The prevalence of trachoma in preschool and school children in Olimpia, Guaraci and Cajobi, Sao Paulo, Brazil.

A school-based prevalence survey of trachoma was conducted in three rural municipalities in the state of Sao Paulo, Brazil, in 1989. A total of 950 children aged 4-11 years were examined. The prevalence of inflammatory trachoma was found to be 6.3%, peaking at 24.1% in the 4 year-old age group. The prevalence of trachomatous scarring was 2.7% and was more prevalent in older children. Risk factors included household sleeping arrangements and nasal discharge.

PIP: In December 1989, researchers gathered data on 950 4-11 year old children attending preschool or primary schools in the rural municipalities of Olimpia, Guaraci, and Cajobi in northwestern Sao Paulo State, Brazil to measure prevalence of active trachoma and to identify its risk factors. Overall prevalence of trachoma was 8.6%. Physicians treated all trachoma cases with topical 1% tetracycline twice daily for 6 weeks and examined them later at a local health care center. Prevalence of inflammatory trachoma stood at 6.3%. This was similar to its prevalence in an Olimpia's neighboring town called Bebedouro. Prevalence of trachomatous scarring was 2.7%. Thus the northwestern part of Sao Paulo state was an important focus of endemic trachoma infection. Inflammatory trachoma was highest among the 4 year olds (24.1%) and fell to 0 by age 11. On the other hand, trachomatous scarring was relatively rare in 4-5 year olds then increased to 7% in 10-11 year old children. In fact, the mean age for inflammatory trachoma was 6.6 years and for trachomatous scarring 8.5 years. Perhaps the recently implemented trachoma control activities in Olimpia explained the lowest prevalence of inflammatory trachoma (5.4%). Guaraci experienced the highest prevalence rate (9.6%), but did not have any cases of trachomatous scarring. Children who slept with others were significantly more likely to have inflammatory trachoma than were those who slept alone (p.005). Sleeping pattern was the only personal hygiene variable significantly associated with inflammatory trachoma. Not even face washing was significantly associated with it. The only clinical symptom significantly associated with inflammatory trachoma was nasal discharge (p.001). A considerable community-based epidemiological survey would qualify these results.

Epidemiology of trachoma in Bebedouro State of São Paulo, Brazil: prevalence and risk factors.

Trachoma was considered to have been 'eradicated' from the state of São Paulo, Brazil, until 1982 when a number of new cases of trachoma were reported in preschool children in Bebedouro, a small town in northwestern São Paulo. A household survey was undertaken to assess the prevalence and epidemiological characteristics of trachoma. A total of 2939 people of all ages was examined having been selected from a two-stage probalilistic household sampling frame based on census data. Overall, 7.2% of the population had evidence of one or more signs of trachoma and 2.1% had inflammatory trachoma. Inflammatory trachoma was more common in children aged one to ten years, especially in the peripheral urban and rural areas, and was more common in boys. The presence of chlamydia was confirmed by direct fluorescent antibody cytology. No cases of blindness due to trachoma were seen. A number of socioeconomic and hygiene variables were studied in order to determine the independent risk factors for trachoma in a household. Variables significantly associated with the occurrence of trachoma in the household were the number of children in the house aged one to ten years, the 'per capita' water consumption, the frequency of garbage collections, source of water, and the educational level of the head of household. Clustering of trachoma in different parts of this community was entirely explained by the concentration of households with these characteristics.