Norma Helen Medina
Sanitary Ophthalmology Center, Brazil
Title: The elimination of trachoma as a public health problem, state of Sao Paulo, Brazil
Biography
Biography: Norma Helen Medina
Abstract
In State of São Paulo, Brazil the prevalence trachoma in the last school survey was 3.8%. The World Health Organization (WHO) has set the global elimination of trachoma, aiming a prevalence of trachomatous inflammation-follicular (TF) in children aged 1–9 years of < 5%, by 2020. Two strategies are used to verify the elimination: a trachoma census, in the municipalities with <2.000 children 1 and 9 years of age, and household survey using a random sample targeting the poorest census tracks, with the mean per capita income below ¼ of the Brazilian minimum wage, in the larger cities. Trachoma cases diagnosed are notified, treated and re-examined twice, in six-month intervals. The interim results of the progress towards elimination is: trachoma censuses were conducted in 68 municipalities, and prevalence survey conducted in Itapevi and Francisco Morato, municipalities of São Paulo metropolitan area, with a population of 223,408 and 168,234 respectively. In these a two stage cluster sample frame was used to select a sample of 2,400 children in each; the ocular examination with a 2.5X glass, according to WHO criteria. Among children 1 and 9 years of age, trachoma prevalence was 1.5% (79/5393). In the 1 to 9 age group, the prevalence was 1.2% among boys, and 1.7% among girls (χ2=1.73; p=0.19). The prevalence was in Francisco Morato (1.3%) and in Itapevi (1.0%). In trachoma censuses the examined children were 42,276 and a prevalence of TF (475-1.1%). The São Paulo state trachoma elimination plan is being implemented; currently three surveys are being conducted, with the objective to assess the extension and distribution of trachoma, in order to implement the control activities for the elimination as a public health problem. After the elimination, epidemiological surveillance for TF prevalence should be conducted in high risk communities.