Rapid assessment of trachoma among children living in rural northern India.

PURPOSE: Rapid assessment of active trachoma in children aged 1-9 years in a previously hyperendemic rural area in Haryana, India. METHODS: Ten disadvantaged villages each with a population of 3000-5000 were chosen by cluster random sampling. One thousand children from 500 households in the most underdeveloped parts of the villages--identified by observation and consultation, between the ages of 1-9 years--were examined for signs of Trachomatous inflammation follicular (TF) and Trachomatous inflammation intense (TI). Assessment was done in a health care unit. Examination of both eyes for signs of trachoma and its complications was done with the aid of binocular loupe (2.5X magnification). Tarsal conjunctival swabs from patients of active trachoma were analyzed by direct immunofluorescence assay and polymerase chain reaction for Chlamydia trachomatis antigen. RESULTS: Forty children (males 21, females 19) had signs of active trachoma that included TF (33) and TI (7). At least one ocular morbidity was present in 69% of all children that were examined. Unclean face carried a 2.70 (confidence interval [CI] = 1.30-5.37) times higher risk and poor ocular hygiene had 2.05 (CI = 1.02-4.11) times higher risk for trachoma infection. Among clinically positive cases, direct immunofluorescence assay and polymerase chain reaction assays were positive in 25% and 10%, respectively. CONCLUSIONS: Active trachoma is not a public health problem in previously hyperendemic areas of North India.