Célia Landmann Szwarcwald, Maria de Fátima Costa Lopes, Paulo Roberto Borges de Souza Junior, Daniela Vaz Ferreira Gómez, Expedito José de Albuquerque Luna, Wanessa da Silva de Almeida, Giseli Nogueira Damacena, Joana da Felicidade Ribeiro Favacho, Norma Helen Medina, Luciano Chaves Franco Filho, Aiara Cogo, Sarah Boyd, Ana Bakhtiari, Cristina Jimenez, Sandra L Talero, Martha Idalí Saboyá-Díaz, Anthony W Solomon, Emma Harding-Esch
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引用次数: 0
摘要
背景：为了为今后宣布在巴西消除沙眼这一公共卫生问题奠定基础，我们按照世卫组织的方法指导进行了挨家挨户的调查。方法：2018 - 2023年在10个非土著和5个土著评价单位（EUs）进行了一项观察性横断面研究；本文首次报道了6例EUs的数据。采用两阶段整群抽样：每个欧盟30个整群，每个整群30户。我们估计了1-9岁儿童中沙眼性炎症-滤泡性（TF）的患病率，以及卫生系统未知的≥15岁儿童中沙眼性倒睫（TT）的患病率。卫生条件数据通过家庭访谈收集。结果：在所有EUs中，TF患病率低于消除阈值（5%）。14个地区的TT患病率低于0.2%的阈值。在挪威中部地区，TT患病率为0.22% (95% CI 0.06 - 0.44%)，但统计分析显示，该地区TT消除的可能性为58%。在三个土著欧盟中，10%的家庭没有卫生设施，露天排便的比例很高。结论：沙眼作为一种公共卫生问题很可能在所有接受调查的EUs中都已被消除。关于卫生条件的调查结果要求公共政策克服社会环境不平等。
Trachoma prevalence surveys in 15 indigenous and non-indigenous evaluation units in Brazil, 2018-2023.
Background: To provide the groundwork for a future declaration of elimination of trachoma as a public health problem in Brazil, we conducted house-to-house surveys following WHO methodological guidance.
Methods: An observational cross-sectional study was conducted in 10 non-indigenous and five indigenous evaluation units (EUs) from 2018 to 2023; data on six EUs are reported here for the first time. Two-stage cluster sampling was used: 30 clusters per EU, and 30 households per cluster. We estimated the prevalence of trachomatous inflammation-follicular (TF) in 1-9-y-olds and trachomatous trichiasis (TT) unknown to the health system in those aged ≥15 y. Data on sanitary conditions were collected in household interviews.
Results: In all EUs, TF prevalence was below the elimination threshold (5%). TT prevalence was lower than the 0.2% threshold in 14 EUs. In 'Noroeste Cearense' mesoregion, TT prevalence was 0.22% (95% CI 0.06 to 0.44%), but statistical analysis showed a 58% likelihood of TT elimination in this EU. In three indigenous EUs, >10% of households had no sanitary facilities and high percentages of open defecation.
Conclusions: It is highly likely that trachoma has been eliminated as a public health problem in all the EUs surveyed. The findings on sanitary conditions mandate public policies to overcome socioenvironmental inequalities.
期刊介绍：
International Health is an official journal of the Royal Society of Tropical Medicine and Hygiene. It publishes original, peer-reviewed articles and reviews on all aspects of global health including the social and economic aspects of communicable and non-communicable diseases, health systems research, policy and implementation, and the evaluation of disease control programmes and healthcare delivery solutions.
It aims to stimulate scientific and policy debate and provide a forum for analysis and opinion sharing for individuals and organisations engaged in all areas of global health.
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