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.