ABSTRACT
PURPOSE: To estimate the prevalence and severity of trachoma among preschool children and to identify the risk factors. METHODS: Cross-sectional study involving preschool children up to seven years of age residing in a neighborhood of the city of São Paulo, Brazil. RESULTS: A total of 1128 children were studied. Although most were of low socioeconomic status, access to good sanitary services was virtually universal. The prevalence of inflammatory trachoma was 4.7%. In the bivariate analysis, being 4-7 years of age and having classroom contact with a trachoma case were associated with the disease. Multivariate logistic regression showed that contact with trachoma in the classroom was an independent predictor of trachoma. CONCLUSIONS: Trachoma persists among children in low-income families, even in urban areas with good sanitation. To eliminate trachoma in a low endemic community, a sensitive surveillance system should be implemented to identify residual sources of infection.
Subject(s)
Trachoma/epidemiology , Urban Population , Brazil/epidemiology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Prevalence , Prognosis , Retrospective Studies , Risk Factors , Socioeconomic FactorsABSTRACT
OBJECTIVE: To assess the prevalence of trachoma among preschool and school children of public schools to give new focus to control programs. METHODS: An epidemiological survey was carried out in São Paulo City in 1999. Children between four and 14 years old were selected by a cluster sampling where school shift was the sampling unit. External eye examination was conducted to detect trachoma. RESULTS: A total of 27,091 children were examined and 597 cases of trachoma were found (2.2%; 95% CI: 1.86-2.55). The prevalence ranged from 0.4% to 4.2% in 10 city areas. The trachoma detection rate in the household contacts examined was 8.7%. Follicular trachoma was found in 99% of the cases and intense trachoma in 1.0%. It was observed that 21.8% of the cases were asymptomatic. CONCLUSIONS: Though the trachoma prevalence was low, the occurrence of severe cases points out to the likelihood of cicatricial trachoma cases in the future if they are not adequately treated and controlled. The great difference in the prevalences in different city areas indicates the need for strengthening epidemiological surveillance activities.
Subject(s)
Trachoma/epidemiology , Adolescent , Brazil/epidemiology , Child , Child, Preschool , Female , Humans , Male , Population Surveillance , Prevalence , Severity of Illness Index , Socioeconomic Factors , Trachoma/diagnosisABSTRACT
OBJETIVO: Conhecer a prevalência de tracoma em pré-escolares e escolares das escolas públicas para redirecionar as atividades de seu controle. MÉTODOS: Realizou-se inquérito epidemiológico no Município de São Paulo, em 1999. A seleção das crianças com idade entre quatro e 14 anos foi feita por meio de amostragem por conglomerados, sendo o turno de estudo a unidade amostral. Foi realizado exame ocular externo para detectar a presença de sinais clínicos de tracoma. RESULTADOS: Das 27.091 crianças examinadas foram diagnosticados 597 casos de tracoma (2,2 por cento; IC 95 por cento: 1,86-2,55). A prevalência variou de 0,4 por cento a 4,2 por cento entre as 10 regiões do Município de São Paulo. A taxa de detecção entre os comunicantes foi de 8,7 por cento. Tracoma folicular foi encontrado em 99,0 por cento dos casos e tracoma intenso em 1,0 por cento dos casos. Verificou-se que 22,5 por cento dos casos eram assintomáticos. CONCLUSÕES: Embora a prevalência tenha sido baixa, a presença de formas graves aponta para a possibilidade da existência de casos cicatriciais no futuro, se não houver tratamento e controle adequado. A grande diferença entre as taxas encontradas para cada uma das regiões da cidade, indica a necessidade de intensificação das ações de vigilância epidemiológica do tracoma.
