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A detailed study was made of the prevalence and associations of trachoma in a prospective, randomised population based study of 9058 Palestinian Arabs living in the West Bank and Gaza Strip, and in a prospective study of 1,000 consecutive unselected ophthalmic outpatients at St John Ophthalmic Hospital, Jerusalem. Trachoma was found to be widely distributed throughout the two regions. This chiefly occurred as a mild, self limited disease, interspersed with discontinuous pockets of blinding disease. The highest prevalence was found in the Hebron and Jericho districts. Sub-populations at increased relative risk included females, older age groups, rural dwellers, patients with pre-disabling or disabling lesions, and patients with moderate to severe active trachoma. An increased recovery of bacteria by culture of the lids and conjunctiva of patients with moderate to severe trachoma was noted. Prevalences of lacrimal disease, dacryocystitis, and acute bacterial ulcer were significantly greater among outpatients with trachoma than among those without trachoma. No difference in prevalence of either mucopurulent conjunctivitis or herpetic dendritic keratitis was demonstrated between patients with and without trachoma. An increased prevalence of trachoma was found in communities without a continuous year-round supply of running water compared with communities with this facility.

Epidemiology of trachoma in the West Bank and Gaza Strip