@article{102525,
  keywords = {Brazil, Elimination, Sanitation, Survey, Trachoma, Trichiasis},
  author = {Szwarcwald CL and Lopes MDFC and de Souza Junior PRB and Gómez DVF and Luna EJDA and de Almeida WDS and Damacena GN and Favacho JDFR and Medina NH and Franco Filho LC and Cogo A and Boyd S and Bakhtiari A and Jimenez C and Talero SL and Saboyá-Díaz MI and Solomon AW and Harding-Esch E},
  title = {Trachoma prevalence surveys in 15 indigenous and non-indigenous evaluation units in Brazil, 2018–2023},
  abstract = {<p><strong>Background</strong> 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.</p>

<p><strong>Methods</strong> 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.</p>

<p><strong>Results</strong> 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, &amp;gt;10% of households had no sanitary facilities and high percentages of open defecation.</p>

<p><strong>Conclusions</strong> 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.</p>
},
  year = {2025},
  journal = {International Health},
  pages = {1-9},
  publisher = {Oxford University Press (OUP)},
  issn = {1876-3413, 1876-3405},
  url = {https://watermark.silverchair.com/ihaf067.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAA3cwggNzBgkqhkiG9w0BBwagggNkMIIDYAIBADCCA1kGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMT5XG4Xs-KhjI2GR2AgEQgIIDKulaHl5LpFO2rXOoL3R-XHsPKNrb8cJUB6U9Ehk4cxxwzmN},
  doi = {10.1093/inthealth/ihaf067},
  language = {eng},
}