La deuxième édition de ce manuel combine et met à jour les éléments contenus dans les trois manuels
antérieurs consacrés à la rotation bilamellaire du tarse, à la méthode de Trabut et à l’évaluation fi nale des
chirurgiens du trichiasis.
Ce manuel est destiné à fournir des informa...tions spécifi ques aux formateurs dans le domaine du trichiasis
trachomateux (TT) à d’autres personnes pour qu’elles puissent pratiquer la chirurgie de l’entropion trichiasis.
Il ne traite pas des autres approches et se divise en deux parties. La première présente les spécifi cités de la
formation des futurs chirurgiens du trichiasis et sert de document de référence. Le formateur peut préférer
que les stagiaires lisent directement le document, utilisent ce manuel comme guide dans le cadre d’une
présentation didactique ou l’exploitent d’autres manières comme aide à la formation. Le manuel contient
des connaissances devant être transmises lors de la formation et une description des compétences devant
être acquises et évaluées pendant la pratique et les sessions de chirurgie. La seconde partie est destinée
UNIQUEMENT aux formateurs des futurs chirurgiens et porte sur la sélection et l’évaluation fi nale des
participants.
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This manual is designed to provide specific information for trachomatous trichiasis (TT) trainers who are training others to undertake surgery for entropion trachomatous trichiasis (TT). Other approaches are not addressed. The manual is divided into two parts. The first part covers specifics designe...d for training TT surgeon candidates, and serves as a resource document. The trainer can elect to have trainees read the material directly, use this manual as a guide for creating a training presentation, or use it in other ways to assist in the training. The manual contains both knowledge that should be imparted during training and a description of the skills that need to be developed and assessed during practice and surgery sessions. The second part is designed only for the trainers of the surgeon trainees and covers selection and final assessment of the trainees.
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En 1998, la Cinquante-et-Unième Assemblée mondiale de la Santé a adopté la résolution
WHA51.11 qui vise l’élimination mondiale du trachome en tant que problème de santé publique
à l’horizon 2020 (1). La stratégie recommandée pour atteindre cet objectif est récapitulée dans
le sig...le « CHANCE » qui signifie CHirurgie pour les personnes atteintes de trichiasis
trachomateux (TT – le dernier stade cécitant du trachome) ; Antibiothérapie, Nettoyage du
visage et Changements Environnementaux (2). Les interventions relatives aux volets A, N et CE
sont menées dans des districts entiers dans lesquels les cas de trachome évolutif
(inflammatoire) sont courants, dans le but de traiter les infections oculaires dues à Chlamydia
trachomatis, l’agent pathogène à l’origine du trachome, et de réduire durablement sa
transmission.
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La quincuagésima primera Asamblea de la Salud Mundial aprobó la resolución WHA51.11 en
1998, que busca la eliminación mundial del tracoma como problema de salud pública para el 2020
(1). La estrategia recomendada para lograr ese objetivo está encapsulada por las siglas "SAFE", que
represent...a: La cirugía para los individuos con triquiasis tracomatosa (TT; la última etapa que causa
ceguera por tracoma); y Antibióticos, Limpieza Facial y Mejoramiento ambiental (2). Las
intervenciones A, F y E se llevan a distritos enteros en los que el tracoma activo (inflamatorio) es
común para tratar la infección ocular causada por Chlamydia trachomatis, el agente causal del
tracoma y reduce de manera sustentable su transmisión.
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The Fifty-first World Health Assembly adopted resolution WHA51.11 in 1998, which targets the
global elimination of trachoma as a public health problem by 2020 (1). The strategy recommended
to achieve that goal is encapsulated by the acronym “SAFE”, which represents: Surgery for
individuals wi...th trachomatous trichiasis (TT; the late blinding stage of trachoma); and Antibiotics,
Facial cleanliness and Environmental improvement (2). The A, F and E interventions are delivered to
entire districts in which active (inflammatory) trachoma is common in order to treat ocular infection
with Chlamydia trachomatis, the causative organism of trachoma, and sustainably reduce its
transmission.
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Countries, partners, and donors are committed to
the global elimination of blinding trachoma by 2020.
Achieving this public health milestone requires more
than funding; it requires health personnel with the
right mix of skills, and well supported and managed
health systems. Mass drug administra...tion (MDA)
with Zithromax®, the Pfizer, Inc. donated antibiotic,
is a key component of the SAFE strategy, endorsed
by the World Health Organization. There is growing
recognition that improving all aspects of MDA, from
planning to training, recording to reporting, and
receipt of drug to distribution (the supply chain), will
be necessary if MDA programmes are going to reduce
the community burden of Chlamydia trachomatis, and
eliminate trachoma as a cause of blindness by 2020.
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Trichiasis is when the eyelashes turn inward towards the eye and scratch the eye. All the lashes may turn in and rub, or it may be just a few eyelashes. The person with trichiasis usually feels pain, like something is in the eye before the vision is damaged,
blindness will be prevented.
In 2016, PAHO's Directing Council, through Resolution CD55.R9, approved the “Plan of Action for Elimination of Neglected Infectious Diseases (NID) and Post-Elimination Actions, 2016-2022.” This Resolution urges Member States to implement a set of interventions to reduce the burden of disease by ...NID in the Americas by 2022, including “…support promotion of treatment, rehabilitation, and related support services through an approach focused on integrated morbidity management and disability prevention for individuals and families afflicted by those neglected infectious diseases that cause disability and generate stigma.” NIDs can have devastating chronic sequelae for patients, such as disability, visible change or loss in body structure, loss of tissue, and impairment of proper tissue and organ function, among others. All of these can in turn lead to unjustified discrimination, stigmatization, mental health problems, and partial or total incapacity to work, perpetuating the vicious cycle of neglected diseases as both a consequence and a cause of poverty. Patients with chronic conditions caused by NIDs require proper health care in order to prevent further damage and improve their living and social conditions. This should be provided at the primary health care level, as patients suffering from NIDs are often unable to travel to or afford to pay for specialized care services. Care for patients suffering from chronic morbidity caused by NID should be integrated into care for other chronic conditions caused by non-communicable diseases. This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be u...sed mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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