Trachoma therapy with topical tetracycline and oral erythromycin: a comparative trial.

Because topical antibiotic treatment has had a limited effect in previous controlled trials against trachoma, treatment with oral erythromycin was compared with topical tetracycline in 6-8-year-old children in southern Tunisia who had potentially blinding active trachoma. A total of 169 children were divided into two groups that were carefully matched for age, sex, locality, and intensity of disease. Oral erythromycin ethyl succinate in a paediatric dosage form was administered to one group and topical 1% tetracycline ointment to the other group, twice daily, six days a week for three weeks.

Intermittent trachoma chemotherapy: a controlled trial of topical tetracycline or erythromycin.

In communities with endemic blinding trachoma, mass (or "blanket") treatment with a topically applied tetracycline derivative is a standard control measure. The widely used "intermittent" treatment schedule consists of the twice daily application of antibiotic ointment for five consecutive days once a month for six months. In this study, the efficacy of "intermittent" treatment was evaluated for the treatment of severe and moderate intensity trachoma in children in southern Tunisia.

Isolation of Chlamydia trachomatis from different areas of conjunctiva in relation to intensity of hyperendemic trachoma in school children in Southern Tunisia.

The simplified one-passage technique of culture in irradiated McCoy cells, in conjunction with certain other developments in technique, was used to isolate Chlamydia trachomatis from specimens collected from 78 children with trachoma in Douz, Southern Tunisia. The results show that C. trachomatis is not confined to the upper tarsal area of the conjunctiva in hyperendemic trachoma.

Antichlamydial antibody in tears and sera, and serotypes of Chlamydia trachomatis isolated from schoolchildren in Southern Tunisia.

A predominance of TRIC serotype A has been isolated from schoolchildren in a population in Southern Tunisia with severe hyperendemic trachoma. The serotyping results correspond precisely with the serological findings in patients' tears and sera. Geometric mean titres of serum or tear antibody in defined populations or areas can thus give a useful indication of the prevalent serotypes.

The use of cycloheximide-treated cells for isolating trachoma agents under field conditions.

Standard procedures for the isolation of Chlamydia trachomatis require pretreatment of the tissue culture cells. We evaluated the use of cycloheximide, an antimetabolite that can be added to the cells with the inoculum. Cycloheximide-treated cells provided a sensitive system for isolating trachoma agents.

Severe endemic trachoma in Tunisia.

In two villages in southern Tunisia where trachoma was endemic 7 per cent and 14 per cent of adults respectively had visual acuity of 20/400 or less. In both villages active trachoma affected most children under the age of two, reached a peak in two- to five-year-olds, then declined to age 15. The chronic inflammatory disease in childhood appeared to produce irreversible scarring of the eyelids, and loss of vision occurred in adult life due to corneal scarring caused by inturned eye lashes and loss of tears (dry-eyed syndrome).

Herpes simplex keratitis in a developing country. Natural history and treatment of epithelial ulcers in Tunisia.

Herpes simplex keratitis was found to be a common ophthalmic problem in Tunisia. Dendritic and geographic ulcers were complicated by deep stromal keratitis in 31% of patients, two thirds of whom were known to have been treated previously with corticosteroids. Herpes simplex virus was isolated from 41% of patients from whom corneal material was cultured.

Acute hemorrhagic conjunctivitis in Tunisia. Report of viral isolations.

Acute hemorrhagic conjunctivitis (AHC), a new disease entity first reported in 1969, has since become pandemic throughout the world. In Tunisia during an epidemic in 1972 to 1973 we studied 25 cases of AHC, which were characterized by explosive onset of lid edema, chemosis, conjunctival hemorrhages, follicular hypertrophy, and epithelial keratitis. Clinical signs peaked in 48 hours and cleared without sequelae in five to seven days.

Topical tetracycline and rifampicin therapy of endemic trachoma in Tunisia.

A controlled chemotherapy trial of trachoma was carried out in a Tunisian oasis among schoolchildren with active disease. We compared 1% tetracycline ointment (79 patients) or 1% rifampicin ointment (76 patients) with 5% boric acid ointment (79 patients). Medications were administered twice daily, six days a week, for ten weeks.

Cytology as a guide to the presence of chlamydial inclusions in Giemsa-stained conjunctival smears in severe endemic trachoma.

Microscopical examination of 927 Giemsa-stained conjunctival smears from children with chronic trachoma in southern Tunisia showed 93 (10 per cent.) with typical trachoma (chlamydial) inclusions in epithelial cells. The accompanying cytological features were a useful indicator for inclusions.

Comparison of media for the isolation of haemophilus species from cases of seasonal conjunctivitis associated with severe endemic trachoma.

Media for isolation of Haemophilus sp. from the conjuctiva were compared in an oasis in southern Tunisia where severe trachoma and seasonal epidemic purulent conjunctivitis are common. Of 89 children tested, IsoVitaleX-supplemented chocolate agar yielded Haemophilus in 87%, plain chocolate agar in 75%, sheep blood agar with a stab of Staphylococcus epidermidis in 74%, and Fildes medium in 58%.