Elimination of Trachoma as cause of blindness in Itapevi, State of São Paulo, Brazil

INTRODUCTION:  Trachoma is a chronic inflammatory disease that affects the eye’s conjunctive and cornea, with recurrent evolution. Its etiological agent is the bacteria Chlamydia trachomatis. The World Health Organization (WHO) has set the year 2020 as the target for global elimination of trachoma as a public health problem. To reach this target, the SAFE strategy (Surgery for trichiasis, Antibiotics to treat the infection, Facial cleanliness and Environmental improvement to reduce transmission. This study was carried out to assess the extension and distribution of trachoma in Itapevi, SP in order to get the trachoma elimination certification. 

METHODS:  Itapevi is a city of 205,877 inhabitants and is located in the greater São Paulo, state of São Paulo. A representative sample of children 1 to 9 years old was selected in census areas where there were houses with a per capita income average of ¼ of the Brazilian minimal wage, using a probabilistic household sampling procedure. The external ocular examination with a 2.5X magnifying glass, according to WHO criteria was performed in the households with children 1 to 9 years old and their relatives. A variety of socioeconomic and hygiene variables were studied in order to determine the risk factors for active trachoma in a household.  

RESULTS: A total of 7.221 people and 2.354 children 1 to 9 years old were examined. The trachoma prevalence was 1%, being 98.6% of inflammatory follicular trachoma (TF) and 1.4% of cicatricial trachoma (TS) and no trachomatous  trichiasis were found.   

CONCLUSIONS: The prevalence of active trachoma was less than 5% in children 1 to 9 years old, showing that trachoma is not a cause of blindness and is not a public health problem in Itapevi, SP, Brazil.