Prevalence of trachoma in Pernambuco State, Brazil (2014-2015).

To estimate the prevalence of cases of trachoma in the population at social risk aged 1-9 years in Pernambuco State and its mesoregions. This was a cross-sectional study in which secondary data from the National Household Survey on Trachoma (2014-2015) were analyzed. The study covered 96 census tracts distributed across the mesoregions of Pernambuco State (Metropolitan Region of Recife, Zona da Mata, Agreste, Sertao do Sao Francisco and Sertao Pernambucano). The study included all homes with children aged 1-9 years, and all of them were examined for trachoma, using the WHO criteria. Among the total of 7,423 children aged 1-9 years who participated in this survey, 446 presented with active trachoma. Thus, the prevalence of trachoma in Pernambuco State, in children between 1-9 years old was 6.65%, and it was higher among children aged 5-9 years (7.12%) and among girls (7.23%). This result was seen in the majority of the mesoregions studied, except in the Zona da Mata and Sertao do Sao Francisco, where there were higher prevalences in the age group of 1-4 years (5.55%) and among boys (5.90%). A tendency towards a higher prevalence between 1 and 6 years of age was observed. The follicular trachoma continues to be an important public health problem in Pernambuco State. It particularly affects poor people, including those living in urban areas of the State.

Spatial analysis of epidemiological and quality indicators of health services for leprosy in hyperendemic areas in Northeastern Brazil.

Leprosy is a public health problem due to the physical disabilities and deformities it causes. This study aimed to describe new leprosy cases using an operational classification and analyzing spatial patterns by means of epidemiological and quality indicators of health services in Pernambuco State, Brazil, between 2005 and 2014. This was an ecological study performed in 184 municipalities grouped into 12 health regions units for analysis. To analyze spatial patterns, the Bayesian local empirical method and Moran's spatial autocorrelation indicator were applied and box and Moran maps were used. Individuals aged ≥15 years old, grade zero physical disability and complete remission as the treatment outcome were predominant in both paucibacillary and multibacillary cases, the only difference was the predominance of females (n=9,286; 63.00%) and males (n=8,564; 60.70%), respectively. These variables were correlated (p<0.05) with the operational classification. The overall detection rate showed three high-priority areas; the indicator rate of grade 2 physical disability revealed clusters in regions IV, V, and VI; and the indicator rate of cases with some degree of disability showed precarious municipalities in seven health regions. Pernambuco maintains an active chain of transmission and ongoing endemicity of leprosy. Therefore, spatial analysis methods allow the identification of priority areas for intervention, thereby supporting the disease elimination strategy.

Household Survey of Trachoma among Children Living in Pernambuco, Brazil.

This study analyzed the association between individual and household factors and the incidence of trachoma among a population aged between 1 and 9 years in the state of Pernambuco. This was a population-based household study conducted using a population-based sample of residents from 96 census sectors of the 1778 sectors considered to be at social risk in the state. The estimated odds ratio of the univariate analysis presented a confidence interval of 95%. Weights and clusters were adjusted through the Generalized Linear and Latent Mixed Model (GLLAM) method. Trachoma cases were the dependent variable in the multivariate analysis. The independent variables were selected through the stepwise forward method, with an input criterion of 20% (p < 0.20) and an output criterion of 10% (p < 0.10). The prevalence was 6.65%. Trachoma was associated with a female sex, age of 5-9 years, either the absence of use or infrequent use of soap to wash the hands and face, the presence of nasal secretion, a lack of piped water from a public supply system, a greater number of rooms used for sleeping, a greater number of people living in the same household, and a family income of up to one minimum monthly wage. The prevalence of follicular trachoma in Pernambuco was higher than what is recommended by the World Health Organization (WHO).