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A Clearer Picture of Trachoma in Southern Sudan: Bacterial Eye Disease Devastates Ayod County

Contact: Emily Staub, The Carter Center
Atlanta office, +1-404-420-5126

ATLANTA…The burden of trachoma in Ayod county, one of the most severe ever documented, is a crucial threat to public health in Jonglei state, Southern Sudan according to a recently conducted survey. These alarming results, published today in the open-access journal PLoS Neglected Tropical Diseases, were uncovered through a collaborative survey between The Carter Center, University of Cambridge, and health officials from the government of Southern Sudan. The research illustrates the extent of the problem and resources needed to eliminate blinding trachoma from the county. A bacterial eye disease, trachoma is the leading cause of infectious blindness worldwide.

"The sheer severity and magnitude of trachoma in Ayod is reason for international alarm. At least one person with clinical signs of trachoma was found in nearly every household, and one in three households had a person with trichiasis or severe blinding trachoma," said Carter Center trachoma expert Jonathan King, the study's lead author.

Trichiasis of more than 1 percent of adults in the population, who usually bear the brunt of blinding trachoma, is a critical public health concern. In Ayod, this threshold exceeded 15-fold in adults and, remarkably, three-fold in children who are usually considered to be free of blinding trachoma. Without immediate corrective eyelid surgery these children may never have the opportunity to enjoy childhood, complete primary education, or get married. These children are disabled by pain and compromised vision; they cannot contribute to household chores, and may further encumber the economic development of an impoverished population.

Any slight overestimate of the problem due to limitations in the recommended system to diagnose trachoma cannot discount the unnecessary suffering that trachoma inflicts on Ayod residents. With support from The Carter Center, Lions Clubs International Foundation, and Christian Blindness Mission, the Ayod County Health Department has built an eye clinic where it is providing surgical services. In addition, the State Ministry of Health is now implementing the *SAFE strategy to stop the spread of infection and prevent trachoma. These findings should renew the international community's urgency to fight this debilitating, yet preventable disease. Ayod is one of 10 counties in Southern Sudan with documented severe trachoma. Trachoma could be of similar public health concern in the other 40 counties within Southern Sudan not yet surveyed. Thus, additional partners are needed urgently to support efforts of the Ministry of Health.


Citation: King JD, Ngondi J, Gatpan G, Lopidia B, Becknell S, et al. (2008) The Burden of Trachoma in Ayod County of Southern Sudan. PLoS Negl Trop Dis 2(9):
e299. doi:10.1371/journal.pntd.0000299. Read full text >

Up-to-date trachoma resources including information on the Carter Center-assisted trachoma program inSudangraphics, and stories from the field, such as young Nyakier Mabor Gai of Southern Sudan, are available on the Center's site.

*SAFE: The World Health Organization recommends the SAFE strategy to stop transmission of trachoma and the damage to vision it causes through: surgery for people with severe trachoma; antibiotics to treat active infections; facial cleanliness to prevent future infections; and environmental sanitation improvements to limit the number of eye-seeking flies that spread the disease.


The Carter Center:  A not-for-profit, nongovernmental organization, The Carter Center has helped to improve life for people in more than 70 countries by resolving conflicts; advancing democracy, human rights, and economic opportunity; preventing diseases; improving mental health care; and teaching farmers in developing nations to increase crop production. The Carter Center was founded in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University, to advance peace and health worldwide. Please visit to learn more about The Carter Center

Visually impaired people arrive at the clinic for trachoma surgery screening.
Photo credit: Paul Emerson
(Click to enlarge)
People blinded by trachoma are dependent upon friends or family to guide them, usually with a long stick.

Visually impaired people arrive at the clinic.
Photo credit:  Carter Center
(Click to enlarge)

Visually impaired people arrive at the clinic for trachoma surgery screening.

People wait outside the clinic for surgery to correct trichiasis.
Photo credit: Carter Center 
(Click to enlarge)
People wait outside the clinic for surgery to correct trichiasis, an advanced stage of trachoma.

A locally trained surgeon operates in the new clinic.
Photo credit: Carter Center
(Click to enlarge
A locally trained surgeon operates in the new clinic.

jyakier mabor
The Human Face of Trachoma
Sudanese Girl Sees Bright Future After Surgery for Trichiasis >

j king
Carter Center Photo

Jonathan King, epidemiologist, Carter Center Trachoma Control Program, and the study's lead author.

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