巴西罗赖马州在校学生沙眼调查。

Survey of Trachoma within school students in the state of Roraima, Brazil.

机构信息

Centro de Oftalmologia Sanitária, Centro de Vigilância Epidemiológica Prof Alexandre Vranjac, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde, São Paulo, Brazil.

出版信息

Ophthalmology. 2011 Oct;118(10):1938-43. doi: 10.1016/j.ophtha.2011.02.047.

DOI:10.1016/j.ophtha.2011.02.047

PMID:21684601

Abstract

PURPOSE

Trachoma, a blinding conjunctivitis, is the result of repeated infection with Chlamydia trachomatis. There are no recent data for the state of Roraima, Brazil, where it was thought that trachoma no longer existed. These data are derived from school children sampled in this state, with additional data collected from the contacts of children with trachoma.

DESIGN

A population-based cross-sectional study with random sampling of students in grades 1 through 4 of all public schools within municipalities where the human development index was less than the national average in 2003. The sample was stratified according to population size.

PARTICIPANTS

A sample size of 7200 was determined and a total of 6986 (93%) students were examined, along with an additional 2152 contacts.

METHODS

All students were examined for trachoma according to World Health Organization criteria. Demographic data and contact information also was collected. The family and school contacts of students with trachoma then were located and examined.

MAIN OUTCOME MEASURES

Prevalence and grade of trachoma, age, gender, race, and municipality location.

RESULTS

The overall prevalence of trachoma was 4.5% (95% confidence interval [CI], 3.7%-5.3%), but there were municipalities within the state where the prevalence of inflammatory trachoma was more than 10%. The prevalence was greater in rural areas (4.9%; 95% CI, 3.7%-6.0%) compared with urban areas (3.9%; 95% CI, 2.9%-4.9%). Living in indigenous communities was associated with trachoma (odds ratio, 1.6; 95% CI, 0.9-2.6). An additional 2152 contacts were examined, and the overall trachoma prevalence was 9.3% (95% CI, 8.1-10.5).

CONCLUSIONS

Trachoma continues to exist in Roraima, Brazil, where there are municipalities with a significant prevalence of disease. The indigenous population is highly mobile, crossing state and international borders, raising the possibility of trachoma in neighboring countries. Trachoma prevalence among the contacts of students with trachoma was higher than the school population, highlighting the importance of contact tracing.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

沙眼是一种致盲性结膜炎，由沙眼衣原体反复感染引起。巴西罗赖马州之前没有最近的数据，此前人们认为该州已经不存在沙眼。这些数据来自该州的在校学生，同时还收集了沙眼儿童接触者的额外数据。

设计

这是一项基于人群的横断面研究，对 2003 年人类发展指数低于全国平均水平的所有市立 1 至 4 年级公立学校的学生进行随机抽样。样本根据人口规模进行分层。

参与者

确定了 7200 人的样本量，共检查了 6986 名（93%）学生，以及另外 2152 名接触者。

方法

所有学生均按照世界卫生组织标准接受沙眼检查。还收集了人口统计数据和接触者信息。然后找到并检查了患有沙眼的学生的家庭和学校接触者。

主要观察指标

沙眼的流行率和严重程度、年龄、性别、种族和所在城市。

结果

沙眼总流行率为 4.5%（95%置信区间[CI]，3.7%-5.3%），但该州内有些城市的炎症性沙眼流行率超过 10%。农村地区（4.9%；95%CI，3.7%-6.0%）的流行率高于城市地区（3.9%；95%CI，2.9%-4.9%）。生活在土著社区与沙眼有关（比值比，1.6；95%CI，0.9-2.6）。另外还检查了 2152 名接触者，总沙眼流行率为 9.3%（95%CI，8.1%-10.5%）。