Australian Trachoma Surveillance Report 2012

Northern Territory Results 2012

Trachoma screening and management data for 2012 were provided to the National Trachoma Surveillance and Reporting Unit by the Northern Territory (NT), South Australia (SA), Western Australia (WA) and Queensland (Qld). Data were analysed by region in the NT, SA and WA, with five regions in the NT, four in SA and four in WA. Queensland screened six communities and its data was aggregated for analysis. Jurisdictional authorities had designated 204 remote Aboriginal communities as being at risk of endemic trachoma in 2012.

Page last updated: 23 December 2013

Screening coverage

  • At-risk community coverage of trachoma screening over the five regions with endemic trachoma in the NT was 93%, with 76 out of 82 at-risk communities screened (Table 2.1).
  • Between 2011 and 2012 an increase in the number of communities screened is observed in the Katherine region and a slight decrease in the Barkly region. Screening coverage has plateaued in all other regions over the last 3 years (Figure 2.2).
  • The proportion of children aged 5-9 years screened in the 76 at-risk communities was 67% with screening coverage ranging from 47% to 86% (Table 2.1, Figure 2.3).
  • The screening coverage of children aged 5-9 years in at-risk communities has increased in all regions of the NT since 2008 (Figure 2.3).
  • Screening was undertaken in the Town Camps of Alice Springs Urban region; however that data was not made available to the NTSRU.

Clean face prevalence

  • The overall prevalence of clean faces among 5-9-year-old children screened in the NT was 75%. The highest levels were found in the Darwin Rural region (Table 2.1, Figure 2.4).

Trachoma prevalence

  • The prevalence of trachoma in children aged 5-9 years screened in the NT was 4%. Prevalence ranged from 1% in East Arnhem and Darwin Rural regions to 9% in Alice Springs Remote region (Table 2.1, Figure 2.5).
  • No active trachoma was detected in 53% (40/76) of communities screened (Figure 2.6), an increase in the proportion of communities screened with no active trachoma from 34% in 2011.
  • A decreasing trend continues in the percentage of communities with endemic trachoma (prevalence greater than 5%), from 63% in 2010, to 46% in 2011 to 28% in 2012 (Figure 1.8).
  • A decreasing trend since 2008 in trachoma prevalence among 5-9-year old children is observed in all regions of the NT (Figure 2.5).
  • The greatest decrease in trachoma prevalence among 5-9-year children between 2011 and 2012 was observed in Alice Springs Remote region with a prevalence of 9% in 2012 compared with 14% in 2011 (Table 2.1, Figure 2.5).
  • The highest prevalence of trachoma among children aged 5-9 years was 37%, recorded within a community in the Alice Springs Remote region where more than 50 children aged 5-9 years were screened.
  • Verbal reports regarding Camps of Alice Springs Urban region were that trachoma prevalence was less than 5%.

Treatment coverage

  • Treatment for trachoma was required for 43 of the 76 at-risk communities screened (Table 2.2).
  • Of the cases of active trachoma detected at screening, 97% received treatment (Table 2.2).
  • Azithromycin was used to treat 79% of the contact population (Table 2.2).
  • Of the 43 communities requiring treatment, 41 communities were treated according to CDNA Guidelines.
  • Six communities received a second community-wide treatment of azithromycin, with overall treatment coverage of 70% in these six communities for the second treatment (Table 2.3).

Trichiasis

  • Trichiasis screening data was provided for 51% (42/82) of at‑risk communities, with 18% (1,278/7,030) of the at‑risk population screened (Table 2.4).
  • It is understood that screening was undertaken in a further 28 communities, however data was not made available to the NTRSU
  • Trichiasis was detected in 5% of the adults screened (Table 2.4).
  • Five cases of trichiasis were reported to have received surgery (Table 2.4).

Health promotion

  • Health promotion activities were reported in 23% (19/82) communities at risk, with an overall 45 health promotion initiatives reported (Table 2.5).
  • Of the health promotion initiatives reported, 38% (17/45) activities were directed at children; 36% (16/45) used a group presentation method and 40% (18/45) reported delivering activities 2‑4 times throughout the year (Table 2.5).

Figure 2.1 Trachoma prevalence in children aged 5-9 years, number of communities screened and number of at-risk communities in the Northern Territory in 2012


Map of NT regions, with shaded legend distinguishing the NT trachoma prevalence in 2012. East Arnhem 8 out of 10 at-risk communities screened is showing 1% trachoma prevalence. Darwin Rural 15 out of 16 at-risk communities screened showing 1% trachoma prevalence. Katherine 19 out of 19 at-risk communities screened showing 4% trachoma prevalence. Barkly 6 out of 7 at-risk communities screened showing 5% trachoma prevalence. Alice Springs Remote 28 out of 30 at-risk communities screened showing 7% trachoma prevalence.


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Figure 2.2 Number of communities screened* by year and region in the Northern Territory, 2007 – 2012


Line graph shows trends for regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).
Trend for all regions dips in 2008 but then continually increases until 2011 when all regions decrease slightly except Barkly which increases. For 2012, Alice Springs Remote and East Arnhem regions increase, Barkly decreases and Darwin Rural and Katherine regions plateau.

* 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 Northern Territory, 2007 – 2012


Line graph shows trends for regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).
For all regions there is generally an increasing trend from 2008 to 2012 except for Darwin Rural which increases until 2011 and then decreases in 2012.

* Including children in communities screened but not at risk
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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 Northern Territory, 2007 – 2012

Line graph shows trends for regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).Trend is reasonably stable until 2011 where the trend dips for Darwin Rural and then increases for 2012.Trend is reasonably stable until 2011 where the trend dips for Alice Springs Remote and continues to decrease in 2012.Trend is reasonably stable until 2011 where the trend increases for East Arnhem and then decreases for 2012.Trend decreases for Katherine until 2011 where the trend increases and then further increases slightly in 2012.Trend increases from 2008 for Barkly until 2011 and then decreases slightly in 2012.

* 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 Northern Territory, 2007 – 2012

Line graph shows trends for regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).In general, the trend for all regions spikes in 2008 and then decreases (with a plateau in Darwin Rural in 2009 and 2010, and a slight increase in 2011 in East Arnhem).

* Including children in communities screened but not at risk
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Figure 2.6 Trachoma prevalence among children 5-9 years in screened at-risk communities in 2012 by Northern Territory region

Histogram graph by regions in the NT (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine).
Data for Alice Springs Remote shows an approx. 33% of communities had no trachoma and approx. 16% each had >0% but<5%; > or equal to 5% but <10%, > or equal to 10%; or > or equal to 20%.
For Barkly 33% of communities and > or equal to 10% trachoma and approx. 16% each had >0% but<5%; > or equal to 5% but <10%, or > or equal to 20%.
For East Arnhem 50% communities had no trachoma and 50% had > 0% but <5%.
For Darwin Rural 80% of communities had no trachoma and 20% had > 0% but <5%.
For Katherine approx. 65% of communities had no trachoma and approx. 9% had >0% but<5%; > or equal to 5% but <10%, > or equal to 10%; or > or equal to 20%.

* Number of communities
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Figure 2.7 Trachoma prevalence among 5-9 year old children in screened at-risk communities in 2012 by sex and Northern Territory region

Column graph by NT regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine). Boys had a higher prevalence than girls in Alice Springs Remote and, then Barkly regions. Girls had a higher prevalence than boys in Darwin Rural, East Arnhem, and Katherine regions.
Data for each region: Alice Springs (remote) recorded 6.60% for girls and 10.60% for boys, Barkly recorded 1.80% for girls and 7.80% for boys, Darwin (rural) recorded 1.50% for girls and 0.3% for boys, East Arhem recorded 1.60% for girls and 0.8% for boys, Katherine recorded 7.50% for girls and 2.60% for boys

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Table 2.1 Trachoma screening coverage, trachoma prevalence and clean face prevalence in the Northern Territory in 2012 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 calculation accounts for uneven coverage with respect to age groups

Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total
Number of communities at risk 30 7 16 10 19 82
Number of communities screened 28 6 15 8 19 76
Trachoma prevalence 1-9 years (weighted by population)* 9% 9% 2% 1% 7% 6%
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
ABS estimated number of Aboriginal children at risk 823 843 728 2394 158 226 163 547 1049 1244 976 3269 776 980 859 2615 686 688 633 2007 3492 3981 3359 10832
Jurisdiction Estimated number of Aboriginal children at risk 573 879 735 2187 48 186 130 364 861 1143 1064 3068 903 939 1010 2852 706 746 794 2246 3091 3893 3733 10717
Children examined for clean face 143 773 499 1415 27 152 117 296 131 711 555 1397 14 452 337 803 131 552 387 1070 446 2640 1895 4981
Children with clean face 56 364 401 821 19 131 115 265 100 641 524 1265 9 359 311 679 109 477 368 954 293 1972 1719 3984
Clean face prevalence 39% 47% 80% 58% 70% 86% 98% 90% 76% 90% 94% 91% 64% 79% 92% 85% 83% 86% 95% 89% 66% 75% 91% 80%
Children examined for trachoma 81 757 499 1337 15 146 116 277 138 723 574 1435 9 445 335 789 119 539 384 1042 362 2610 1908 4880
Trachoma screening coverage 14% 86% 68% 61% 31% 78% 89% 76% 16% 63% 54% 47% 1% 47% 33% 28% 17% 72% 48% 46% 12% 67% 51% 46%
Children with active trachoma 7 69 18 94 2 8 5 15 5 7 3 15 0 6 1 7 10 27 8 45 24 117 35 176
Active trachoma prevalence 9% 9% 4% 7% 13% 5% 4% 5% 4% 1% 1% 1% 0% 1% 0% 1% 8% 5% 2% 4% 7% 4% 2% 4%

Table 2.2 Trachoma treatment coverage in the Northern Territory in 2012

* Communicable Diseases Network Australia. Guidelines for the public health management of trachoma in Australia. March 2006.

Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total
Number of communities at risk 30 7 16 10 19 82
Number of communities screened 28 6 15 8 19 76
Number of communities requiring treatment 18 5 7 5 8 43
Number of communities treated according to CDNA guidelines* 17 5 6 5 8 41
Age group (years) 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All
Active cases requiring treatment 7 69 18 94 2 8 5 15 5 7 3 15 0 6 1 7 10 27 8 45 24 117 35 176
Active cases received treatment 7 67 17 91 2 8 5 15 4 6 2 12 0 6 1 7 10 27 8 45 23 114 33 170
% Active cases received treatment 100% 97% 94% 97% 100% 100% 100% 100% 80% 86% 67% 80% 100% 100% 100% 100% 100% 100% 100% 96% 97% 94% 97%
Estimated contacts requiring treatment 378 432 390 1715 2915 19 29 13 69 130 25 19 14 66 124 18 15 22 92 147 132 124 142 590 988 572 619 581 2532 4304
Total number of contacts who received treatment 282 388 306 1149 2125 19 29 13 68 129 24 16 10 59 109 18 15 22 92 147 107 109 123 543 882 450 557 474 1911 3392
% estimated contacts received treatment 75% 90% 78% 67% 73% 100% 100% 100% 99% 99% 96% 84% 71% 89% 88% 100% 100% 100% 100% 100% 81% 88% 87% 92% 89% 79% 90% 82% 75% 79%
Estimated overall treatment coverage 75% 91% 79% 67% 74% 100% 100% 100% 99% 99% 93% 85% 71% 89% 87% 100% 100% 100% 100% 100% 82% 90% 87% 92% 90% 79% 91% 82% 75% 80%
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Table 2.3 Treatment coverage for second treatment of trachoma in hyperendemic communities in the Northern Territory in 2012
Alice Springs Remote Darwin Remote Total
Number of communities that received second treatment in a calendar year 4 2 6
Age group (years) 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All 0-4 5-9 10-14 15+ All
Estimated Number of contacts requiring treatment 90 105 83 369 647 360 592 548 3353 4853 450 697 631 3722 5500
Number of cases and contacts who received a second treatment 79 105 76 296 556 371 406 323 2181 3281 450 511 399 2477 3837
Estimated overall second treatment coverage 88% 100% 92% 80% 86% 103% 69% 59% 65% 68% 100% 73% 63% 67% 70%
Table 2.4 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults aged over 40 years in 2012 in the Northern Territory

* Twenty-eight further communities were screened across all regions, however findings were not made available to the NTSRU

Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total
Number of communities at risk 30 7 16 10 19 82
Number of communities screened for trichiasis 11 (37%) 0 (0%) 16 (100%) 7 (70%) 8 (42%) 42 (51%)*
Adult population of at-risk communities 1773 274 2090 1810 1083 7030
Adults examined (% of estimated population at risk) 175 (10%) 0 (0%) 879 (42%) 41 (2%) 183 (17%) 1278 (18%)
With trichiasis (% of adults examined) 26 (15%) 32 (4%) 0 3 (2%) 61 (5%)
Offered ophthalmic consultation 17 0 32 0 0 49
Surgery in past 12 months 5 0 0 0 0 5
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Table 2.5 Health promotion activities by region in the Northern Territory in 2012

* 2 -4 times per year

† 5-12 times per year

Alice Springs Remote Barkly Darwin Rural East Arnhem Katherine Total
Number of communities at-risk 30 7 16 10 19 82
Number of communities who reported health promotion activities 6 1 3 0 9 19
Methods of Health Promotion
One-on-one discussion 2 12% 3 43% 5 29% 10 22%
Presentation to group 5 29% 3 43% 8 47% 16 36%
Interactive group session 5 29% 2 100% 1 14% 4 24% 12 27%
Social Marketing 3 18% 3 7%
Print material 2 12% 2 4%
Mass Media 1 6% 1 2%
Sporting/community events 1 6% 1 2%
Other 0 0%
Total number of programs 19 2 7 0 17 45
Target audience
Health professionals/staff 2 12% 1 14% 1 6% 4 9%
Children 6 35% 1 50% 3 43% 7 41% 17 38%
Youth 2 12% 3 18% 5 11%
Teachers/childcare/preschool staff 3 18% 1 50% 1 14% 3 18% 8 18%
Caregivers/parents 1 6% 1 14% 3 18% 5 11%
Community members 4 24% 1 14% 5 11%
Community educators/health promoters 1 6% 0 0% 1 2%
Interagency members 0 0% 0 0%
Frequency of health promotion activities
Once 3 18% 3 7%
Occasional * 9 53% 2 100% 7 100% 18 40%
Regular† 4 24% 4 9%
Ongoing/routine 3 18% 3 7%
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