope for countries to reduce the global burden of blindness from this preventable cause.
沙眼是全球失明的主要传染性病因。世界卫生组织（WHO）估计，约有590万人因沙眼而失明或视力严重受损，另有1000万人面临高风险。沙眼主要影响最贫困社区，在这些社区中，妇女和儿童首当其冲。近年来，人们重新关注研究，并对加强沙眼流行国家的控制项目表现出更高的热情。WHO召集了一个由成员国、非政府组织和其他合作伙伴组成的联盟，以在2020年前全球消除致盲性沙眼，并批准了控制沙眼的多方面SAFE战略。SAFE即手术、抗生素、面部清洁和环境改善，它纳入了对可能减少沙眼流行社区沙眼及沙眼衣原体致盲的因素的合理研究。本综述总结了关于沙眼及其病原体沙眼衣原体的现有知识、沙眼的流行病学和危险因素，作为回顾SAFE战略的前奏。虽然持续开展研究以支持SAFE的知识库必须继续作为优先事项，但全面实施SAFE是各国减轻这一可预防病因导致的全球失明负担的最大希望。
