Prevalence of trachoma in Brazilian schoolchildren

Maria de Fátima Costa Lopes Expedito José de Albuquerque Luna Norma Helen Medina Maria Regina Alves Cardoso Helen Selma de Abreu Freitas Inês Kazue Koizumi Neusa Aparecida Ferreira Alves Bernardes José Alfredo Guimarães About the authors

OBJECTIVE:

To estimate the prevalence and describe the distribution of trachoma among schoolchildren in Brazilian municipalities.

METHODS:

Cross-sectional study, using cluster sampling, of the schoolchildren population of the Brazilian municipalities with Human Development Index - Municipal lower than the national average. This trachoma prevalence survey was conducted by the Ministry of Health, in the period 2002-2007. There were 119,531 schoolchildren selected from 2,270 schools located in 1,156 municipalities. The selected schoolchildren underwent an external ocular examination, with a magnifying glass (2.5X), to detect clinical signs of trachoma according to the WHO criteria. The prevalence of trachoma, by state and national level, and their respective 95% confidence intervals were estimated. Chi-square and Chi-square for trends tests were used to compare categorical variables.

RESULTS:

There were 6,030 cases of trachoma detected, resulting in a prevalence of 5.0% (95%CI 4.5;5.4). There was no significant difference between the sexes. The prevalence of trachoma was 8.2% among children under 5 years of age, decreasing among higher age groups (p < 0.01). There was a significant difference in prevalence between urban and rural areas, 4.3% versus 6.2% respectively (p < 0.01). Cases were detected in 901 municipalities (77.7% of the sample), in all regions of the country. In 36.8% of the selected municipalities, the prevalence was higher than 5%.

CONCLUSIONS:

The study shows that trachoma is a significant public health problem in Brazil, contradicting the belief that the disease had been controlled in the country. The survey provides a baseline for evaluating planned interventions aimed at achieving the goal of global certification of elimination of trachoma as a cause of blindness in Brazil by 2020.

Child; Trachoma, epidemiology; Cross-Sectional Studies; Epidemiological Surveillance


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