Australia Trachoma Surveillance Report 2011

Western Australia Results 2011

Page last updated: 09 April 2013

Screening coverage

  • The overall community screening coverage in WA over the four regions with endemic trachoma was 91%, with 68 communities screened for trachoma out of the 75 at-risk communities (Table 4.1).
  • No definitive trend is obvious over time across the regions, however, fewer communities were screened in the Kimberley region compared to last year (Figure 4.2).
  • Ten communities within the Goldfields region were amalgamated for the purpose of presenting data for this report, which may alter data presented in the 2010 report.
  • The proportion of children aged 5-9 years screened in the 68 screened at-risk communities was 60%; this ranged from 47% in the Goldfields region to 87% in the Midwest region (Table 4.1, Figure 4.3).
  • There was a decrease in the number of children screened in the Kimberley region, with 855 children being screened in 2011 (58% of at-risk population) compared to 933 in 2010 (71% of at-risk population).

Clean face prevalence

  • The overall prevalence of clean faces among screened populations in WA was 80%, and 78% in at-risk communities.
  • There was a decrease in the prevalence of clean face in all regions except in the Midwest region which remained stable at 92% compared to the results of the previous year. (Table 4.1, Figure 4.4).

Trachoma prevalence

  • The prevalence of trachoma among children screened age 5-9 in WA was 8%. The prevalence of active trachoma among screened children aged 5-9 years was 5% in Pilbara, 7% in the Kimberley, 9% in the Midwest and 12% in the Goldfields region (Table 4.1).
  • No active trachoma was detected in 58% (40/69) of communities screened (Table 4.3).
  • Of communities screened, 26% (18/69) had a prevalence of trachoma of greater than 10% (Table 4.3).

Treatment coverage

  • In 29/69 of communities screened treatment was required for trachoma (Table 4.2).
  • An estimated 85% of the at-risk population requiring treatment were actually treated with azithromycin (Table 4.2).

Trichiasis

  • Overall, 6% of the target population were screened for trichiasis (Table 4.4).
  • Two cases of trichiasis were reported in adults screened; both were found in the Pilbara region.
  • No cases of trichiasis were reported to have received surgery, although 3 cases were reported to have been offered an ophthalmic consultation (Table 4.4).

SAFE strategy compliance

  • Of all communities screened for trichiasis, 67% reported an operating trichiasis referral process.
  • Of communities screened, 58% reported the presence and use of facial cleanliness resources.
  • Of communities screened, 71% reported having facial cleanliness programs functioning within the community.
  • Of communities screened, 49% reported good environmental conditions, 13% reported variable environmental conditions, 6% reported poor environmental conditions, and 32 % did not report on environmental conditions (Table 4.5).
Figure 4.1 Colour-coded trachoma prevalence, community screening coverage and treatment coverage in communities designated as at-risk of trachoma and screened in 2011 in WA
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Map of WA, 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 WA
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Figure 4.2 Number of communities screened* by year and region in WA

line graph demonstrates the number of communities screened by year (2007–2011) and region in WA (Goldfields, Kimberley, Midwest and Pilbara). The trend over time was stable in the Kimberley, Midwest and Pilbara.

* Including communities screened but not at risk


Figure 4.3 Population screening coverage* of children aged 5-9 years over all regions containing at least one at-risk community by year and region in WA

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 WA (Goldfields, Kimberley, Midwest and Pilbara)

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

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Figure 4.4 Proportion of screened children* aged 5-9 years who had a clean face by year and region in WA[

line graph demonstrates the proportion of screened children aged 5-9 years who had a clean face by year (2007-2011) and region in WA (Goldfields, Kimberley, Midwest and Pilbara)

* Including children in communities screened but not at risk


Figure 4.5 Trachoma prevalence among screened* children aged 5-9 years by year and region in WA[

line graph demonstrates trachoma prevalence (%) in screened children aged 5-9 years by year (2007-2011) and region in WA (Goldfields, Kimberley, Midwest and Pilbara)

* Including children in communities screened but not at risk


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Figure 4.6 Screening coverage of children in at-risk communities in 2011 by age group and region in WA

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 WA (Goldfields, Kimberley, Midwest and Pilbara)

* Number of children screened


Figure 4.7 Trachoma prevalence among children screened in at-risk communities* in 2011 by age group and region in WA

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 WA (Goldfields, Kimberley, Midwest and Pilbara)

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

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Figure 4.8 Proportion of screened children* who had a clean face in 2011 by age group and region in WA

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 WA (Goldfields, Kimberley, Midwest and Pilbara).

* In communities where more than 5 children were screened
† Number of children observed to have a clean face


Figure 4.9 Trachoma prevalence among screened at-risk communities in 2011 by region in WA

graph demonstrates trachoma prevalence among screened at-risk communities in 2011 by region in WA (Goldfields, Kimberley, Midwest and Pilbara)

* Number of communities screened for trachoma

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Table 4.1 Trachoma screening coverage, trachoma prevalence, and clean face prevalence in WA 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
Goldfields
Kimberley
Midwest
Pilbara
Total
Total
Number of communities at risk
14
35
8
18
75
Number of communities screened
14
30
8
16
68
1
Age group (years)
1-4
5-9
10-14
All
1-4
5-9
10-14
All
1-4
5-9
10-14
All
1-4
5-9
10-14
All
1-4
5-9
10-14
All
1-4
5-9
10-14
All
Estimated number of Aboriginal children at risk
558
602
540
1700
1346
1475
1167
3988
92
141
139
372
269
280
249
798
2265
2498
2095
6858
Children examined for clean face
48
281
239
568
97
854
438
1389
24
123
120
267
38
240
149
427
207
1498
946
2651
9
6
39
54
Children with clean face
22
139
191
352
62
685
383
1130
20
110
115
245
19
183
131
333
123
1117
820
2060
4
1
38
43
Clean face prevalence
46%
49%
80%
62%
64%
80%
87%
81%
83%
89%
96%
92%
50%
76%
88%
78%
59%
75%
87%
78%
44%
17%
97%
80%
Children examined for trachoma
44
281
239
564
97
855
438
1390
24
122
120
266
38
240
149
427
203
1498
946
2647
9
6
39
54
Trachoma screening coverage
8%
47%
44%
33%
7%
58%
38%
35%
26%
87%
86%
72%
14%
86%
60%
54%
9%
60%
45%
39%
Children with active trachoma
0
35
10
45
3
64
12
79
0
11
5
16
0
13
11
24
3
123
38
164
0
0
0
0
Active trachoma prevalence
0%
12%
4%
8%
3%
7%
3%
6%
0%
9%
4%
6%
0%
5%
7%
6%
1%
8%
4%
6%
0%
0%
0%
0%
Trachoma prevalence 1-9 years
11%
7%
8%
5%
7%
0%
Trachoma prevalence 1-9 years (weighted by population) *
6%
5%
5%
3%
5%
0%
    Table 4.2 Treatment coverage in WA in 2011 by region

    * 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
    Goldfields
    Kimberley
    Midwest
    Pilbara
    Total
    Number of communities at risk
    14
    35
    8
    18
    75
    Number of communities requiring treatment
    6
    13
    4
    6
    29
    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
    Active cases requiring treatment
    0
    35
    10
    45
    3
    64
    12
    79
    0
    11
    5
    16
    0
    13
    11
    24
    3
    123
    38
    164
    Active cases received treatment
    0
    35
    10
    45
    3
    64
    10
    77
    0
    11
    5
    16
    0
    11
    10
    21
    3
    121
    35
    159
    % Active cases received treatment
    100%
    100%
    100%
    100%
    100%
    100%
    83%
    97%
    100%
    100%
    100%
    100%
    100%
    85%
    91%
    88%
    100%
    98%
    92%
    97%
    Estimated contacts requiring treatment (according to jurisdictional interpretation of the guidelines)
    315
    579
    121
    289
    1304
    Number of contacts who received treatment
    18
    72
    46
    178
    314
    63
    116
    79
    235
    493
    17
    20
    13
    59
    109
    20
    46
    39
    84
    189
    118
    254
    177
    556
    1105
    Estimated overall treatment coverage (total) *
    98%
    47%
    90%
    65%
    85%
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Table 4.3 Number of communities according to different trachoma prevalence ranges among children aged 5-9 years in WA in 2011
Prevalence
At-risk communities
Not-at-risk communities
Goldfields
Kimberley
Midwest
Pilbara
Total
0%
8
57%
17
57%
4
50%
10
63%
39
57%
1
100%
>0% but <5%
1
7%
2
7%
1
13%
0
0%
4
6%
0
0%
≥5% but <10%
1
7%
3
10%
1
13%
2
13%
7
10%
0
0%
10% but <20%
3
21%
3
10%
0
0%
2
13%
8
12%
0
0%
≥20%
1
7%
5
17%
2
25%
2
13%
10
15%
0
0%
Total
14
30
8
16
68
1
    Table 4.4 Trichiasis screening coverage, prevalence and treatment among Aboriginal Adults aged over 40 years in 2011 in WA
    Goldfields
    Kimberley
    Midwest
    Pilbara
    Total
    Adult population of at risk communities
    1212
    2481
    274
    571
    4538
    Number of communities at risk
    14
    35
    8
    18
    75
    Number of communities screened for trichiasis
    3
    21%
    0
    0
    8
    100
    2
    11%
    5
    7%
    Adults examined (% of estimated population at risk)
    34
    3%
    0
    0%
    198
    72%
    23
    4%
    255
    6%
    With trichiasis (% of adults examined)
    0
    0%
    0
    0%
    0
    0%
    2
    9%
    2
    1%
    Offered ophthalmic consultation
    0
    0
    0
    3
    3
    Surgery in past 12 months
    N/R
    N/R
    N/R
    N/R
    N/R
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    Table 4.5 Adherence to SAFE protocols in screened* communities in 2011 in WA

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

    Goldfields
    Kimberley
    Midwest
    Pilbara
    Total
    Surgery for trichiasis
    Referral process exists
    12
    86%
    23
    74%
    8
    100%
    3
    19%
    46
    67%
    No referral process
    2
    14%
    4
    13%
    0
    0%
    0
    0%
    6
    9%
    Referral unknown
    0
    0%
    4
    13%
    0
    0%
    10
    65%
    14
    20%
    Not Reported
    0
    0%
    0
    0%
    0
    0%
    3
    16%
    3
    4%
    Antibiotics
    Distribution in line with CDNA guidelines
    13
    100%
    28
    90%
    8
    100%
    10
    63%
    59
    87%
      Active cases and contacts treated within two weeks
    6
    46%
    13
    46%
    6
    75%
    3
    30%
    0
    0%
      No treatment required
    7
    64%
    15
    54%
    2
    25%
    7
    70%
    0
    0%
    Distribution not in line with CDNA guidelines
    0
    0%
    3
    10%
    0
    0%
    6
    37%
    9
    13%
      Active cases and contacts treated but not within two weeks
    0
    0%
    1
    33%
    0
    0%
    2
    33%
    0
    0%
      Not all contacts treated†
    0
    0%
    0
    0%
    2
    33%
    0
    0%
      Active cases only treated
    0
    0%
    2
    77%
    0
    0%
    1
    17%
    0
    0%
      No distribution
    0
    0%
    0
    0%
    1
    17%
    0
    0%
    Facial cleanliness resources
    Present and used
    13
    93%
    24
    77%
    2
    25%
    1
    6%
    40
    58%
    Present, not used
    1
    7%
    3
    10%
    3
    37.5%
    3
    19%
    10
    14%
    No resources
    0
    0%
    2
    6%
    3
    37.5%
    8
    50%
    13
    19%
    Not reported/unsure
    0
    0%
    2
    6%
    0
    0%
    4
    25%
    6
    9%
    Facial cleanliness programs
    Program exists
    14
    100%
    27
    87%
    5
    62.5%
    3
    19%
    49
    71%
    No program
    0
    0%
    1
    3%
    3
    37.5%
    8
    50%
    12
    17%
    Not reported/Unsure
    0
    0%
    3
    10%
    0
    0%
    5
    31%
    8
    12%
    Environmental Conditions
    Good
    0
    0%
    18
    58%
    7
    88%
    9
    56%
    34
    49%
    Variable
    0
    0%
    6
    19%
    1
    12%
    2
    12.5%
    9
    13%
    Poor
    0
    0%
    1
    3%
    0
    0%
    3
    19%
    4
    6%
    Not reported
    14
    100%
    6
    19%
    0
    0%
    2
    12.5%
    22
    32%