Problematic use of the internet as a predictor of oral health-related quality of life: the mediating role of lifestyles in Peruvian schoolchildren.

BACKGROUND: The pervasiveness of the Internet in everyday life, especially among young people, has raised concerns about its effects on mental health, education, and, recently, oral health. Previous research has suggested a complex relationship between Problematic Internet Use (PIU), lifestyles, and oral health-related quality of life, highlighting the need to examine these interactions further. This study seeks to explore the PIU as a predictor of oral health-related quality of life and examine the mediating role of lifestyles between both in a sample of Peruvian schoolchildren. METHODS: A cross-sectional study was carried out with 293 Peruvian students aged 12 to 17 years (M = 14.42, SD = 1.5), using structural equations to analyze the relationship between PIU, lifestyles, and quality of life related to oral health. The data collection procedure was through a face-to-face survey. Validated instruments measured PIU, lifestyles, and oral health-related quality of life. The study's theoretical model was analyzed through structural equation modeling with the MLR estimator. The fit assessment was performed using the comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR). RESULTS: They indicated significant correlations between PIU, lifestyles, and oral health-related quality of life. A negative influence of PIU on lifestyles (ß = -0.30, p < .001) and on oral health-related quality of life (ß = -0.35, p < .001) was observed, as well as a positive relationship between PIU and oral health-related quality of life (ß = 0.29, p < .001). The mediation of lifestyles was statistically significant, suggesting that they mediate the relationship between PIU and oral health-related quality of life. CONCLUSIONS: The study confirms that PIU can negatively affect adolescents' oral health-related quality of life, mediated by unhealthy lifestyles. It underlines the importance of promoting balanced Internet use and healthy lifestyles among young people to improve their oral well-being.

Gut microbial composition and functionality of school-age Mexican population with metabolic syndrome and type-2 diabetes mellitus using shotgun metagenomic sequencing.

Gut metagenome in pediatric subjects with metabolic syndrome (MetS) and type-2 diabetes mellitus (T2DM) has been poorly studied, despite an alarming worldwide increase in the prevalence and incidence of obesity and MetS within this population. The objective of this study was to characterize the gut microbiome taxonomic composition of Mexican pediatric subjects with MetS and T2DM using shotgun metagenomics and analyze the potential relationship with metabolic changes and proinflammatory effects. Paired-end reads of fecal DNA samples were obtained through the Illumina HiSeq X Platform. Statistical analyses and correlational studies were conducted using gut microbiome data and metadata from all individuals. Gut microbial dysbiosis was observed in MetS and T2DM children compared to healthy subjects, which was characterized by an increase in facultative anaerobes (i.e., enteric and lactic acid bacteria) and a decrease in strict anaerobes (i.e., Erysipelatoclostridium, Shaalia, and Actinomyces genera). This may cause a loss of gut hypoxic environment, increased gut microbial nitrogen metabolism, and higher production of pathogen-associated molecular patterns. These metabolic changes may trigger the activation of proinflammatory activity and impair the host's intermediate metabolism, leading to a possible progression of the characteristic risk factors of MetS and T2DM, such as insulin resistance, dyslipidemia, and an increased abdominal circumference. Furthermore, specific viruses (Jiaodavirus genus and Inoviridae family) showed positive correlations with proinflammatory cytokines involved in these metabolic diseases. This study provides novel evidence for the characterization of MetS and T2DM pediatric subjects in which the whole gut microbial composition has been characterized. Additionally, it describes specific gut microorganisms with functional changes that may influence the onset of relevant health risk factors.

Ultra-Processed Food Consumption Is Related to Higher Trans Fatty Acids, Sugar Intake, and Micronutrient-Impaired Status in Schoolchildren of Bahia, Brazil.

Ultra-processed food (UPF) consumption impacts nutrient intake and plays an important role in non-communicable diseases (NCD), even among schoolchildren. This cross-sectional study aimed to characterize the food consumption of this population and its relationship with laboratory and anthropometric aspects. A sample of 190 subjects aged 5 to 19 y was randomly selected for dietary, laboratory, and anthropometric assessment. Statistical inference was calculated using Spearman's correlation. Excess weight was observed in 34%, a high Waist-to-Height Ratio in 9%, and hypertriglyceridemia in 17% of the subjects, higher among those from urban schools (45%, p = 0.011; 15%, p = 0.015; 24%, p = 0.026, respectively). UPF consumption represented 21% of caloric intake and showed a positive correlation with trans fatty acids (r = 0.70) and sugar (r = 0.59) intake. Unprocessed food consumption showed a weak, but significant, correlation with Body Mass Index (r = 0.22) and Waist Circumference (r = 0.23), while processed meat showed a negative correlation with serum ferritin (r = -0.16) and vitamins D (r = -0.20) and B12 (r = -0.15). These findings highlight the need for public policies to promote Food and Nutritional Security for schoolchildren to prevent NCD and nutritional deficiencies.

Self-efficacy and Social Settings Matter for Fostering Healthy Eating in Mexican Schoolchildren.

OBJECTIVE: To identify differences in schoolchildren's self-efficacy for eating behaviors across social settings and self-efficacy sources favoring healthy and unhealthy eating. DESIGN: A cross-sectional, mixed-methods study using self-efficacy and demographic surveys, focus groups, and school environment semistructured observations. SETTING: Morelos, Mexico, Cuernavaca City school district, public elementary schools in the National School Lunch Program. PARTICIPANTS AND RECRUITMENT: We studied 274 fifth- and sixth-grade children from 8 elementary schools during the 2016-2017 school year. VARIABLES MEASURED: Children's self-efficacy for healthy and unhealthy eating across 3 settings (school cafeteria, recess, and home). Children's perceptions about sources of self-efficacy, which favor their healthy or unhealthy eating (performance accomplishments, behavior modeling, verbal persuasion, and emotional or physiological states). Sociodemographic information was obtained from parents. ANALYSIS: We performed a variance components analysis with school and students within schools as random effects with paired t tests (quantitative data) and content analysis on the basis of the Social Cognitive Theory (qualitative data). RESULTS: Schoolchildren's self-efficacy for healthy eating differed across social settings, being greater in the school cafeteria than at recess or home, except for drinking water. On average, self-efficacy for unhealthy eating was lower in the cafeteria than in other studied settings. Performance achievements and behavior modeling were key sources of self-efficacy for healthy and unhealthy eating. CONCLUSION AND IMPLICATIONS: Sources of self-efficacy and social settings matter to understanding schoolchildren's healthy and unhealthy eating. Future interventions might consider developing collective efficacy among the school community and boosting children's participation in home meal planning. Further research could explore locus of control and other intrapersonal dimensions influencing self-efficacy.

An assessment of school kiosks in Chimbote (Peru) to curb obesity. / Evaluación de kioscos escolares en Chimbote (Perú) en el control de obesidad en la edad escolar.

School kiosks are spaces where food is provided to preschool and school-age students. Sanitary control of products can help curb and reduce obesity in this study population. We determined compliance and regularity of the evaluation of school kiosks in general and by Regular Elementary Education Institutions in an area of Peru. We performed a secondary cross-sectional analysis of the database of biannual evaluations of school kiosks conducted by the North Pacific Health Network. The main response variables were (a) level of compliance, categorized in Initial (I), In-Process (P), Healthy Kiosk (KS), and Outstanding Healthy Kiosk (KSD). We assigned values from 1 = I to 4 = KSD and assessed the regularity of assessment (schools visited in either semester 1 or 2 or visited in both semesters). The study population consisted of 31 (47.7%) schools out of a total of 65. KS level was reached by 29.1% of the preschool facilities, while 40% of kindergarten/elementary kiosks reached the KS level. Regarding regularity of assessments, 54.8% of kiosks were evaluated in both semesters. All strategic actors of the Ministry of Health and Education must become involved in promoting and facilitating the attainment of the health goals by increasing the number of healthy or featured school kiosks.

Los kioscos escolares son espacios donde se ofrecen alimentos a los alumnos de los niveles preescolar y escolar. Un control sanitario y de productos ofertados puede ayudar a controlar y reducir el riesgo de sobrepeso y obesidad en esta población de estudio. Se determinó el nivel de logro y cumplimento en la periodicidad de la evaluación de los kioscos escolares en general, y por tipo de Instituciones de Educación Básica Regular en una zona de Perú. Se realizó un análisis secundario de corte transversal de la base de datos de evaluaciones semestrales del nivel de logro de los kioscos escolares de las Instituciones de Educación Básica Regular efectuadas por la Red de Salud Pacífico Norte. Las principales variables fueron: nivel de logro, categorizado en inicio (I), proceso (P), kiosco saludable (KS) y kiosco saludable destacado (KSD). Se asignaron valores de 1 = I hasta 4 = KSD y periodicidad de evaluación, caracterizada en (i) semestre 1 o 2, que fueron visitados entre enero y junio o julio y diciembre, y (ii) semestre 1 y 2, que fueron visitados en ambos semestres. Se evaluó a los kioscos de 31 colegios de un total de 65 Instituciones de Educación Básica Regular (47,7%). El 29,1% de las Instituciones de Educación Básica Regular alcanzó el nivel de kiosco saludable. Mientras que el 40% de los kioscos de establecimientos de educación inicial y primaria llegaron al nivel de kiosco saludable. En relación con la periodicidad de evaluación, el 54,8% de kioscos fueron evaluados en ambos semestres. Es necesario que todos los actores estratégicos de los Ministerios de Salud y Educación se involucren para el logro de los objetivos de la directiva sanitaria, a fin de aumentar el porcentaje de kioscos escolares saludables y/o kioscos escolares saludables destacados.

Perception about barriers and facilitators of the school-based HPV vaccine program of Manizales, Colombia: A qualitative study in school-enrolled girls and their parents.

In 2012, Colombia implemented a school-based HPV vaccination program of a 3-dose series for nine year old girls. Following a mass psychogenic response after vaccination in a Colombian town, vaccination rates dropped from 80% in 2012-2013 to 5% in 2016. The study aimed to identify barriers and facilitators of HPV vaccine uptake among girls eligible for vaccination in the initial years of vaccine implementation from 2012 to 2014, and their parents. We conducted 19 individual qualitative interviews and 18 focus groups with an average of 5 girls, in Manizales, Colombia between 2016 and 2017. In total, 49 girls from six schools and 58 of their parents participated in the study. Participants had some degree of awareness about cervical cancer, especially among those of middle and upper socioeconomic level. However, the vaccine was known as a prevention measure only after pap-smears and condoms. The main facilitator for vaccine uptake for parents was the desire to prevent diseases in general and for girls, it was facilitated by receiving positive information about the vaccine. The main barriers for vaccine uptake or for three doses completion were the event in Carmen de Bolivar, fear of adverse effects and fear of needles. Girls and parents stated that they received little or no information from schools or health care services about the HPV vaccine prior to vaccination. Our results suggest that improving HPV vaccination rates in Colombia will require a comprehensive education program including mass media information about HPV vaccine.

Impact of anthropometric nutritional parameters on the university selection test in Chile: A multifactorial approach.

OBJECTIVES: Scholastic achievement (SA) is a multifactorial problem that depends on factors related to the child, the child's family, and the educational system. The aim of this study was to quantify the relative impact of significant variables at the beginning of high school during 2010 (first grade of high school [1 HSG]) on 2013 university selection test (Prueba de Seleccion Universitaria [PSU]) outcomes, both in language scholastic achievement (LSA) and mathematics scholastic achievement (MSA), when students graduated from high school (4 HSG). This was done at the time of university admission with a multicausal approach. The purpose was to confirm the hypothesis that the level of educational establishment SA, intellectual ability, sex, parental schooling levels, and head circumference for age Z-score at the onset of high school are the most relevant parameters associated with 2013 PSU outcomes, both in LSA and MSA. METHODS: A representative, proportional, and stratified sample of 671 children of both sexes who enrolled in 1 HSG in 2010 (mean age: 14.8 ± 0.6 y) participated in the study. Nutritional, intellectual, brain developmental, cardiovascular risk, socio-to-economic, demographic, and educational variables were quantitated. SA was assessed at 4 HSG with the 2013 PSU tests. Data were analyzed with SAS software. RESULTS: Educational establishment SA, intellectual ability, maternal schooling, and age Z-score were the most relevant parameters to explain LSA (R2 = 0.493; P < 0.0001) and MSA variance in addition to sex (male), but only in MSA (R2 = 0.600; P < 0.0001). CONCLUSIONS: These findings confirm the hypothesis and can be useful to support nutritional, health, and educational planning.

Physical activity in the classroom to prevent childhood obesity: a pilot study in Santiago, Chile.

This paper describes a 4-month pilot study that tested the suitability of a physical activity intervention for first graders (children aged 6 and 7 years) in a public school in Santiago, Chile. Teachers were trained to deliver the programme in the classroom during the school day. Teachers were surveyed to determine if this intervention fit within their curriculum and classroom routines and they reported in a focus group that it was suitable for them. All children actively participated in the programme and positive changes in their attitudes towards physical activity were observed by their teachers. Anthropometrics, blood pressure and hand grip strength were measured in the students. A significant reduction was observed in children with high waist circumference ≥ 90th percentile, and in mean systolic blood pressure. However, statistical power values for those comparisons were rather low. Anthropometry and hand grip strength were not modified. The latter calculations and the lack of a control group are showing the weaknesses of this pilot study and that further research with a larger sample size and an experimental design is strongly needed.

¿Bebés en las escuelas? infancias hiperescolarizadas en una cultura prefigurativa / Babies at school? hyper schooling of infancy in a prefigurative culture / Bebês nas escolas? Infâncias “hiperescolarizadas” numa cultura pré-figurativa

(descriptivo): Desde hace más de una década, se observa en la Ciudad de Buenos Aires un notorio crecimiento de la población de niños y niñas de edades entre 0 a 3 años, con escolarización. En este estudio aportamos evidencia estadística corroborando un relevante incremento de las vacantes disponibles, la privatización de la matrícula y la persistencia de una elevada demanda insatisfecha. Proponemos un andamiaje conceptual para contribuir a responder una pregunta central: ¿cuáles son los cambios culturales y demográficos que están implícitos en el reclamo por más bebés con escolarización? Centramos el estudio en este proceso como emergente de un cambio de época, con nuevas concepciones de infancia y adultez. Por medio del concepto cultura prefigurativa, de Margaret Mead, arriesgamos algunas hipótesis sobre el deterioro del valor del sacrificio adulto‒paterno.

(descriptive): In the City of Buenos Aires, there has been important growth inpreschool enrollment for over a decade. The empirical data evidences a significant increase inenrollment, the privatization of preschool education and the prevalence of unsatisfied demand: Whatcultural and demographic changes underlie the general demand that more babies should go to school?The emergence of a new era starting with a change in thinking, and a new conceptualization ofchildhood and adulthood is proposed. Through Margaret Mead’s concept of “prefigurative culture”,we hypothesize the devaluation of the adult‒parental sacrifice.

(descritivo): Nos últimos dez anos, o aumento de crianças escolarizadas em seusprimeiros anos de vida cresceu muito na cidade de Buenos Aires. Este estudo traz estatísticasque provam o aumento do número de vagas, a privatização da matrícula e a persistente demandainsatisfeita. Com esses dados, a proposta é desvendar o conceito que contribui a responder umaquestão central: Quais são as mudanças culturais e demográficas que ficam por trás das discussõesque reclamam por mais e mais bebés na escola? Propõe‒se a emergência de uma nova época, comconcepções diferentes da infância e da vida adulta. Através do conceito de “cultura pré‒figurativa”de Margaret Mead, os autores arriscam a hipótese da deterioração do valor do sacrifício adulto‒paterno o que torna o ingresso na educação infantil cada vez mais cedo.

Peso de nacimiento y posterior estado nutricional, desarrollo cognitivo y actividad ocupacional: una revisión crítica / Birth weight and later nutritional status, cognitive development and job status: a critical review

El impacto del estado nutricional prenatal, especialmente lo concerniente al peso de nacimiento (PN) y sus efectos tanto en el corto, mediano o largo plazo, sobre el estado nutricional y el desarrollo cognitivo del niño y, sobre la ocupación desempeñada en la vida adulta, ha sido una problemática de interés para diversos investigadores; al respecto, algunos autores encuentran una asociación positiva y significativa entre estas variables, mientras que otros no encuentran ninguna relación. Es así como se ha descrito que niños con PN insuficiente, bajo o, extremadamente bajo, además del deterioro temprano del estado nutricional, presentarían en el corto plazo, un mayor riesgo de daño en la maduración cerebral, retraso del desarrollo cognitivo y menores circunferencias craneanas, lo que implicaría menor volumen encefálico y bajo rendimiento intelectual. En el corto y mediano plazo, esta situación perjudicaría el proceso enseñanza-aprendizaje en la etapa escolar, mientras que en el largo plazo, esto condicionaría la ocupación a desempeñar en la vida adulta. Actualmente, el cuerpo de conocimientos pone de manifiesto que los hallazgos relativos a estas asociaciones no son concluyentes, existiendo gran controversia en estas materias. Este artículo de revisión tiene el propósito de analizar la evidencia existente hasta este momento, con el objeto de incentivar la investigación en estos aspectos que son de gran relevancia para el desarrollo del niño y su vida futura.

The impact of prenatal nutritional status, assessed through birth weight (BW) and their effects in the short, medium and long-term on nutritional status, cognitive development and job status in the adult life, has been a problem of interest for several researchers; as regards, some of these report a positive and significant association between these variables and others do not find any relation. Children with insufficient, low or very low BW despite the early more deteriorate nutritional status should present higher risk for brain maturation, failure cognitive development and lowered head circumference which implies both lowered brain volume and intellectual development. In the short and medium-term, this situation damages the learning process at school-age, while in the long-term this might condition the quality of jobs. At present, the body of knowledge pinpoints that findings related to these associations is not conclusive verifying a great controversy in these matters. This review article has the purpose of analyzing the current evidence, in order to stimulate research about to these aspects which are relevant for child development and their future life.

Family size, schooling and child labor in Peru -- an empirical analysis.

PIP: Many children in developing countries work outside of school regardless of their school enrollment status. Such work in itself is not damaging to children, but the conditions in which children work may be of concern. However, prohibiting child labor without first raising the income of the poor will create an even worse situation, forcing even more children into poverty. In addition to poverty, family size is thought to be a determining factor in the decision to enrol in school. That is, the larger the family, the lower the probability that a child is in school. The authors investigated children's work activities and schooling performance using data from the 1991 Peru Living Standards Survey (PLSS). Ethnic characteristics of the population are considered, as are aspects of the family, including its size, and the age structure and activities of the child's siblings. The analysis produces evidence of the importance of family size and the importance of considering siblings' activities. The number of siblings not enrolled in school is an important control variable in at least one specification of the empirical model. More research is needed on the interactions between siblings, their activities, and their age structure. Having a greater number of younger siblings implies less schooling, more age-grade distortion in the classroom, and more child labor.^ieng

Fetal growth and cardiovascular risk factors in Jamaican schoolchildren.

OBJECTIVE: To determine relation between schoolchildren's blood pressure, glycated haemoglobin level, and cholesterol concentration and their anthropometry, socioeconomic status, and birth measurements. DESIGN: Retrospective cohort study. SETTING: 27 schools closest to University Hospital of the West Indies, Kingston, Jamaica. SUBJECTS: 2337 children aged 6-16 years who were born at university hospital were recruited, and their birth records were recovered: 1610 had suitable records, 659 had records including birth length, and 610 of these were prepubertal. MAIN OUTCOME MEASURES: Blood pressure, glycated haemoglobin level, serum cholesterol concentration, anthropometry at birth, current anthropometry, and socioeconomic status. RESULTS: Multiple regression analysis showed that children's systolic blood pressure was inversely related to their birth weight (P < 0.0001) and directly related to their current weight. Glycated haemoglobin level was higher in children with thicker triceps skinfolds (P < 0.001) and who had been shorter at birth (P = 0.003). Serum cholesterol concentration was inversely related to current height (P = 0.001) and to length at birth (P = 0.09) and was directly related to triceps skinfold thickness and higher socioeconomic status (P < 0.001). CONCLUSIONS: Blood pressure in childhood was inversely related to birth weight and directly to current weight. Glycaemic control and serum cholesterol were related to short length at birth, height deficit in childhood, and childhood obesity.

[Population and education. The educational situation in El Salvador]. / Poblacion y educacion. Situacion educativa en El Salvador.

PIP: Because the majority of El Salvador's population is young, the provision of educational services is a priority. The Ministry of Education reports that 1,028,877 students, of whom 51% were male, were enrolled in basic education courses in 1994. However, an estimated 1,600,000 children of school age were not enrolled. The country was able to offer educational services to only around 40% of school age youth. Many communities in El Salvador must share facilities. The case of 2 communities in Jocoaitique is not unusual: they share 4 teachers for 6 grades in 2 shifts, serving 270 children. The lives of rural children are difficult, and the costs of school for 4 or 5 children are beyond the reach of many rural families. Myths and taboos surrounding family planning in many regions of the country are an obstacle to solving the problem.^ieng

Positive "Vibes" in Jamaica: drama helps teens, parents and teachers discuss sexuality and AIDS.

PIP: The threat of sexually transmitted diseases (STD) and other sexual challenges facing young people are depicted with humor and creativity in Vibes in a World of Sexuality, a musical revue by the ASHE Caribbean Arts Ensemble, a Jamaican performing arts group of young people 8-19 years old. The Little People and Teen Players, another youth drama group, and ASHE have performed Vibes more than 100 times in 5 countries, reaching over 50,000 people. In the revue's allegorical world, strong sexual urges, jealousy, ignorance, disease, and guilt struggle to overcome the super safer sexual skills of self control, trust, knowledge, and communication. A series of skits and catchy songs show how these skills can influence the choices made by teenagers. The music is a mixture of pop, blues, and Afro-Caribbean rhythms. Catherine Brokenshire, the resident advisor for the AIDSCAP Project in Jamaica and the US Agency for International Development Mission in Jamaica, decided to support 60 Vibes performances in Jamaican schools, youth clubs, communities, and churches. 20 audience members were asked to fill out a questionnaire about STDs and their transmission before and after each performance to assess whether it had changed their knowledge or attitudes about sex and STDs. An analysis of 100 sets of the forms found a 20% increase in correct answers to these questions. Each performance is followed by a 15-minute question-and-answer period. The most common questions are about handling peer pressure, talking to parents about sex and dating, and obtaining condoms. AIDSCAP is supporting the development of a manual to help teachers lead discussions with students after they see Vibes. Educational materials are available at every performance with addresses and phone numbers for Jamaica AIDS Support, The Family Center, and the Ministry of Health's Helpline, where people can request more information or assistance.^ieng

Mexican agencies reach teenagers.

PIP: The Gente Joven project of the Mexican Foundation for Family Planning (MEXFAM) trains young volunteers in 19 cities to spread messages about sexually transmitted diseases and population growth to their peers. They also distribute condoms and spermicides. It also uses films and materials to spread its messages. The project would like to influence young men's behavior, but the Latin image of machismo poses a big challenge. It would like to become more responsible toward pregnancy prevention. About 50% of adolescents have sexual intercourse, but few use contraceptives resulting in a high adolescent pregnancy rate. Many of these pregnant teenagers choose not to marry. Adolescent pregnancy leads to girls leaving school, few marketable skills, and rearing children alone. Besides women who began childbearing as a teenager have 1.5 times more children than other women. Male involvement in pregnancy prevention should improve these statistics. As late as 1973, the Health Code banned promotion and sales of contraceptives, but by 1992 about 50% of women of reproductive age use contraceptives. The Center for the Orientation of Adolescents has organized 8 Young Men's Clubs in Mexico City to involve male teenagers more in family planning and to develop self-confidence. It uses a holistic approach to their development through discussions with their peers. A MEXFAM study shows that young men are not close with their fathers who tend to exude a machismo attitude, thus the young men do not have a role model for responsible sexual behavior. MEXFAM's work is cut out for them, however, since the same study indicates that 50% of the young men believe it is fine to have 1 girlfriend and 33% think women should earn more than men. A teenager volunteer reports, however, that more boys have been coming to him for contraception and information than girls in 1992 while in other years girls outnumbered the boys.^ieng

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.