ObjectiveTo 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 aged four to 14 years old were selected by a cluster sampling in which school shift was the sampling unit. External eye examination was conducted to detect clinical signs of 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.
In Brazil, trachoma appears to be a serious public health problem in indigenous settlements, which should therefore be given priority in programs aimed at the elimination of trachoma in the country.
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.
Human resources, technical expertise, and equipment are crucial to reach the WHO goal. Brazil has enough ophthalmologists but needs improved planning and infrastructure in order to eliminate the problem, aspects that require greater financial investment and stronger political commitment.
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