Orientador: Silvana Artioli Schellini / Banca: Antônio Augusto Velasco e Cruz / Banca: Norma Helen Medina / Banca: Lucieni Cristina Barbarini Ferra / Banca: Edson Nacib Jorge / Resumo: O tracoma ainda figura entre as grandes causas de cegueira do mundo, sendo a principal causa de cegueira evitável e a principal causa de cegueira corneana. No Brasil, por vários anos, acreditou-se que a doença havia sido erradicada, o que impediu seu ensino nas escolas médicas e diminuiu a busca ativa, aumentando o número de pessoas não tratadas e portadoras da doença. Além disso, os fatores que mantém a doença no meio ambiente precisam ser detectados para melhor controle da mesma. Diante destes fatos, desenvolveu-se este estudo com os objetivos de promover educação em saúde; prevenir a cegueira por tracoma detectando e tratando os casos da doença; descrever o perfil socioeconômico dos portadores da doença no município de Botucatu; pesquisar a presença de vetores da doença e da bactéria causadora de tracoma nesses vetores. Material e Métodos: Estudo transversal conduzido na cidade de Botucatu, estado de São Paulo - Brasil no ano de 2010. Um grupo composto por oito estudantes do curso de graduação em Medicina ou Enfermagem e duas agentes de saúde foi treinado por dois oftalmologistas para detectar e tratar o tracoma na população, segundo as recomendações da Organização Mundial de Saúde (OMS). Após treinamento, foi realizado trabalho de campo, com exame de uma amostra aleatorizada de 3568 crianças, calculada baseando-se nos dados históricos da prevalência de tracoma em Botucatu e no número de crianças matriculadas no ensino fundamental das escolas municipais. A unidade primária de amostra foi a classe, examinado-se todas as crianças da classe sorteada. O diagnóstico foi clínico, com eversão palpebral à procura de folículos em conjuntivas tarsais superiores usando-se lupa binocular de 2,5 vezes de aumento e iluminação artificial (lanterna). As crianças com tracoma inflamatório foram tratadas com Azitromicina, 20 mg/kg de peso e visitadas em suas casas para aplicação de um questionário... / Abstract: Trachoma still ranks among the major causes of blindness in the world, being the leading cause of preventable blindness and the leading cause of corneal blindness. In Brazil, for several years, it was believed that the disease had been eradicated, which prevented the searching and the teaching of the disease in medical schools and decreased the active search, increasing the number of untreated people and affected by the disease. Furthermore, the maintenance factors of the disease in the environment must be detected for its better control. Based on these facts, this study was developed with the objectives of promoting health education; prevent blindness from trachoma detecting and treating cases of the disease; describe the socioeconomic profile of disease carriers in Botucatu; search for the presence of vectors of the disease and for the bacterium which causes trachoma in these vectors. Methods: A cross-sectional study was conducted in the city of Botucatu, state of São Paulo - Brazil in 2010. A group of eight students from the graduation course in Medicine or in Nursing and two health workers was trained by two ophthalmologists to detect and how to treat trachoma in the population, according to the recommendations of the World Health Organization (WHO). After training, a fieldwork was conducted by the exam of a random sample of 3568 children, calculated based on historical data of the prevalence of trachoma in Botucatu and on the number of children enrolled in primary education in municipal schools. The primary unit of the sample was the class, and all children from the selected class were examined. The diagnosis was clinical, with eyelid eversion looking for follicles on the superior tarsal conjunctiva by using a 2.5-fold increase binocular magnifier lenses and artificial light (flashlight). Children with inflammatory trachoma were treated with Azithromycin, 20 mg/kg of weight and visited at home for a socioeconomic questionnaire ... / Doutor

Orientador: Silvana Artioli Schellini / Banca: Marino Scarpi / Banca: Norma Helen Medina / Banca: Ivete Dalben / Banca: Carlos Roberto Padovani / Resumo: Tendo em vista que o Tracoma é causa de cegueira e que há cinco anos não havia nenhum caso notificado no Município de Bauru - São Paulo, foi realizado o presente estudo que teve por objetivo determinar a prevalência de tracoma e as características de seus portadores, assim como estabelecer um programa de controle da doença para Bauru. Material e método: foi realizado um estudo transversal, aleatorizado, nas escolas estaduais de Bauru, São Paulo. Foram examinadas 1749 crianças do ensino fundamental, de 6 a 14 anos, durante o ano de 2005. As escolas foram escolhidas por sorteio, de acordo com o número de estudantes e de acordo com a localização dentro do setor da cidade (centro, região intermediária e periferia). O diagnóstico dos casos foi clínico, seguindo as normas da Organização Mundial de Saúde, confirmado laboratorialmente em três pacientes que apresentavam o diagnóstico de Tracoma folicular, pelo método da imunofluorescência indireta para detecção de Chlamydia trachomatis. A associação entre presença de doença e características dos portadores foi feita usando o teste de Goodman, teste não-paramétrico de Kruskal-Wallis e estatística descritiva. Todos os casos foram tratados com azitromicina oral, em dose única, e foram acompanhados periodicamente. Resultados: A prevalência de Tracoma inflamatório foi de 3,77%, tendo sido diagnosticado Tracoma folicular em 3,71% e Tracoma intenso em 0,06% das crianças examinadas. As crianças com Tracoma moravam principalmente na região intermediária e periférica da cidade, áreas onde o fornecimento de água pode ser descontínuo e o tratamento do esgoto pode estar ausente. Meninos e meninas foram acometidos de forma semelhante. Prurido e ardor ocular foram sintomas que estavam relacionados com a presença da doença. Foram detectados 175 comunicantes com o diagnóstico... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Trachoma is one of cause of blindness. The last five years there were no cases detected in Bauru, São Paulo. The purpose of this study aimed to determine the prevalence of trachoma in schoolchildren in Bauru and to establish a control program of this disease in Bauru. Material and methods: A transversal random study was carried out in state schools of Bauru, São Paulo. One thousand seven hundred and forty nine children were examined at fundamental classes, between six to fourteen years old during the year 2005. The schools were chosen by random, according to the number of scholar children and the school region and it was represented by section of the city (downtown, middle and periphery). The diagnosis of the cases was clinical, it was according to the World Health Organization protocol, and three patients with clinical follicular trachoma had laboratory confirmation. The laboratory technique chosen was direct smear fluorescent antibodies cytology for Chlamydia trachomatis. The association study among trachoma and relatives variables was done by Goodman test, Kruskal-Wallis test and descriptive statistics. All cases were treated with Azitromycin orally and they had followed up periodically. Results: The sample was composed of 1749 children and the trachoma prevalence was 3,77%. Follicular trachoma was diagnosed in 3,71% of children, and intense trachoma in one child (0,06%). The children with trachoma were living mainly in the middle and periphery region of the city, regions with discontinuous water supply and absent sewerage system. Itching and burning were complains more related to trachoma. One hundred and seventy five contacts were found and were clinic diagnostic with the disease. Conclusion: The Trachoma prevalence in Bauru - São Paulo State is 3,77%. A control program is development to treat ant detect the contacts. This way, there was a bauruense community mobilization to prevent Trachoma blindness in the municipal district. / Doutor

Background High incidence of post-operative trichiasis and other poor outcomes after surgery in most trachoma-endemic settings poses a major challenge to global elimination of trachoma. This systematic review aimed to assess the incidence of post-operative trichiasis and other poor outcomes of trichiasis surgery in Africa, based on findings of observational and interventional studies. Search methods We searched PubMed, Academic Search Premier, Africa-Wide Information, CINAHL and Health Source Nursing through EBSCOhost, Web of Science [all databases], and Cochrane Central Register of Controlled Trials for relevant studies on the subject. We also searched the reference lists of included studies to identify further potentially relevant studies. We included all observational and interventional studies that measured post-operative trichiasis as one of the primary outcomes. Only studies conducted in Africa were included in this review. Data collection and analysis Two reviewers independently screened the titles and abstracts, selected and assessed the articles for inclusion in this review. Any disagreements were resolved through discussion or by consulting a third reviewer. Where necessary, the corresponding authors of included studies were contacted to provide any missing data. Our primary outcome was post-operative trichiasis, which was defined as any eyelash touching the globe at different time points after surgery. Main results Thirty-five studies, including 12,943 participants, met the inclusion criteria. A number of the studies included in this review utilized the same data to measure the incidence of post-operative trichiasis and other poor outcomes over different follow-up periods. Overall, a review of the included studies revealed a pattern of high incidence of post-operative trichiasis and other poor outcomes ranging from 2.3 at 6 weeks to 65% at 7 years. This incidence varied by type of study design, surgical procedure and technique used as well as the follow up period among other factors.

Thesis (Ph.D.)--University of Melbourne, Dept. of Opthalmology, 2007. / Typescript. SAFE Strategy refers to Surgery for trichiasis, Antibiotics for active infection, Facial cleanliness and Environmental improvements. Includes bibliographical references (leaves 233-253). Also available electronically: http://eprints.unimelb.edu.au/archive/00003844.

Made available in DSpace on 2014-06-11T19:32:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-24Bitstream added on 2014-06-13T20:42:39Z : No. of bitstreams: 1 macharelli_ca_dr_botfm.pdf: 2403268 bytes, checksum: a44fffeaff80c6818630f8724462477f (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O tracoma ainda é um importante problema de saúde pública, causando morbidade, deficiência visual e cegueira em diversos países subdesenvolvidos ou em desenvolvimento. Em 2006 foi realizado um estudo transversal nas escolas estaduais na de Bauru, estado de São Paulo, que revelou uma prevalência de 3,7% de tracoma no município. O presente estudo tem como objetivo analisar o comportamento espacial da ocorrência dos casos de tracoma detectados na cidade de Bauru pelo referido estudo, a fim de utilizar as informações apuradas para definir áreas prioritárias para a otimização dos recursos do setor Saúde. Para atingirmos nossos objetivos lançamos mão de uma ferramenta que é o geoprocessamento em saúde ‐ uma das maneiras de se conhecer mais detalhadamente as condições de saúde da população através de mapas que permitem observar a distribuição espacial de situações de risco e dos problemas de saúde. A quantificação dos fenômenos observados pode ser feita de várias formas, sendo a estimativa de Kernel uma delas. Esse procedimento permite filtrar a variabilidade de um conjunto de dados, sem alterar as suas características locais. Os casos de tracoma foram georreferenciados com uso do GPS e depois as coordenadas transformadas em latitudes e longitudes decimais, com o auxílio do TCGeo. As análises espaciais foram feitas com o TerraView, utilizando‐se os pontos dos casos, das escolas, e dados do censo IBGE 2000, contidos nos CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002. O protocolo empregado possibilitou que todas as crianças detectadas pelo estudo de Ferraz (2006) fossem visitadas pela equipe executora do presente e georeferenciadas usando aparelho de GPS. As crianças que fizeram parte da amostra apresentavam média de idade de 8.5 anos, eram na sua maioria do sexo masculino e... / Trachoma still is an important issue for public health; it increases morbidity, causing visual deficiency and blindness in several underdeveloped or developing countries. In 2006, a transversal study was carried out among public schools in Bauru, São Paulo state. The study revealed a prevalence of 3.7% of trachoma in the town. This study aims at analyzing the spatial behavior of the cases detected in Bauru by the 2006 research, in order to define areas that should have priority when improving the municipal health system. We used health geoprocessing – which is done by maps that show the spatial distribution of risk situations and health problems, allowing to know details about the population health. The phenomena observed can be quantified in different manners – Kernel estimation is one of them, and the one we used, because it permits to filter the variability of a set of data without altering its local features. Trachoma cases were georeferenced with a GPS and their coordinates were converted with TCGeo into decimal latitudes and longitudes. Spatial analyses were carried out with TerraView, using points of cases and schools, and data from IBGE 2000 census found in the CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002 (Information database on each censual sector. Demographic census 2000, Universal Results. Bauru. IBGE, 2002). The procedures allowed our team to visit and georeference all the children detected by Ferraz (2006). The children are mostly males, with a mean age of 8.5 years and presenting uni or bilateral trachoma. Geoprocessing was important for it facilitates the process of spatial localization through Google Earth (2007) – which allowed us to notice a concentration of cases in regions with low income. We could also observe that individuals with low income are not concentrated on the ...(Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:32:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-09-22Bitstream added on 2014-06-13T20:22:58Z : No. of bitstreams: 1 ferraz_lcb_dr_botfm.pdf: 1272413 bytes, checksum: e6358f733b6708125fc92291189f5991 (MD5) / Tendo em vista que o Tracoma é causa de cegueira e que há cinco anos não havia nenhum caso notificado no Município de Bauru - São Paulo, foi realizado o presente estudo que teve por objetivo determinar a prevalência de tracoma e as características de seus portadores, assim como estabelecer um programa de controle da doença para Bauru. Material e método: foi realizado um estudo transversal, aleatorizado, nas escolas estaduais de Bauru, São Paulo. Foram examinadas 1749 crianças do ensino fundamental, de 6 a 14 anos, durante o ano de 2005. As escolas foram escolhidas por sorteio, de acordo com o número de estudantes e de acordo com a localização dentro do setor da cidade (centro, região intermediária e periferia). O diagnóstico dos casos foi clínico, seguindo as normas da Organização Mundial de Saúde, confirmado laboratorialmente em três pacientes que apresentavam o diagnóstico de Tracoma folicular, pelo método da imunofluorescência indireta para detecção de Chlamydia trachomatis. A associação entre presença de doença e características dos portadores foi feita usando o teste de Goodman, teste não-paramétrico de Kruskal-Wallis e estatística descritiva. Todos os casos foram tratados com azitromicina oral, em dose única, e foram acompanhados periodicamente. Resultados: A prevalência de Tracoma inflamatório foi de 3,77%, tendo sido diagnosticado Tracoma folicular em 3,71% e Tracoma intenso em 0,06% das crianças examinadas. As crianças com Tracoma moravam principalmente na região intermediária e periférica da cidade, áreas onde o fornecimento de água pode ser descontínuo e o tratamento do esgoto pode estar ausente. Meninos e meninas foram acometidos de forma semelhante. Prurido e ardor ocular foram sintomas que estavam relacionados com a presença da doença. Foram detectados 175 comunicantes com o diagnóstico... / Trachoma is one of cause of blindness. The last five years there were no cases detected in Bauru, São Paulo. The purpose of this study aimed to determine the prevalence of trachoma in schoolchildren in Bauru and to establish a control program of this disease in Bauru. Material and methods: A transversal random study was carried out in state schools of Bauru, São Paulo. One thousand seven hundred and forty nine children were examined at fundamental classes, between six to fourteen years old during the year 2005. The schools were chosen by random, according to the number of scholar children and the school region and it was represented by section of the city (downtown, middle and periphery). The diagnosis of the cases was clinical, it was according to the World Health Organization protocol, and three patients with clinical follicular trachoma had laboratory confirmation. The laboratory technique chosen was direct smear fluorescent antibodies cytology for Chlamydia trachomatis. The association study among trachoma and relatives variables was done by Goodman test, Kruskal-Wallis test and descriptive statistics. All cases were treated with Azitromycin orally and they had followed up periodically. Results: The sample was composed of 1749 children and the trachoma prevalence was 3,77%. Follicular trachoma was diagnosed in 3,71% of children, and intense trachoma in one child (0,06%). The children with trachoma were living mainly in the middle and periphery region of the city, regions with discontinuous water supply and absent sewerage system. Itching and burning were complains more related to trachoma. One hundred and seventy five contacts were found and were clinic diagnostic with the disease. Conclusion: The Trachoma prevalence in Bauru - São Paulo State is 3,77%. A control program is development to treat ant detect the contacts. This way, there was a bauruense community mobilization to prevent Trachoma blindness in the municipal district.

Orientador: Silvana Artioli Schellini / Banca: Ivete Dalben Soares / Banca: Luciene Cristina Barbarini Ferraz / Banca: Paula Araújo Opromolla / Banca: Norma Helen Medina / Resumo: O tracoma ainda é um importante problema de saúde pública, causando morbidade, deficiência visual e cegueira em diversos países subdesenvolvidos ou em desenvolvimento. Em 2006 foi realizado um estudo transversal nas escolas estaduais na de Bauru, estado de São Paulo, que revelou uma prevalência de 3,7% de tracoma no município. O presente estudo tem como objetivo analisar o comportamento espacial da ocorrência dos casos de tracoma detectados na cidade de Bauru pelo referido estudo, a fim de utilizar as informações apuradas para definir áreas prioritárias para a otimização dos recursos do setor Saúde. Para atingirmos nossos objetivos lançamos mão de uma ferramenta que é o geoprocessamento em saúde ‐ uma das maneiras de se conhecer mais detalhadamente as condições de saúde da população através de mapas que permitem observar a distribuição espacial de situações de risco e dos problemas de saúde. A quantificação dos fenômenos observados pode ser feita de várias formas, sendo a estimativa de Kernel uma delas. Esse procedimento permite filtrar a variabilidade de um conjunto de dados, sem alterar as suas características locais. Os casos de tracoma foram georreferenciados com uso do GPS e depois as coordenadas transformadas em latitudes e longitudes decimais, com o auxílio do TCGeo. As análises espaciais foram feitas com o TerraView, utilizando‐se os pontos dos casos, das escolas, e dados do censo IBGE 2000, contidos nos CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002. O protocolo empregado possibilitou que todas as crianças detectadas pelo estudo de Ferraz (2006) fossem visitadas pela equipe executora do presente e georeferenciadas usando aparelho de GPS. As crianças que fizeram parte da amostra apresentavam média de idade de 8.5 anos, eram na sua maioria do sexo masculino e ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Trachoma still is an important issue for public health; it increases morbidity, causing visual deficiency and blindness in several underdeveloped or developing countries. In 2006, a transversal study was carried out among public schools in Bauru, São Paulo state. The study revealed a prevalence of 3.7% of trachoma in the town. This study aims at analyzing the spatial behavior of the cases detected in Bauru by the 2006 research, in order to define areas that should have priority when improving the municipal health system. We used health geoprocessing - which is done by maps that show the spatial distribution of risk situations and health problems, allowing to know details about the population health. The phenomena observed can be quantified in different manners - Kernel estimation is one of them, and the one we used, because it permits to filter the variability of a set of data without altering its local features. Trachoma cases were georeferenced with a GPS and their coordinates were converted with TCGeo into decimal latitudes and longitudes. Spatial analyses were carried out with TerraView, using points of cases and schools, and data from IBGE 2000 census found in the CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002 (Information database on each censual sector. Demographic census 2000, Universal Results. Bauru. IBGE, 2002). The procedures allowed our team to visit and georeference all the children detected by Ferraz (2006). The children are mostly males, with a mean age of 8.5 years and presenting uni or bilateral trachoma. Geoprocessing was important for it facilitates the process of spatial localization through Google Earth (2007) - which allowed us to notice a concentration of cases in regions with low income. We could also observe that individuals with low income are not concentrated on the ...(Complete abstract click electronic access below) / Doutor

BACKGROUND: Trachoma is a leading cause of avoidable blindness. Currently, trachoma is endemic in 57 countries, infects approximately 84 million people globally, and continues to threaten over 10 % of the world’s population with the risk of blindness. Caused by the bacteria Chlamydia trachomatis, blindness due to trachoma is caused by repeated eye infection resulting in the inflammation of the upper eyelid eventually leading the upper lid to pull inward scratching and tearing the cornea causing it to become opaque resulting in loss of vision. The World Health Organization recommends eliminating trachoma as a public health problem using the SAFE strategy: Surgery, Antibiotic, Face washing and Environmental control. OBJECTIVES: This review examined the benefits of the added value of water, sanitation, and hygiene education interventions on preventive mass drug administration for trachoma. METHODS: Trials were identified from MEDLINE, PubMed, and LISTA EBSCO databases using a series of search terms. No restrictions were put on study date, location, design, or language of publication. The abstracts were examined from each of the searches, and any abstract describing risk factors, survey results of mass drug administration (MDA), or providing a general overview of trachoma were automatically discarded. Full text of papers including the combined use of key words including SAFE, WASH, intervention, impact, added value, MDA, azithromycin/ Zithromax® were obtained for review. Twelve full texts articles were retrieved all relevant information were placed in a standardized data extraction form. MAIN RESULTS: Three studies met the complete criteria for inclusion. All studies found a significant change in reduction of active trachoma prevalence. One study focused on the added benefit of antibiotic and environmental components on hygiene education delivered by radio. Another trial compared two villages; the control community performed MDA and the surgery while the intervention village added the F and E components. The final study as well focused the added benefit of ‘F’ and ‘E’ on ‘A’. Two of the three studies found this reduction was from the added benefit of face washing ‘F’ and environmental control ‘E’ to antibiotic use. CONCLUSIONS: In order to eliminate blinding trachoma as a public health problem, recurrence of the active form of the disease must be interrupted before repeated scarring leads to trichiasis. The antibiotic component of the SAFE strategy is a quick fix to the immediate problem. The ‘F’ and ‘E’ components are the more sustainable interventions, yet little research has been done on the actual amount of added value the individual ‘A’‘F’&’E’ components have to one another. After thorough review of the articles, articles were found which documented the ‘F’ and ‘E’ components provide significant value to the overall decrease of prevalence of active. However, the limited results of the search suggest more research can better elucidate the ability of the ‘F’ and ‘E’ components to reduce trachoma prevalence and ultimately impact blinding.

No description available.

In Ethiopia, one of the primary contributors to blindness is trachoma, which is an infectious ocular disease. There is no record of any prevention programs in rural Ethiopian villages of Oromia, where the prevalence of trachoma is high. The original purpose of this phenomenological study was to explore the perceptions of rural Oromo villagers in Ethiopia on the causes, treatment, and prevention of trachoma, using the health belief model and the social-ecological model as a theoretical framework. Due to a security situation in Ethiopia, final interviews were conducted with immigrant Ethiopians in the US, all of them from the trachoma-endemic rural areas of Oromia, all now living in Phoenix, Arizona. Results showed that this sample of former villagers had limited knowledge of the causes, prevention or treatment of trachoma, and could not recognize, or differentiate it from other eye diseases. The participants had some knowledge of governmental and nongovernmental efforts to control trachoma in their home country - through education and pit latrines. They also knew about the limitations of those programs. All reported that people would be willing to attend classes for trachoma prevention if held at a convenient time and place. These results may be useful in preparing a program to prevent trachoma in rural Ethiopia, and reduce blindness in this population, enabling more individuals to become educated and contributing to their community's well-being. Since trachoma is highly infectious, and participants in this study come from a trachoma-endemic area and do not know how to recognize it for themselves, the need for screening for trachoma on arrival in the US should be examined in more detail.