TRACHOMA 283 ages 0-4 and 5-9), but its share increases until around ages 20-29 approximately 90 percent or more of all trachoma is of trivial intensity. Mild trachoma has its largest share for the youngest ages, around 0-4 and 5-9. It has a larger share of trachoma than the two high- intensity categories moderate and severe for nearly all ages, although after age 20 its share is virtually the same as moderate and severe intensity. The moderate and severe intensity trachoma scores have the larger shares for younger ages, declining for both males and females to a level that is low for all ages after 30 years. Among females, there is a slight rise in the relative share of severe intensity trachoma at ages 20-29. This small increase may be as- sociated with the entry of these women into the child-rearing years, and, hence, greater exposure to children who have high-intensity trachoma infections. There is also a slight but statistically significant rise in the shares of mild, moderate, and severe intensity trachoma for females after age 50. This may also be associated with increased exposure to infected children. The geographic distribution of high-intensity trachoma can be expected to be similar to that observed for all trachoma, for trichiasis and entropion, and for trachoma blindness. Table 7-34 shows the distribution of high-intensity trachoma for all ages for selected zones. Because of small numbers of cases in zones outside the Far West region, the zones have been grouped into regions except in the Far West. Thus, Mechi, Koshi, and Sagarmatha zones represent the East region, Janakpur, Bagmati, and Narayani the Central region, and Gandaki, Lumbini, and Dhaulagiri the West region. The estimated 126,579 cases of high-intensity trachoma represent an estimated prevalence of 0.9 cases per 100 persons. Bheri and Seti zones alone contain two-thirds (85,297 cases, or 67.4%) of the high- intensity trachoma in Nepal and have prevalence rates of 6.3 and 3.7 high-intensity trachoma cases per 100 persons, respectively. Only the Central region among the remaining areas has more than 10 percent of the high-intensity trachoma, and none of the prevalence rates in those areas exceeds 1.0 per 100 persons. Even more than for trachoma, trichiasis and entropion, and trachoma blindness, Bheri and Seti zones are the major focus of high-intensity trachoma in Nepal. The largest share of high-intensity trachoma among all trachoma occurs for younger ages, and Table 7-35 displays the distribution of high-intensity trachoma for children ages 0-9 by the
