Population Prevalence of Trachoma in Nine Rural Non-Indigenous Evaluation Units of Brazil.

PURPOSE: To assess the contemporary prevalence of trachoma in Brazil's non-indigenous population, surveys of those thought to be at greatest risk of disease were conducted. METHODS: Rural census tracts of non-indigenous population from nine mesoregions were selected to compose the survey evaluation units (EUs) by considering previously endemic municipalities at greatest risk of trachoma. In each of the nine EUs, we conducted a population-based prevalence survey. Every resident of selected households aged ≥1 year was examined for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT). Additionally, data were collected on household-level access to water, sanitation, hygiene (WASH) and education. RESULTS: A total of 27,962 individuals were examined across nine EUs. The age-adjusted TF prevalence in 1-9-year-olds was <5% in each EU. The age- and gender-adjusted prevalence of TT unknown to the health system in ≥15-year-olds was <0.2% in eight EUs; in one EU, it was 0.22%. The median number of households surveyed per EU with access to an improved drinking water source within a 30-minute roundtrip of the house was 66%. School attendance was >99% of surveyed children. CONCLUSIONS: The prevalence of TF was well below the target for elimination as a public health problem in all EUs. Because EUs surveyed were selected to represent the highest-risk non-indigenous areas of the country, TF prevalence is unlikely to be ≥5% in non-indigenous populations elsewhere. In one EU, the prevalence of TT was above the target threshold for elimination. Further investigation and possibly improvement in TT surgical provision are required in that EU.

[Breast-feeding: assessment of the implementation of a program at basic healthcare units in Recife, Pernambuco State (2002)]. / Aleitamento materno: avaliação da implantação do programa em unidades básicas de saúde do Recife, Pernambuco (2002).

This paper analyses the implementation level of a breast-feeding incentive program at Government healthcare facilities in Recife, Pernambuco State, Brazil, through a normative assessment conducted through 84 Family Health Teams and at 42 Health Centers in January 2002. A tool containing structured questions was used, related to rules and routines for promoting breast-feeding. The Family Health Teams performed better, with the actions implemented in 7.1% of these Teams and at none of the Health Centers; they were rated as 'not implemented' for 1.2% of the Family Health Teams and 47.6% of the Health Centers. This leads to the conclusion that implementation levels are not satisfactory, reflecting difficulties in breaking away from clinical practice and individual habits in order to introduce universal and all-round health promotion measures.