02747nas a2200409   4500000000100000008004100001260003400042653001100076653001600087653001500103653001100118653001300129653001500142100001800157700001500175700002400190700001500214700001400229700001900243700001600262700001700278700001400295700002000309700001100329700001100340700001600351700001400367700001400381700002100395700001500416700001900431245010800450856026000558300000800818520148600826022002502312       2025                            d  bOxford University Press (OUP)10aBrazil10aElimination10aSanitation10aSurvey10aTrachoma10aTrichiasis1 aSzwarcwald CL1 aLopes MDFC1 ade Souza Junior PRB1 aGómez DVF1 aLuna EJDA1 ade Almeida WDS1 aDamacena GN1 aFavacho JDFR1 aMedina NH1 aFranco Filho LC1 aCogo A1 aBoyd S1 aBakhtiari A1 aJimenez C1 aTalero SL1 aSaboyá-Díaz MI1 aSolomon AW1 aHarding-Esch E00aTrachoma prevalence surveys in 15 indigenous and non-indigenous evaluation units in Brazil, 2018–2023  uhttps://watermark.silverchair.com/ihaf067.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAA3cwggNzBgkqhkiG9w0BBwagggNkMIIDYAIBADCCA1kGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMT5XG4Xs-KhjI2GR2AgEQgIIDKulaHl5LpFO2rXOoL3R-XHsPKNrb8cJUB6U9Ehk4cxxwzmN  a1-93 a<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>
  a1876-3413, 1876-3405