Population Prevalence of Trachoma in Nine Rural Non-Indigenous Evaluation Units of Brazil

• Published in: Ophthalmic epidemiology Vol. ahead-of-print; no. ahead-of-print; pp. 1 - 10
• Main Authors: Szwarcwald, Célia Landmann, Lopes, Maria de Fátima Costa, Borges de Souza Junior, Paulo Roberto, Vaz Ferreira Gómez, Daniela, Luna, Expedito José de Albuquerque, da Silva de Almeida, Wanessa, Damacena, Giseli Nogueira, Ribeiro Favacho, Joana da Felidade, Germano de Frias, Paulo, Butcher, Robert, Boyd, Sarah, Bakhtiari, Ana, Willis, Rebecca, Jimenez, Cristina, Harding-Esch, Emma, Saboyá-Díaz, Martha Idalí, Solomon, Anthony W.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.12.2023
• Subjects: Brazil; Brazil - epidemiology; Child; Cross-Sectional Studies; elimination; Humans; Infant; neglected tropical diseases; Prevalence; Public Health; Trachoma; Trachoma - epidemiology; trichiasis; Trichiasis - epidemiology; Tropical Data; WASH; Brazil; prevalence; Tropical Data; neglected tropical diseases; WASH; trichiasis; Brazil; Trachoma; elimination
• ISSN: 0928-6586; 1744-5086
• DOI: 10.1080/09286586.2021.1941127

Purpose : To assess the contemporary prevalence of trachoma in Brazil's non-indigenous population, surveys of those thought to be at greatest risk of disease were conducted. Methods : Rural census tracts of non-indigenous population from nine mesoregions were selected to compose the survey evaluation units (EUs) by considering previously endemic municipalities at greatest risk of trachoma. In each of the nine EUs, we conducted a population-based prevalence survey. Every resident of selected households aged 1 year was examined for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT). Additionally, data were collected on household-level access to water, sanitation, hygiene (WASH) and education. Results : A total of 27,962 individuals were examined across nine EUs. The age-adjusted TF prevalence in 1-9-year-olds was <5% in each EU. The age- and gender-adjusted prevalence of TT unknown to the health system in ≥15-year-olds was <0.2% in eight EUs; in one EU, it was 0.22%. The median number of households surveyed per EU with access to an improved drinking water source within a 30-minute roundtrip of the house was 66%. School attendance was >99% of surveyed children. Conclusions : The prevalence of TF was well below the target for elimination as a public health problem in all EUs. Because EUs surveyed were selected to represent the highest-risk non-indigenous areas of the country, TF prevalence is unlikely to be ≥5% in non-indigenous populations elsewhere. In one EU, the prevalence of TT was above the target threshold for elimination. Further investigation and possibly improvement in TT surgical provision are required in that EU.