International health · 2026
Trachoma prevalence surveys in 15 indigenous and non-indigenous evaluation units in Brazil, 2018-2023.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Szwarcwald Célia Landmann, Lopes Maria de Fátima Costa, de Souza Junior Paulo Roberto Borges, Gómez Daniela Vaz Ferreira, Luna Expedito José de Albuquerque, de Almeida Wanessa da Silva, Damacena Giseli Nogueira, Favacho Joana da Felicidade Ribeiro, Medina Norma Helen, Franco Filho Luciano Chaves, Cogo Aiara, Boyd Sarah, Bakhtiari Ana, Jimenez Cristina, Talero Sandra L, Saboyá-Díaz Martha Idalí, Solomon Anthony W, Harding-Esch Emma
Аннотация
BACKGROUND: To provide the groundwork for a future declaration of elimination of trachoma as a public health problem in Brazil, we conducted house-to-house surveys following WHO methodological guidance.
METHODS: An observational cross-sectional study was conducted in 10 non-indigenous and five indigenous evaluation units (EUs) from 2018 to 2023; data on six EUs are reported here for the first time. Two-stage cluster sampling was used: 30 clusters per EU, and 30 households per cluster. We estimated the prevalence of trachomatous inflammation-follicular (TF) in 1-9-y-olds and trachomatous trichiasis (TT) unknown to the health system in those aged ≥15 y. Data on sanitary conditions were collected in household interviews.
RESULTS: In all EUs, TF prevalence was below the elimination threshold (5%). TT prevalence was lower than the 0.2% threshold in 14 EUs. In 'Noroeste Cearense' mesoregion, TT prevalence was 0.22% (95% CI 0.06 to 0.44%), but statistical analysis showed a 58% likelihood of TT elimination in this EU. In three indigenous EUs, >10% of households had no sanitary facilities and high percentages of open defecation.
CONCLUSIONS: It is highly likely that trachoma has been eliminated as a public health problem in all the EUs surveyed. The findings on sanitary conditions mandate public policies to overcome socioenvironmental inequalities.
METHODS: An observational cross-sectional study was conducted in 10 non-indigenous and five indigenous evaluation units (EUs) from 2018 to 2023; data on six EUs are reported here for the first time. Two-stage cluster sampling was used: 30 clusters per EU, and 30 households per cluster. We estimated the prevalence of trachomatous inflammation-follicular (TF) in 1-9-y-olds and trachomatous trichiasis (TT) unknown to the health system in those aged ≥15 y. Data on sanitary conditions were collected in household interviews.
RESULTS: In all EUs, TF prevalence was below the elimination threshold (5%). TT prevalence was lower than the 0.2% threshold in 14 EUs. In 'Noroeste Cearense' mesoregion, TT prevalence was 0.22% (95% CI 0.06 to 0.44%), but statistical analysis showed a 58% likelihood of TT elimination in this EU. In three indigenous EUs, >10% of households had no sanitary facilities and high percentages of open defecation.
CONCLUSIONS: It is highly likely that trachoma has been eliminated as a public health problem in all the EUs surveyed. The findings on sanitary conditions mandate public policies to overcome socioenvironmental inequalities.