# Trachoma-associated morbidity and mortality in Brazil: an ecological study focusing on hospitalization and mortality data, 2000−2022

## TL;DR

This study examines trachoma-related hospitalizations and deaths in Brazil from 2000 to 2022, highlighting regional and demographic patterns.

## Contribution

The study provides the first comprehensive analysis of trachoma-associated morbidity and mortality in Brazil using national hospital and mortality data.

## Key findings

- Trachoma was more common in males, older adults, and those with brown skin in Brazil.
- Hospital admissions and deaths were more frequent in the North and Northeast regions.
- Trachoma-related sequelae were reported in a notable percentage of cases.

## Abstract

Trachoma is the leading infectious cause of blindness worldwide. It is a
neglected tropical disease caused by Chlamydia trachomatis.
The objective of this study was to analyze the trachoma-associated morbidity
and mortality in Brazil from 2000 to 2022. This ecological time-series study
was based on secondary data on trachoma obtained from hospital admissions
(trachoma as the primary or secondary cause) and death certificates
(trachoma as the underlying or associated cause).

We calculated the sex- and age-standardized rates of hospital admissions and
trachoma-specific mortality according to sociodemographic variables and
analyzed the spatial distribution.

We identified 141/263,292,807 hospital admissions (primary cause: 83.0%) and
126/27,596,830 death certificates (associated cause: 91.3%) related to
trachoma. Trachoma-related sequelae were reported in 8.5% of hospital
admissions and 6.3% of death certificates. Trachoma was more common in males
(hospital admissions and death certificates), people aged ≥70 years
(hospital admissions and death certificates), those with brown skin
(hospital admissions and death certificates), and those living in the North
(hospital admissions) and Northeast (death certificates) regions of Brazil.

Despite the relatively low rates of trachoma morbidity in Brazil, the
associated mortality rates are of concern. The heterogeneous patterns of
occurrence in the country in terms of population and territory reinforce the
need to evaluate and monitor the available data, despite the low prevalence,
in order to achieve and maintain the elimination targets in Brazil in the
future.