The campaign against trachoma in the Republic of Türkiye until the 1970s


Temel M. K.

in: Uluslar ve Alanlararası Bakışla Salgınlar Tarihi (History of Epidemics from International and Interdisciplinary Perspectives), Arın Namal,M. Kemal Temel,Ayşegül Erdemir,Bozena Płonka-Syroka,Burak Kazan, Editor, Platanus Publishing, Ankara, pp.93-102, 2023

  • Publication Type: Book Chapter / Chapter Vocational Book
  • Publication Date: 2023
  • Publisher: Platanus Publishing
  • City: Ankara
  • Page Numbers: pp.93-102
  • Editors: Arın Namal,M. Kemal Temel,Ayşegül Erdemir,Bozena Płonka-Syroka,Burak Kazan, Editor
  • Istanbul University Affiliated: Yes

Abstract

Introduction

 

Trachoma is a sight-threatening disease caused by ocular infection with Chlamydia trachomatis, strains of which also cause infections involving other parts of the human body, including urethritis, epididymitis cervicitis, salpingitis, lymphogranuloma venereum, and pelvic inflammatory disease. It can be spread by sexual contact, vertical transmission, and contact with fomites (contaminated objects) as well as with disease vectors, most notably the housefly. While the sexually transmitted C. trachomatis infections are generally referred to as chlamydia, the infection of the eye is termed as trachoma. The most common sexually transmitted bacterium, C. trachomatis is also the most common infectious cause of sight loss as an outcome of poorly treated trachoma (CDC, 2014; Nunes & Gomes, 2014).

 

Analyses found that the ocular strains of C. trachomatis diverged from the genital strains about two to five million years ago (Taylor, 2009). Also known as “Egyptian ophthalmia”, ocular chlamydial infection has a millennia-long history in the Middle Eastern territories surrounding Türkiye. The earliest records of the disease in the region date back to the Ebers papyrus from Egypt circa 1550 BCE, with the presence of even earlier findings in the remains of Egyptian mummies and cities of ancient Mesopotamia (Taylor, 2008; Temel, 2015; Temel, 2019). The later records include the descriptions found in Hippocratic, Alexandrian, and Roman writings from classical antiquity. With the Nile Basin having been a traditional hotbed of trachoma, the disease became rampant on the other side of the Mediterranean Sea in modernity, particularly the 19th century, as a result of military movements in the Napoleonic campaign in Egypt and wars across Europe.

 

Until only about a century ago, trachoma remained a widespread malady, against which there was no adequate remedy. Unlike preventive medicine, therapeutic interventions, both medical and surgical, generally failed to achieve satisfactory outcomes, let alone cure the disease. This began to change only after the preliminary use of antibacterial drugs derived from sulfonamides in the late 1930s, and more so after the clinical introduction of antibiotics in the late 1940s and the correct identification of the trachoma pathogen as a bacterium (and not a virus) in the late 1960s (Tower, 1963; Moulder, 1966; Feibel, 2011; Barış, Temel, & Ertin, 2020).

 

The campaign against trachoma in the Republic of Türkiye until the 1970s

 

The Turkish War of Independence, fought against the occupying Allied Powers of World War I (WWI) between May 1919 and July 1923, resulted in the abolition of the Ottoman Sultanate in November 1922 and, finally, establishment of the Republic of Türkiye in October 1923. From the mid-1920s to the late 1930s, a series of political, legal, sociocultural, and economic reforms were implemented under the leadership of Mustafa Kemal Atatürk, who also led the War of Independence before becoming the first president of the new, unitary country. In line with the revolutionary spirit of the period, national-scale programs were initiated also in the field of healthcare, to address problems that had long been plaguing the Turkish people, such as epidemic diseases. […]