Australia Trachoma Surveillance Report 2011

Northern Territory Results 2011

Page last updated: 09 April 2013

Screening coverage

  • There has been a steady increase over the past four years in the number of at-risk communities being screened for trachoma (Figure 2.2), with a plateau in most regions over the past two years.
  • Community coverage of trachoma screening over the five endemic regions was 76%, with 65 out of 86 at-risk communities screened (Table 2.1). In addition, three communities designated as not-at-risk were screened.
  • The proportion of children aged 5-9 years screened in the 65 communities was 65%, with screening coverage ranging from 49% to 82% (Table 2.1, Figure 2.3).
  • Since 2008, the screening rates of children aged 5-9 years in at-risk communities has increased in all regions of the NT (Figure 2.3), with greatest coverage in Darwin Rural and Alice Springs Remote.

Clean face prevalence

  • The overall prevalence of clean faces among 5-9 year old children screened in the NT was 74%. The highest levels were found in East Arnhem (Figure 2.4).

Trachoma prevalence

  • The overall prevalence of trachoma in children aged 5-9 years screened in the NT was 7%. Prevalence ranged from 4% in East Arnhem to 14% in Alice Springs Remote (Table 2.1).
  • No active trachoma was detected in 34% (22/65) of communities screened (Table 2.1).
  • There was a substantial decrease in the percentage of communities with trachoma prevalence greater than 5%, from 62% in 2010, to 46% in 2011 (Figure 1.10).
  • There is evidence of a decreasing trend since 2008 in trachoma prevalence among 5-9 year old children in all regions except East Arnhem (Figure 2.5).
  • The highest prevalence of trachoma among children aged 5-9 years was 52% within a community in the Alice Springs Remote region.
  • Three not at-risk communities were screened. Trachoma was detected in two of those communities.

Treatment coverage

  • Of the active cases of trachoma detected at screening, 82% received treatment.
  • An estimated 53% of the population requiring treatment were treated with azithromycin (Table 2.2). Treatment coverage differed substantially between regions, ranging from 38% to 99% (Table 2.2).

Trichiasis

  • Trichiasis screening was undertaken in Alice Springs Remote and Katherine regions with 6% (212/3423) of the target population in these regions screened, and 3% (212/7007) of the overall at-risk population screened in the NT (Table 2.4).
  • Trichiasis was detected in 4% of adults screened.
  • No cases of trichiasis were reported to have received surgery (Table 2.4).

SAFE strategy compliance

  • A trichiasis referral process was in place in 66% (43/65) of communities screened.
  • The presence of facial cleanliness resources and programs was reported for less than half (48%) of screened communities.
  • Of 15 screened communities that reported on environmental conditions, seven stated that they had good conditions, six described conditions as variable, and two had poor conditions (Table 2.5).
  • NT did not report on the environmental conditions in 72% of communities screened.
Figure 2.1 Colour-coded trachoma prevalence and number of communities screened/ number of at-risk communities in the NT in 2011
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Map of NT, with shading legend distinguishing the trachoma prevalence, community screening coverage and treatment coverage in communities designated as ‘at-risk’ of trachoma and screened in 2011 in the NT


Figure 2.2 Number of communities screened* by year and region in the NT
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line graph demonstrates the number of communities screened by year (2007-2011) and region (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).

* Including communities screened but not at risk



Figure 2.3 Population screening coverage* of children aged 5-9 years in regions containing at least one at-risk community by year and region in the NT

line graph demonstrates the population screening coverage of children aged 5-9 years (%) in regions containing at least one at-risk community by year (2007-2011) and region in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).

* Calculated as the number of children screened (in at-risk and not-at-risk communities) in region containing at least one at-risk community divided by the estimated population of region

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Figure 2.4 Proportion of screened* children aged 5-9 years who had a clean face by year and region in the NT

line graph demonstrates the proportion of screened children aged 5-9 years who had a clean face by year (2007-2011) and region in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine)

* Including children in communities screened but not at risk



Figure 2.5 Trachoma prevalence among screened* children aged 5-9 years by year and region in the NT

Trachoma prevalence among screened* children aged 5-9 years by year and region in the NT

* Including children in communities screened but not at risk

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Figure 2.6 Screening coverage of children in at-risk communities in 2011 by age group and region in the NT

histogram demonstrates screening coverage of children in at-risk communities in 2011 by age group (1-4years, 5-9 years, and 10-14 years) and region in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine)

* Number of children screened



Figure 2.7 Trachoma prevalence among children screened in at-risk communities in 2011 by age group and region in the NT*

histogram demonstrates trachoma prevalence in children screened in at-risk communities in 2011 by age group (1-4 years, 5-9 years and 10-14 years) and region in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine) in communities

* In communities where more than 5 children were screened
† Number of children detected with trachoma

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Figure 2.8 Proportion of screened children who had a clean face in 2011 by age group and region in the NT*[

histogram demonstrates the proportion of screened children who had a clean face in 2011 by age group (1-4 years, 5-9 years and 10-14 years) and region in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine)

* In communities where more than 5 children were screened


† Number of children observed to have a clean face



Figure 2.9 Trachoma prevalence among screened at-risk communities in 2011 by region in the NT[

graph demonstrates trachoma prevalence among screened at-risk communities in 2011 by region in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine)

* Number of communities screened for trachoma

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Table 2.1 Trachoma screening coverage, trachoma prevalence and clean face prevalence in the NT in 2011 by region

*Calculated as the proportions of children with active trachoma in age groups 1-4 and 5-9 years, weighted by the estimated population sizes of each age group. This was done in order to account for uneven coverage with respect to age groups

 

  

At-risk communities Not at risk communities
Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total Total
Number of communities at risk 30 10 17 12 17 86
Number of communities screened 26 8 15 7 9 65 3
Age group (years)  1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14 1-4 5-9 10-14 1-14
Estimated number of Aboriginal children at risk 1021 1072 1166 3259 202 200 169 571 1086 1142 1018 3246 579 720 624 1923 748 774 677 2199 3637 3909 3653 11199
Children examined for clean face 105 700 505 1310 22 164 107 293 230 939 654 1823 39 370 345 754 102 377 179 658 498 2550 1790 4838 15 28 39 82
Children with clean face 35 351 391 777 22 149 106 277 116 692 537 1345 39 365 345 749 69 318 171 558 281 1875 1550 3706 5 19 36 60
Clean face prevalence 33% 50% 77% 59% 100% 91% 99% 95% 50% 74% 82% 74% 100% 99% 100% 99% 68% 84% 96% 85% 56% 74% 87% 77% 33% 68% 92% 73%
Children examined for trachoma 62 697 505 1264 22 164 107 293 217 922 649 1788 39 370 345 754 99 377 179 655 439 2530 1785 4754 11 33 38 82
Trachoma screening coverage 6% 65% 43% 39% 11% 82% 63% 51% 20% 81% 64% 55% 7% 51% 55% 39% 13% 49% 26% 30% 12% 65% 49% 42%
Children with active trachoma 15 97 47 159 1 13 7 21 3 36 19 58 0 13 11 24 0 16 7 23 19 175 91 285 1 3 0 4
Active trachoma prevalence 24% 14% 9% 13% 5% 8% 7% 7% 1% 4% 3% 3% 0% 4% 3% 3% 0% 4% 4% 4% 4% 7% 5% 6% 9% 9% 0% 5%
Trachoma prevalence 1-9 15% 8% 3% 3% 2% 7%
Trachoma prevalence 1-9 years (weighted by population) * 19% 6% 3% 2% 2% 6%
Table 2.2 Trachoma treatment coverage in the NT in 2011

* Estimated using average number of household contacts per child in communities who reported number of contacts requiring treatment and population statistics (see Methodology for detail)


  
At-risk communities Not at risk communities
Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total Total
Age group (years) 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All
Number of communities at risk 30 10 17 12 17 86
Number of communities requiring treatment 20 6 6 4 7 43 2
Age group (years)  1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All 1-4 5-9 10-14 15+ All
Active cases requiring treatment 15 97 47 N/A 159 1 13 7 N/A 21 3 36 19 N/A 58 0 13 11 N/A 24 0 16 7 N/A 23 19 175 91 N/A 285 1 3 0 N/A 4
Active cases received treatment 15 90 42 N/A 147 1 13 7 N/A 21 3 22 5 N/A 30 0 10 7 N/A 17 0 15 5 N/A 20 19 150 66 N/A 235 1 3 0 N/A 4
% Active cases received treatment 100% 93% 89% N/A 92% 100% 100% 100% N/A 100% 100% 61% 26% N/A 52% 77% 64% N/A 71% 94% 71% N/A 87% 100% 86% 73% N/A 82% 100% 100% 0% N/A 100%
Estimated contacts requiring treatment (according to jurisdictional interpretation of the guidelines) 4046 185 2606 268 1667 8772 38
Total Number of contacts who received treatment 288 361 252 1066 1967 23 45 23 93 184 209 263 144 1013 1629 16 27 26 137 206 90 145 67 327 629 626 841 512 2636 4615 5 8 4 21 38
Estimated overall treatment coverage* 49% 99% 63% 77% 38% 53% 100%
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Table 2.3 Number of communities according to different trachoma prevalence ranges (among children aged 5-9 years) in the NT in 2011
Prevalence At-risk communities Not at-risk communities
Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total
0% 6 23% 2 25% 9 60% 3 43% 2 22% 22 34% 1 33%
>0% but <5% 3 12% 1 13% 4 27% 2 29% 4 44% 14 22% 0 0%
≥5% but <10% 2 8% 2 25% 2 13% 2 29% 3 33% 11 17% 1 33%
≥10% but <20% 7 27% 2 25% 0 0% 0 0% 0 0% 9 14% 1 33%
≥20% 8 31% 1 13% 0 0% 0 0% 0 0% 9 14% 0 0%
Total 26 8 15 7 9 65 3

Table 2.4 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults aged over 40 years in 2011 in the NT
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
Adult population of at-risk communities
2259
350
1803
1432
1164
7007
Number of communities at risk*
30
10
17
12
17
86
Number of communities screened for trichiasis
3
10%
0
0%
0
0%
0
0%
5
29%
8
9%
Adults examined (% of estimated population at risk)
70
3%
0
0%
0
0%
0
0%
142
12%
212
3%
With trichiasis (% of adults examined)
4
6%
0
0%
0
0%
0
0%
5
4%
9
4%
Offered ophthalmic consultation
1
0
0
0
0
1
Surgery in past 12 months
N/R†
N/R
N/R
N/R
N/R
N/R
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Table 2.5 Adherence to SAFE protocols in reported communities* in 2011 in the NT

* Including communities screened but not at risk
† Less than 80% of contacts treated

Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
Surgery for trichiasis
Referral process exists
17
73%
3
38%
10
66%
2
29%
9
100%
43
63%
No referral process
0
0%
0
0%
0
0%
0
0
0
0%
0
0%
3Referral unknown
0
0%
0
0%
0
0%
0
0
0
0%
0
0%
Not Reported
7
27%
5
72%
5
34%
5
71%
0
0%
25
37%
Antibiotics
Distribution in line with CDNA guidelines
23
88%
6
75%
9
60%
5
71%
9
100%
52
80%
Active cases and contacts treated within two weeks
19
80%
5
83%
1
11%
3
60%
7
88%
0
0%
No treatment required
4
20%
1
17%
8
89%
2
40%
2
22%
0
0%
Distribution not in line with CDNA guidelines
3
12%
2
25%
6
40%
2
39%
0
0%
13
20%
Active cases and contacts treated but not within two weeks
2
77%
2
100%
5
83%
1
50%
0
0%
0
0%
Not all contacts treated†
0
0%
0
0%
1
17%
0
0%
0
0%
0
0%
Active cases only treated
0
0%
0
0%
0
0%
0
0%
0
0%
0
0%
No distribution
1
33%
0
0%
0
0%
1
50%
0
0%
0
0%
Facial cleanliness resources
Present and used
16
62%
0
0%
4
27%
1
13%
8
88%
29
45%
Present, not used
2
8%
0
0%
0
0%
0
0%
0
0%
2
3%
No resources
0
0%
0
0%
0
0%
0
0%
0
0%
0
0%
Not reported/Unsure
8
30%
8
100%
11
73%
7
87%
1
12%
34
52%
Facial cleanliness programs
Program exists
15
58%
0
0%
2
13%
1
13%
6
67%
24
37%
No program
3
12%
0
0%
0
0%
0
0%
2
22%
5
8%
Not reported/Unsure
8
30%
8
100%
13
87%
7
87%
1
11%
36
55%
Environmental Conditions
Good
8
30%
0
0%
1
6%
0
0%
1
11%
7
11%
Variable
4
15%
0
0%
1
6%
0
0%
1
11%
6
9%
Poor
1
4%
0
0%
0
0
0%
1
11%
2
3%
Not reported
13
50%
8
100%
13
86%
7
100%
6
77%
47
72%
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Table 2.6 Treatment coverage for second treatment of trachoma in hyper endemic communities in the NT from 2009—2011.

* Number of communities with second treatment was 1, 6, and 7 in 2009, 2010 and 2011 respectively
† Number of communities with second treatment in Katherine was 2 in 2010.
‡ Number of contacts estimated from ABS projections of whole of community.

Region
Alice Springs Remote*
Alice Springs Remote*
Alice Springs Remote*
Katherine
Year
2009
2010
2011
2010
Age group (years)
1-4
5-9
10-14
15+
All
1-4
5-9
10-14
15+
All
1-4
5-9
10-14
15+
All
1-4
5-9
10-14
15+
All
Estimated Number of contacts requiring treatment
26
30
35
152
243
210
225
210
1205
1850
330
329
354
1867
2880
102
100
97
592
891
Number of cases and contacts who received a second treatment
31
26
17
141
215
137
166
140
706
1149
234
213
151
467
1065
16
17
7
45
85
Estimated overall second treatment coverage
118%
85%
49%
93%
88%
65%
74%
67%
59%
62%
71%
65%
43%
25%
37%
16%
17%
7%
8%
10%


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