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Year : 1960  |  Volume : 8  |  Issue : 4  |  Page : 103

Note on uneven distribution of trachoma among the hill people of the Punjab and different communities in southern India

Christian Medical Collage, Ludhiana, India

Date of Web Publication5-May-2008

Correspondence Address:
Victor C Rambo
Christian Medical Collage, Ludhiana
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Rambo VC. Note on uneven distribution of trachoma among the hill people of the Punjab and different communities in southern India. Indian J Ophthalmol 1960;8:103

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Rambo VC. Note on uneven distribution of trachoma among the hill people of the Punjab and different communities in southern India. Indian J Ophthalmol [serial online] 1960 [cited 2023 Dec 8];8:103. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1960/8/4/103/40676

On our Eye Camp trip to the Kulu Valley we confirmed our opinion that there was practically no trachoma among the hill people.

It was good to see so many eyes with no trace of trachoma; nice clear upper limbi with not even a little caul of covering extending down over the upper corneas. And there were those who had a physiological slight grey caul, and these were referred to the slit-lamp microscope to look for pannus. Child after child had no pannus, It was such a relief !

While in the Punjab plains one, two or three in a hundred would have clear corneas, in the Kulu Valley, Raison, Manali, conditions were quite reverse, two or three in a hundred among the people originating in the hills had visible grossly diagnosable trachoma while only 12 - 23 in a hundred had biomicroscopic evidence of pannus. There were those who had come up from the trachomatous plains who had trachoma, but these were mostly found in a non-active state. From this we determned that in the hlls not only was there less trachoma in the population but that if trachoma was present it was running a much milder course.

There is not in the hills the amount of dust and grit that is so common in the plains of the Punjab and other plac­es in India free from dust. This free­dom from dust can be a part of the reason for the low incidence of tra­choma.

Making enquiry I have found no reference in any publication to this happy state of relatively little tra­choma in the hills of the Punjab. MacCallan in his article "The Epidemiology of Trachoma" (Brit. J. of Ophthalmology, 15 : p.369, 1931) says : "Given the same social condi­tions there is not much difference between countries on the score of altitude". On enquiring from Doctor Tulsi Das; he answered : "Trachoma is not present in the hills and it is a very well known fact. During the recent discussions at Jaipur, in the meeting of the Trachoma Advisory Committee of the I.C.M.R., I pointed out that poverty was not a special attraction for trachoma. If poverty were the main or important factor, the people of the hilly areas like Kangra and Simla would all be suffer­ing from trachoma. But they are not."

In Vellore Madras State, it was quite common to observe that Brah­mans and Moslems almost exclusively have trachoma. In both of these groups "kajal" (a kind of mascara) could transmit the infection for both of these groups use it. Adults using kajal infect the young. In the cere­monies of infancy, "protecting against the evil eye" and for "good luck", these probably infected ointments are smeared over the eyes of infants, and thus could start the infection from very early infancy. But this is only a suggestion, for other groups of people use kajal but do not necessarily have trachoma. I found that the hill peopl­es, as a rule, do not use kajal.

The common use of soiled garments to wipe childrens' eyes, the pardah for women and insects which trouble eyes, are other possibilities of spreading in­fection, but do not throw light on why Moslems and Brahmans in the South are more likely to have trachoma than other groups.


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