ijd.rl f .' ,',9.14o.rr-r .r-o*n .r-so ,'org!,*.r lj ri,r...
TRANSCRIPT
( \lAA ,t: tb) f o_rL"-i: - \ \ or9.: -L- *s,j,;F,€ "t+.
Rapid Assessment of Trachoma (RAT) in South Provinces of Iran
ZareaM, MD; Aghadoost D, MD; Delavari A, MD; Mostafaii G, MS; Hajijafari M, MD; ParsikiaA, MD; Namvar I, MS
Purpose: To evaluate four southern provinces of Iran for trachoma bv rapid assessment of trachoma(RAT) during 2004.Methods: This descriptive study was performed in rural areas of four probable contaminatedprovinces in south oflran including Bushehre, Kerman, Hormozgan, and Sistan and Baluchestan.By multistage sampling, 5328 subjects inclluding 4782 children aged 1-9 years and 546 adults wereselected and examined based on the World Health Organization (WHO) protocol. Children wereevaluated for presence of follicular and intense trachoma and adults were examined for presence oftrachomatous tdchiasis. Prevalence of these t5rpes of trachoma was determined and compared withacceptable WHO limits.Results: Only in Sistan and Baluchestan province, 7 cases of active follicular trachoma wereobserved equal to a local prevalence of0.57o and a total prevalence of 0.15o/o.No case of severetrachoma was observed. Trichiasis was seen in 0.03% of adult subjects including 0.17% in Bushehrprovince and 0.03% in Kerman province. No trichiasis was detected in Hormozgan or Sistan andBaluchestan provinces.Conclusion: The prevalence of active follicular trachoma and Trichiasis is less than the acceptedlevel of WHO. There seems to be no need for nationwide intervention in this regard.
Key words: follicular trachoma, intense trachoma, trichiasis, prevalence
. Bina J Ophthalmot 2006; 11 (4):432-438.
lfAiJL ,1o drlyl dg;r .5|lsti{l,s{Gar., rp0..rs plj ca1;9 6y orlr-.111
ijd.rl F .' ,',9.14o.rr-r .r-o*n .r-So ,'orG!,*.r lj ri,r,rit ,r,g4is ur$ lSs,rc-,sologto 1So,!J|j.r.*. J:'Jr!.0 CJ/ r
-ktgJrti
..,r ,-_,L--tr! r ,..rb-.::- r Olt'r^ ,irl-_j .r4,i9 .gla;L-l .Ab:_, .itL )s ,$.rli i^*;9 er- .rqjrl
o*5r
:.i.r.l
. '\YAY JLory'1 ..:9'9. ul4 ,.Llr, A :yS ,Slo ,Ll ,k; .9LoL-9, ,s ,5.-i ,ySt a, .i;d :OlA9t ,j9_)f . J JU4; oi AfP e aJL \-l .'J9' fVAY J.ti,i: ArYA ot,s..r,-sf pt+l !.!r,6.l.; o;lo ra.-:.:j
,j+ *!l.:J_5 ,lt o.li .sF!f .sto.'.,_,_,1 c.,., , Jj.j,jl -L"ill .gla]>r.,r._- |s.{us- ,-*, + .U-g.)
J JUS.t.t rl,'!l , JLi F I; r.L:i e r*, ,r\;t JL. t-1 ;rtl;el ,OVHO).Jtle "rk?,L;L,ptry-oWHO t-i oriJ---j .r.- t 9 oe.:rf ";:- F-lt elil J,-l &.-t . ',:if ,li a.:,-L- ,r_r9. .r--,;lS*. o-l,; .rl;
.u-i o--rLi. abl.r. pl-*;l .9lrg
-1o JfJt' ty Jl,s o-l; rr9" Y ,;L-o9! , ;l: , ., ;L;l ,.r .Liii ..,-rr., r)ri lrs+ ge4. J :laciil.r-
fYY
..r1.;r-l wr'e ,. p-l; --*t e:- eL-;r!-2rl;,t -.
_rf .9cr9. g-.o ,Lr'))t s)9. dl"L. f-f _r! .$1r,.,* ,9y .rb-l ,r ,r-ro . yA g9.i, ,,1r, 4' .\.:ri o.rol-:r 65.:95. /\A .,,-r c,r .!!b e9-+. ,.l J#t' p-l-; er"-i .r-lrl+ !.*i o$-c &-rj, et L. J#t' e3: JLi F-ltct (rr9. Y) .r,_r.) . I' Y ;rLr5 ,L"l ,o 9 (s_19- \ A) u-rc . 1\ Y ,4.1,2 6h-l -,o .r"-jtS1-f e9+.ir ..:dl or91 r,.rr
./.f G-rt r.rr c"s-+ jr.r..2jL.!-f .,J5 aro; +-l;t+ !J.$ &iU o-ijtiS,_i ;l ,5.>r9..bgh-l r_L, jo J9
.cal oca .r,ar.r:
.r-;l ;-Jt .Y!.rfcy'i JLi,l t ltrt G;er" ,jb-t .,tc? )r oajts__f e J#f F lt eJ+j :4;j*f
.f & -'s- { .,9"5 .u* .}bb-,,r ro-l_J c*';9 6!19 rc a r-:LG. WHO Flr*-, ,"LI; nBlu-.r.r
.crl.s c99 ;ll."o ,rb + ;t r" , GiJIJ+ dtl& 6lt d)rr, ,.fYY-tfA :f orLj .\ I orgo r'IYAA l'.t .'f.ilF.r.> alr.".
(e-mail: dnarea@yahoo,com) eJt j.r,.n.
,rrj.{i .r.e- tst-i f+ .ls.iilr -aJ;
OLil' |.lSlt r.+ oB:.$1.' -.i'r 1
i,lr{r- ,,<l; f+ .KJlr -.'Bl.,
\ YAf rlrt Y. :alli. c"il.srs 6,-_11-\fAA c-.t e-rrl t :ajb. r..lj C,_rb
,L:5 ,rf-:;a p,L oti-llr s.lc .:tA 9,r -Ja.tu cJre
f--" ,j,.. -,r+ OLf
.;hi of-l L Jl,s ey ;l .srLc aLr. 9.r ,.r,_l .r:,1
rh ab). .5F_o , +i.r. 6.1,_; lroo r.r vJ;l af 6,L4o$-n sjlg? dr- jl r+ !r* oi .SrLo q9;15.-l al-,p L-
.o.r.ldl./ u..-jt5,_i )l+.tl q 9 +i.,..)b-l ;l ,*-r .r;..,_l ol-:.,_l for JJc + .F-lt + OUy-.-
9 ,-i.F + ,'.1 gr_l a5 s* ;frc ,f. ,9Ja o c*l 65*
6,[,,-, oLi.i",: .r-"lr,jlr. .rtl e"lp -,,r 6)L* 6rlJel+
.5cLa-:,!l .r;, ,* ,c -.ry'i 6"197 a> ,o a5 slorlr 6Ls
i, .9rl ::l gL-oc-i,u:,.l o5 "l;"- ," 4 9 .$ldijlr, el5jl .oaL-.; a.ElJ- ajfe" Or"., r ,l;-.. ,La a, :slocl.:
*& 6.192 ,o p>l; o;9ral.r'rc-l 6$ 4:-E F l,; et .i
J.-; e!- .gllo t-9; Jb ,.r 6"194 L- o.r".i, a;..i,1oa51:,:.*, la6i,,r.5sLa:!l 6,-r- ,.9ta;3r.ri+ + r.-l "J !"i-q
.j.rL--":-t !,-+l ..S-_jy'r.-. ,ll olSs-.: 1l .c9.io" c.!L_ rc-l
;l o.-.;; .,r11;1yi .glo_;pJ ooL:il9c .91-ok-9, .Jnl ,.>
9 ,r,9--.2 .915,_r.l !Ui; J tsil ..rsr' zul;L_.r. .9l.6195' .tc-l 41Lr .,,-1.-1 6L6J9..IJ jl .gol.r,; ;
ftr
6L;t" 9 L-or9*5 ,r;; ,91-oa,c.rc.r 9
r) L ,o-l,,; g5".1 .rc-l F-l-J &:sqt r)9- rs .rslo.rr5;rlf ,vro I.
,r .,r; -Lojl Jl'.,| J6L . ),,1,c ,..,1 .-
9 Jtlc + .ll1 d ,ra1rlu c^Srp ,. lL.:s + l. . -L-1; ,L;l- a-J .uos -
.. .ta-.. .c , c -J. .i . Lt! . -l!U . [Ic
F.li C OQ? rr F ,-r*- Af . o9.u
Jt'r ,-[^r a, I Ori!- I A ' .51 ' -: 6-_1 1l+ A-' cil.! .r;.o19; ,Lrc q jl+ r $J,|rs
cYL ..5rLr.1 .-b5 r 6sr + oL.,o I
).! L_ Jj'.i.,. lr.:U.slL*.,,-l ;l OL47
jr ir-l
4:ilr
4) SJ|CO* {-l J.(d
c9.>9 &t! +o,r.!> lb !
(\tAA ;b*1b) f o.rLi -\ \ o-rro -t+ ,rLi;69 +la*
u.L-l )- ru;:il.: 1., e-li "r-+9 JL.-sl "L--;;r'L* a5
L6U-e) o-_l .Jj,r,ii -1,.!l p'li e-r'" dqjrl Flr1-J
;-*-i: ..rrl.t ,ai,.:-L; :.r';sy .|,-S t^:lr- ,l ,rl,- JSle .9lrl.:
,r9---9 .,2- Jls .9uo!9i s9--9 .rf r glttll o"Ll t otli
A. . jl ;F.f c9-'7 L och!1.19c 6!6U-9) .4:;ii5 )r Fj'li
a-5 s,-L6U-9) .a..-i.jA. ltb 9 fL-S- ....-? .glrls L- p
,.u-,llc .r-r;-r (r---- + l+ $:.;l$ -l { p+lo .r-;-o
.glrlc t- d-j;lu4; algl .rLri a-l)l 6L6ajt L. u!L! .5LoL:-9.1
.a--r.r. .riG .9bU-9, 9 Jr'; 9 ,"-l!-l .glocLL
,!PU".ro 6-fJl+f ol-:.r-ko pl-{l -p9r cJ.'Jl
fYAY Ll:'). ;r-l ,o :(Active Field Work) ou.jo..d
6rS{P grel + JL51; ri Afi e aJL 1 [ \ 5oe5
;l .-15* .gr|5 "9f .JjJ-ii u,L- 9 -L-il .5lal.-r''r'-;->
I r ,.r,:t.rO.,"b,,|5 f ,.rllo .,-*..SJr-i.p-ii€
9 ,Lro ,c*ll,rE .:,rlr9 .rs Lo.grL- L "rrt- fr- .r<-oLr
.Ot-Jt ,4-,jr9i -tu; nrb 6L-ool5;::ls 9 ,S;k J)fI
c-.*; ,.!lj .F; e+ o,rl-ll.: e ;Li;S .;l.rol., ,;lf;ra
plu-ll a-:l5lu> r:t- * C.F .'{.i?i .916"15)15 6)ljJt a
.r)99*" 9 ;L-LJ_rK ,G.9--.e ols-i; ,otfrlf ,o ,.: .,r9^;
)r:--' 6Jj-L;!l .+t:- jL)J -,r*l.r4, flr- .r;loa3
.f.t-^l a--L- o* ,eP 6)r )r OJ.i *,j J-; J Jlrq
t"J#p e \q Or,-o .)9:ls+L"l ,!-r { 5l+ a! gsl.:fy
JL-rl e J*"Sj e larl ;L; s,9d.2" s;;or.! rl .oL;u-l L
.JrjJf li l) Gjl'Ytl a't
,,> ty:,> L o.r5a...r,-L- .SL""I-J .rJl3 .ra ,u\rrSllt
,1ly .olc)ltl ;i 9 6.,9l'>f a, c*; ,o.ris3; 6taL-9.,
:L'*; J-l* c; $Li .t $re-j r"lull 7.tb JAtty-':
.r-'J ;l o-:-;ts-i jleli .u-i) '-,-":;L .il-j" ,l ,rL'-"'
r JU e.r,- .rr--i e ;reri, ifr;]ii,;";"i
,r-r; 5e5i.t- ;lpl Lq.; .,J-:jl-,5,-t ;�l9llt u-.,s 6ly
..r"Ll_,.r a*-f l+ -$ ;)15.1 a.i9fr-o .glrlc rlil !i.;-- lJjJ*ij
clr-sl l-, 4.,-L- t- 9 ,r-*lo-p or-;9p )J et.t.. &ll-
liJ ..iJ,:, ;9-o 9 ,r,-LL; ,,rJlq1 .5l.o t^rl, 9 e.L-i,-
,---r JL.'r; clr--sl ;4.-a Ji .rul-,1 .)--jLs,-t S9-+i
.$ d!Lt. ur9)
a-l t-oc;rL"* .,^r+l a-li; ,o 6lr-1 69"2 q9t-o..1L-l
jl .c-lr arL-* b# tb rl rc-l o.r..:a,-lrlWHO t-9:
)D L5r::-* ;Lr)ttl ,rJ9 Y
v-: t,r. JrS,i- 6tti' a'1"-
c-o ,o ,9,5 .rc ;,1 U"-:' ;tli--r. s F-l)i rFag r)t-
.uos!r. ;Ll l, a--; 6,-l ,c ;U*;* pl{l p9J a5 J.i!.r*
,.5-.: .SJ + ,g,-QL 4J9; )J a-ltl& .9lr-.,. WHO
9 6;,*.-..51r- l1 ,r-L: a-l;r1 .,rllJl6- cgtorL;L
eL*;l 6> .1o9o" ,L.l ! .,51L*l t 6u;; .5la.91Ln gLlo
(Vision 2O2O) Y. Y' g-L;a a.Lr-.1 af oo*.; o>ltl 'c
I
.gl-oc.1y'el ,l .,5- F F-lt jka ..ii- .;-l or-i o.g'l':
i*-t9 a*-+n c^-{a 9 L:-l) .r,-l ,s WHO .c-l a.lr, ,'l
4L-;tl ,5lr- l, ,rl-Jlr9:-c ,,r,.:..c 6b)tl:-5 )J pilFj
.s--t,a* r1l a7r5.Y;-l "ca; +l-1l e-D ':---;s e-*
l+ Jr -r!o- e tVe )ss e t* G")r..5.->15 a,Jtt'
a--.{1,.9 6)L* r9?J { .59S.j^" .*lr- eLj G-)r. a. aa?
G.,,L{? oJ-ia:ir-.-\ e.p 1*U- al t'> p; dr)* ).: Dl'il
u-41 ; ,;L> oj.ori .^'l.r.iL.=. eli u*t s-)J -^te
.;tL- .rr p;l; o*)9 g'-, o2L-:'.,1 ty$;- a- 9E-lt
.c.!rf ft+l \fAl JL .rs ,95 ,.r,9;-- .51-orl':-l .r1b-9..;
,Jbrl .jtJ
-- ,.r:lr.r-,1 ,-|..JI.r.r-D lll s eo'i ,.ts; + or^
9o ,c "|,-i .rLlJ.!l ,Clb eldl c{a .t*".q ,.t+t ,"-t;
..r; ;lz.l a.l-r"
;--l ,r :(Desk Work) .,tL.r-i. 6lr-;11 -J9l ab;o
;l '-+l ,o p;11 <S;J: :bl-zs rilJ-,i*" 9 J--61'.X 'd-!)'
! o;1!- lso )s r9>9r.,lor9c 9,9>1y '5\a.;.rlf ,t"l-li
.s- ) j .# n .r:r;9.1 9 6Lrc .c*lluq.:rlrg rr lo.t-rL*r
,-e.rl:t t- .srL"l s9-9 .llil ;A! .rjlJ.;*. JJ-l c;'..r.! '$
l-,J.f ,*Ly.)l:--l .!-L.l )t'S G.r^".9tr;b"l ,o ..f
of ..,S1 -,Qa i.*lrQ .oy OLar! I OU*..- e ,ltiP
;9-a^ i;l 9 4-,"y c--+z 9 JjJ"5 -l,.ijl cp 619l:^a,7
.$; er.l, ,gLo.l5lsl.: ! 1.;Y a;to,rloLo ,ets ,sl*l
..r'.i ;|., a, u6U-l 611
**; rf, ..rs;-.;|.: ; t ;Jt f+ ot53lo ,r ;l
t-e1 1' 69.".'...,o e U-e) V b A,*.-* J e r{-r'Y'"}:l-i
gl,,-l -9-.- ,.r f;.1; c--;e *- eL-)J -al) r.,.. itr
a5r, A ,;.> e l5l.> cL 2ya q Vt9.1)a a, ttl Jbytl
.o.trjL5_i AS J ,U-t) rL;;- aS I J-Li a5 $,r,.! c^,j
a-.\i aS s e ,&"* &lf 45r ,Jti ptli ,s t4 8 t
."j".:r CrL
9 &*i 9 JjJ.-3 6+a.l.'.! ,;lc)ttl .gloa5a .9lo"rl.r
prly ,OF) J#t' F-lt (CI715) .r"orr 1A ,L*.J"l re.r.-
al--lu .r.-"rl; .r- lr r S ar:+ .r--jq!i r: r OI) r_.r-i
€J-! .+lr? ..r"-srf a-.91;i. WHO .:rl.r,;L-l ,.Llr, ;lK-r
F--ll &e- 9.r-.r,.: Y' jl r:* C9ld;L* _," JfJt' c-li
tr*; Ol,,*- 9 J-r,r A jl ,j-..1 JL. \ . ,,_, ,5.:95 ,.: ,rr_.r;
d;li a5 r-5(5. oat L lrliL ,r-rJ ,5.: 1l .ii,* .r.,jl':s]_i
aL-;'.r- 9 .:-l .r-:;1.4p ,f fs W 5_ ,..riL:-" ,l ,.:
.t" "rl" c,-r9r; ;L)J -s:-ilJ€
l,ndirl,
,s-.), t)f .9laL::.--9, ,r "5L. ,i AIYAf 69,"-'." ,l
.r--_ro f 27A 9 ,- .r=_ro dYTY Jbti 4JL- \ -1 5.:95 f YAY
p-li p--)le d-;1.: + 5e51i JL.Sr; c,.. At2 e ;;c
A\yV 9 rr-.r--ro fATl J"Li (u{jL,sri) ,s.--+ils*-
1 .9!L 5s15 e-b . ' ,-if )lF .,-)t r)ts ,oj e)r
.r_ij 4Jl.t .:.r19,.5la1L
;';9a g.>J rr"L-l ; ;5c95 .9.:r-! c-il.9.1 c ---;9
a5.ro.:,r. ,Ll 9 ;-l o.r-i (\ ) Jir: ,,r (dirty face) .Lj
-)9a (Ja)r \ A71) r.r9- 1 . f ..'-.r.r or9. ;5o95 .15 ,c
;.,,r-rr 1A JL--l t Jj ,roli "lr=" 9 i:jls s9>9.r.5
,L-l ,.: ,i t9=. ,W; rr .orr5.r. r19i.2, -r,oro \ YlA Y .
,---{it -)! 9 (.r-,r.t Y61V) ,,-;,.;:* ;L:-el 9 ,t' , .
.ro o.r.-i:zu-i-L- g5c95 .;Jlo l) OIF (r,)J \ rY) .r,-,p r"5
ol+ , ol5Fr-a Jl : .l 9r ;5L c.rl9- .r-r.: Af12
Y \ 7Y to;1 ,r- ,c -i:5 J.tg ts-:; aJ JjrJ.i JLL-*>+
.c-l ort J,rr
.r"Ll _c .s-.r.* lr9- .9l,orl;l-' J--'+* J^1* c1J"2 t
(Y) Jr.r.-z rJ s-r_i or9-" .9l.oJU-l 5J.o; { , lao;Li
jl ,-i--i l-i;,i 6-1- al-G a5.roc.r.;Li! 9 ;-1 o.u a,lrl
l-a *--3tt oJlrj "f-:f ,o-ars \ \ 7Y rJ 6r)oJlir aii-^,!J l.
ftd
A, U-9r g )J,Jl4 rvrl;;r-i 9 fu4;,rr;.;.2r
-b;! .,!oL; .,* + Jits \A Y. ctU-.,1 alL \-l .5.:ef
..r-;,.:9 a-rJ.o )l ,Lij ir+- ,; .rfi jl !l.+ ,FlJ.> !5 J,j&i
;5o95 r,r9o: [:-9.r rc aJL 1-1 Jc95 s-il5 rl.r.; a, a'jL--
,"L-ly ;5.:95.rs F-11" et*.s$.r^ -l-:a;l ;.-r- y-1"
.$ aala, od.::€-)t 4i'.j F+>
.S.r--.14 o"L,l t.5)l^.1 ;ri J.iJ 9 .gqa'ji*.b
:$ et .jl J,i cr"- { wHo
;J9l :fiF: Follicular Trachoma) Jtl-Jr3 F lt 0
)J J#t' A $lu- ;e-e L af ;-l .srL* ;l' a.br. a:.!!
,-lrl* *l LJfJ*."r.+u;:.-;L!i !5-)u 4-,.t
..uL +;lo ,l! .74 mm
,aLr".r,1 ,o :(fI: Intense Tra€homa) .r-,lr,i p.>l/ (Y
.A:i ,r-S a-.t!L 9 ".r-i .:{+:l c":cJ- ,o u,-..l"i *Qll
a-"etL 6-+:L ,_!lf jl .r^: jl ox. 9 ;*l oi; , .!L.L
a5 .r;rls ,:9'9 a--J. ,c Jf!9! ;l9l).i JlJ..i 9 $lori 9a
.r.yt 9* 9..!L!9, ,4.*lL ,JJ.ji p*;; t i-l JS-
J--l :(Ts: Trachomatous scarring) (J)15*rl Frl' (f
cr.;:- aft' cs-rlJ +-":clL ,c .rL5-l ,19-29 ! al>r.
Jr.-!- a--! L t-arli .J+i- L9L; ;:r9- a, ,tl-l .ocr5o"
9 ;9 -rrs Ly-b; r.t9-o .-. L+; O'-l.sp,r. ou,o .5.J,
lr u.rLj ard- -.* clC c-l ;S- 4J- . - ^ ;Li!j.rr
..rJL o,!Li9;
Fl :(TT: Trachomatous Trichiasis) ,,.r';l-5-'-/ (f
rsri "+l-5 o1f C, o-5 "F.l--,pl.r-- 19"79 L.t.r9.
F-lF "F !(--� .r- ilr-ja jl .'Jll'- 1+Lq .sJf g* .4_r-
.o.ri.r. df F )r .rjti-i r.r-iL a:il.: .:99 1o;
4+f g)9!t :(CO: Corneal OPacity) aliJ.i OJ9JJ (A
.5-.rr. q-ib ,;' )9b o'-l )r at c-l o$LL.l.tL! Gi'l) a
cJ:-65 JJ-i a+ F.eL-rt J.l2 9 rgj,(Jai o$J Grgi A,
.(r/\A L r/\ . J;,,f) +t",:r
*_r- .;l-:= j,,l -51--ol, ,-Llr, ,! .i,-;S :.,y- u"->LI
4-1 JJtJ r.29:1o c-0.5 J.tyo 9 S Ji+' €l,; c"+J9
t_ F-+ nl,,-:,i 1l .9rtl | .glrlc .grotD a;1L..r.: al;ir rF
.J^l! i.,,to G9r ,r G-ii
(\YAA OU .ib) f .rL.i, -\ I oreo -1'.., F;,,-* a'q-
OU.--ar! I Ol: ....61: .l ,,r sLo rr9- Y 6,1 ..ro.ro.
195L ,b-l _,o JfJ9s f:-l.s egrl r,lr,l-;. r.r,i,r,.i o,uLL
o.rlc c,a4;r"- .r,_J*i F-'-l;; jl 6r)9o .69.., .r-_r.r .74 l9.r--->
ul;-.." .G-)? rJr- .91-oc9- ,o tf.; .r-l + ouF tr .tL;
JL-J>I L ,\s-u).|, 6)r. "-l+ $ rr J-fJ* o-li .r*lr
,--o,c a5 ssrf,r..rr9ir, u-rr .lyA b .i.A 6-..r-r,r 1A
.c-l WHO J"-9i or.iro-J jlr,., "- _il trJ Jt-oJ,^! 4-lrl G) Jrr: .,o ..,--.15,-- q y+" olil C,-;9olil ,c ,-;$-; or9. \V .rt5 ro a5.u.r,r. 6Ll 9 c-l
JoL" a5 $ oolo r.-i,s ,e.), 6)9 5rS..t* Jt"Jri
ec-rci* ..r,:lrcs. (CI716: rl;orc .-\1YY) rlror.: .iYl g,:.l
-q-9 ,U-l a LS+- ,=.*)- C ..)4jq52i g-i, .rl;_"-
tr-.i .cr-.1 (11;--or.r .7YYy ;Ly' "U-l : (rlF.rr \ryy)
o.-iJJrr ;1.,--:.1 u> r t",r" :i.;ffir::
6l *:- ,l,r ;; 9 .r-rc f .11 ,o Ja :.. _ro ,rS:t- i:Yp!
.Jj oJ,to Gr)t cr9. .5lorl9;B .r,-rr Y \ 7l ,c .gr,rl' .9lrlc
O:,3lr o,tilt .'rlr o19r 6l5.ref llelrs gjy -1 Jr.r+lbou4l d.<ir 4 J.5 ojr.a
o)r- \ i)19. rr9. g5.:95 sl.r.;eb-l pl;
(..r-)l) rl&i :J!5
Ou--+d.1 OU-*-
,lltiP
ol-t
*;lt
1 . f ( l A / 1 )
.r5o95 ,c (IF) JriJt' n-lrj c.r:- Y .aJtla rlsrc
,L:; I u-r.r .7\ A &,* af a-l oclc ro.i:;.r-ry cr9-
aYY (rd/Y)
Yl ' (YA/A)
Yr (t/Y)
\ f ( \ / r )
l . 1 Y
'lf^f JL r.! Olt-l sr9i" (Jtbotr-,t 6tbU-,91jc ,*rU"ob 15la,.*,o ,-f,olg cq,r;9 _l J9.rq
(..b)o) Jl.l.j :sb.*.,-l.lf
.5yr6 .9!ls gly* ,l.ri.i-Ye.;! ! ,ril; dtj .re?e
,l9B ]. :.." ,.r ,r5:.;B
Y' J "+ -J c.- b aLll
, c"."rL d--is
(rliLt rl,$) Oli-,! r.U
\A l (11 / t )
lYt (Yr/l)
YYA (Yl/Y)
I t (YrY)
rt\ (Y/t)
fY l (aYi. )
YtY (YY/\ )
YYY (YY/A)
?? (? t\)'\ aY (Y./Y)
Y \ ( 1 . / t )
?. <^f>
(1Al) ;L.-;eL r;rt:. . '
(YYl) "lf.;.ro
(Y. 1) oLt(tl1) )+ir.i
ta l (Y \ iY) I YYY ( f . i 1 ) fa. ( \ \ / r ) G\ 't) c.+
bott-rl s$ii o ..9.1r^:l cqrje g,rLrt_; d,-jt+t",-i q y+. Jt-JLfr,;1 +i tV jtrt.1.i e-j, _l Jr.r"!lAr) .)lJ.j :o-_j!S-i c..*;9 ;!LJ; ol.s
!r--jli5,-t J)19. Jt **,rJL>l .:r19. *ael, rrl9. a+; o)9Jt L a:,j o,ll5 ,,.rt+ o$(JdJt c"f.." J''
6b-l pl;
Y ( . i YY)
1A ( l /VY)
rfY Yrf^f
YY YAf'
IYP 'YYA
\ f t l Y t t
oL--tr! r ol' . -
olJ-F)a
tV"YI ( . / \ 1 )
\ ( . / \ t )
a ( . /AY)
t ( . i l t )
A ( . /1Y) \ ( . / ' l l )
\ Y ( ' i Y l ) \ ( . r . Y ) I ( . i \ ) 1 ( . i \ A ) \ ( . i . Y ) aft dlr f
..t :s-J ,lt .tl" .-l; ,La c.r,i )! ,! JI .r> .t ;lL* *
.cdl oo9..j o"Fr )J o.*jr- J9*. sri **
jlt_l !9:> )r ,o>ly :.11.-9 3_r- gL-rrl -51.r.r.:,-" 150
eLjil oJ-j-6DoUj (,it:S ;, ,ya ,.:;L:;) ;5.:95 ,.: .grr-i
&le rjl9,*^ a5.:-l o.:9, r,-11 ,r-,4-t -4g l.oa:9- gitu
at_l ! 4?i Li ..jl.t Jl-r $-l).; al+ o.r5.rc-- , .5la*-,
YAiV L O[.-+ e Jl- 1 . JU-l jl !.,;rlf O,i,r:* af
r.:-l aJlll.rs JL, F-lt..roLi ajiL- Q-; a-' .:y.r-rs
jJ)-..] l.t .9Jl *llq1 .-elc, r L,1., c , " al "J56L slr;.r-
tS-:J ,tr ;-g 4..', J-ly. F-o .'-r_" .Jj! .9)L-*or--i-L;:jl jlL- "-J J,6J(J! rrLir.i F (y Jr":) ,SrL*-6Jl ^ ,;l Lrlr_i t s egr* ,,*L- ;l ,Ck.5lr7l r.42
.i:ul o.:9 4-.:< ,.r.,,! .Jr(.;2l
;i o: r.lo.p -.9r1 -r;l et- L .a-l--.1,- )r p:;li €Ji-;
.,-ly ,;:! *:-.l]l{J Ct- ..:rl.: o*;i:* .t^,1, .r!pl 9 a*l>
+--j i;,,r--L ,;L:>l .9.:l ̂ - i l et-,;..":-r-_, &-]-i
.'rrjlJ f r--' ,,Jl- Js, J* ,e_5 .slr. r -l ,*tj-Lj
J9-*i Fe ,di--i ;"a.7 -i 4,1- + 3L-i 9 *U-
sggggggggggggggg� ril-' at Car p-r--c 9 .g.:r--i c-l,l.r-q., c"-l-c) pe 9 J;9-
;L- *; ,.ll* jl ..tlr*- [ ;t*;l -)e:l e .ul- .sLraJL,
.5;-i- J,-LJ t c-J &rt jl :-.Ll .srL* J.b ..r- x!.r
.t toy,r.
.p* ,f,-J Fr*? ar 6rti ,c;q 5- .rl 9 or9J1
:t- *; ,-Ft* FL a.l "r^:fi .st".r-f ,€J-+" )r
€r 1!-:-,.a F.rli fra 6FJS.i ..,s ,.rcL;--l J 4jtfl
Jjli(s^ 4;iL!" ,.: .l-19 ;l r9?, .$ri(J- i.J,y'!.U c":-;9
cS s-.t;uN S a5 .u.: ;lrsl lr .S,,L: e.u; ..(-s! .:lo"t;l
eL- .5L-i:rl 9 ILJL .,altl uqlil r+Lj- a, al!.l,r" cg
.S.r .,J! lJ.;L.- (5<i.6i G;i: l*:
G&?- )S+; J-lf rrai €..r{ .cjf .gtoa:s! a,_11r1
t9ij pJe + 4?9;! ,4Jt " rr9. .:i..? ,.: .9.:.rs c;1u41 ,
;l;) +ii,L- ,.: .L-djl J)9- q J.i 9 JLs f"-li .9)t-:
.!#L -,J ,-s..,L* ",-l l5 iif 4++ ,jli.,. ,(WHO a-r;
a5 ;9r!.=- a-...i 9 L-l "$ J,.:.is ,,r-rr, c.r9- J9f,;
,5.: .9.r15-o t ,*-S:; ;19-i 9 ;Lro ..:;[{, ;rlj,
.,jjl.\e Ct- .5Ujrl .:^{a .l+;.,. gib;L)L , l-aa.;Ui;.,1.r,
L; .ro.: ,.Hl l, p.r! .g;ra."br- ."F_l !-gfil ! J!L- .-el
.{! p9l..u , .:cf -1"15 ,,u;l; .ii- c-1" .:r9io,
e)
. / \ A J}5-JeJ et Jl,r F-lt €J.; a5 olo JLr JJ,.r
o-l-; 9 r9--.?.rarl . YA o-l- r.r; i .rr9l, ;51.r- 9.r-rs
).r a-5 (J,9+'l .91>9Jls ,,: a,L:- aJtt ,r .J,.:i i-!L J,:$
Fi;l i JL \. t j 6l-o4+ ,rar,: A\7\ lr j f l- i l Y. ' \ JL
F;l;.!--)J \t/A , Jt-! ,"-;l; .r-r.: ffyt) -',- r,l.r JL!
6--l a5 .uc9: .s-.+itsi- ,#1y .9lrl.: .r-rc A7A 9 (.r-.r.;
. ' J,it.r- l-,L"i J ylL,t* r l-orLi
.l-> a.? 4?1; t ,aJtt J,-l -,.: J#t' prtli €J.*1, jlF
J* "SZg ! .S.,L* ,r.";1 puc t':;L .WHO a-L;I,.r," p9!
crl9.9.rjL,r. r;Li-. Et-.,," F...,: l , l ";1.-q,r.9c
..r' r" a lir-: r ,.1-l rJ c9,'L:.r ,ir91 ,*tJ3 Ji.;L .oJ;o'uLl-
..,c u-rc Y. j l " i.: J#t' '+ lt; lel;,WHO pe!,r-
\ . ;, ;5o95 ,,r .r.-ro d jl oi,* qrX l!;l; 9 ;!L.Jr;
;i ,.: p;l; aJ .r'5G- .r.ii- 9 ;-l a;L- .5,_ ,.r JL.al-;l.u ,r..1 9 .:-l .;-l:1-ra1 ,s-^9^. ,t:*.1-_ ,, ;L .
.t ot+. o.,9- ;L)r -;:;l.IE
;L;-l .rc ,a-JLt 6,1 ,c les.Jg *--:;1; crle- .:lo;'
d5 ir^i oJil-:- "U, "t-X. gl9 9 ;L:..,-"L , ;t. .- .
!t!, jl ,iL.. .rl r*r?k" *:.--? drli ,F,f ,b ;" L.
rl9j(5. ,J+5 ;i ,l *f,reJ'i JLrrl JLj-l e ;L;k!t )e-;l
.r,i! l*a::f
)r .\-€)J . /. Y tt-*. -&q ,r.p_j$_i .,1L-rrl 611;
FL* o5.rr a-b ,r.r-r: . \VY Jr9i, FrJ> L 4JLL.
.WHO lt l.r. a9/ .r- ,-Lr y',,1,:*t J.,L* ,5-ir p.rc
l.j'L!" F rJ.r-r.:.5- J "-*..,.*_i!!; A-.- glr.-
,l�9-.. ,_r* (J--_i15.:- pi;li d5 .:-l J,l oJjjJlra,.i-
pj! a;la! ,11 ,o .;i1.13 al">l.u 9 e-l a.;iL ,.: .;-11q,
;-l ,sE ,r;l> a.Jtt- ,c .r-rs '/. Y €9i- Ji '
-:1,.r"
.J-,;L.,- a;ld" _,J.r-^:fK* F li .,-!l es r3l* i
U- el--. Ft i ^t ;.J .r...:il5.- '* li jl JlJ.j J,l !pt-,-,Lj.;:l -r..-9- rc-l ajt:,o rc jp .91-oJt ,c .SrL.: JG
.d-l F li e-/. GL-)) l9l 4>,. ,.: aiLt- er',-
.:*ih1i *;G u,a.,.: I A71 r9"9 .'.*?pi a,JlL ,,1 ,r
(\YAA ;t... rby f o)Ll -t ,| ,.,e.: -L=+ oir;p;.? rl+.
.91---o.9rL-; ll ";rG Fr- 41rca oL.,; ;l 6!L ,o
,L:9L. 9 c*!, ,*--5;; "l;9"i 9 ;Lrc ".il.r.q ,:1119-G.*lJ.qqd s!.u:! 9 15J, plr-.gtool3Lilc .,.;|".S.1 er-*"o.r-S-t;l.r 9 ,Lit' .rlu-ol, .OL_I-' ..rli;.p .rapl9; jLro
.o.rr5.r. ,,_$; 9 ,5i_r J.?lj ,sSj; f+
Glli.
o.1tiJsbr
,L_rc .;.ilq; ;rl;9 9 WHO .ri.:b C Crt ;,-l .:tg.r-
dt' rl+ rr -t-9; O'i 6t!d-r,-,l e ..',.., J^l; ;;9.'i e
6t"ceL- jl at-r .r-+ a5 c-l o.qorf c,il.rr, g .r"-b.o9-iG. dloJ.\t j F.ri l^Oi G--; , Jl-
6- Mecaskey JW, Knirsch CA, Kumaresan JA,Cook JA. The possibility of eliminatingblinding trachoma. Lancet Infect Dis2003:3:728-734.
7- Mabey DC, Solomon AW, Foster A.Trachoma. Lancet 2003'362:22d-229.
8- Global elimination of blinding trachoma [WHOE8101.R51. Geneva: World HealthOrganization; 1998. Available:www.who.int/pbd/trachoma/ebresgS-e.htm(access date: 2004 Mar 16)
9- Weir E, Haider S, Telio D. Trachoma: leadinqcause of infectious blindness. C,414-r2004:170:1225.
10- Bejiga A, Alemayehu W. Prevalence oftrachoma and its determinants in DalochaDistrict, Central Ethiopia. OphthalmicEpidemio I 2001:8: 1 I 9- I 25.
Chandler R, John D. Follicular coniunctivitis.external diseases. In: William T, Eiward A.Duane's Ophthalmologr. Revised Edition.USA: J. Stuart Freeman; lgg5, Vol. 4, Chao. T .Negrel AD, Taylor HR, West S. Guidelinei forrapid assessment for blindinq trachoma.WHO/PBD/GET/00.8, 2OO1:Dominique N, Silvio P. Trachoma rapidassessment: rational and basic principles.Program for prevention of blindness anddeaftress. World Health Organization; 2003.American Academy of Ophthalmolory.Extemal disease and cornea. In: BasiC andclinical science couse. San Francisco: TheAcademy; 2002-3: 162-165.Arffa RC. Clarnidia infection. In: Grayson,sdisease of the cornea. 3rd ed. Missouri: Mosbv-Year book; 1997: I l5 l - t l6 t .