Australian Trachoma Surveillance Report 2012

South Australia 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

  • The 2011 and 2012 regional data reported is different to that reported in previous years. Communities screened in previous years have been reclassified in this report for consistency with 2012 reporting.
  • Data collected to February 2013 in SA were included in this year’s report.
  • Some trend figures do not include data collected in 2010 due to differences in age ranges reported in 2010.

Screening coverage

  • An increase in the number of at-risk communities screened was observed across all regions in SA in 2012 (Figure 3.2).
  • At-risk community coverage of trachoma screening over the four at-risk regions was 95% with 36 out of 38 at-risk communities screened (Table 3.1).
  • The proportion of children screened aged 5-9 years in at-risk regions was 79%with screening coverage ranging from 56% to 92% (Table 3.1, Table 3.3).
  • Compared to 2011, the screening rates of children aged 5-9 years in at-risk communities decreased in the Far North region, and increased in all other regions in SA in 2012 (Figure 3.3).

Clean face prevalence

  • The overall prevalence of clean faces among screened children aged 5-9 in SA was 90%, ranging from 77% to 100% (Table 3.1, Figure 3.4).

Trachoma prevalence

  • The overall prevalence of trachoma in children screened aged 5-9 years in SA was 2% (Table 3.1).
  • No active trachoma was detected in 81% (29/36) of at-risk communities screened in the 5-9 year age group (Figure 3.6).
  • A decreasing trend in the number of communities in SA with trachoma prevalence greater than 5% has been observed since 2008 (Figure 1.8).
  • No trachoma was detected in the Far North, and York and Mid North regions in the 5-9 year age group (Figure 3.6); however one case of trachoma was detected in the 10-14 year age group in the York and Mid North region (Table 3.1).
  • Comparing 2011 to 2012, lower trachoma prevalence among 5-9-year-old children is observed in both Anangu Pitjantjatjara Yankunytjatjara (APY) Lands, and Eyre and Western regions (Figure 3.5).
  • The highest prevalence of trachoma among children aged 5-9 years was 20% within a community in the APY Lands where less than 10 children were screened.

Treatment coverage

  • Treatment was required for 9 of the 36 communities screened (Table 3.1, Table 3.2).
  • Of the active cases requiring treatment for trachoma, 100% received treatment (Table 3.2).
  • Azithromycin was used to treat the estimated 97% of the population requiring treatment (Table 3.2).

Trichiasis

  • Trichiasis screening was undertaken in all at-risk regions in SA in 2012, with 14 at-risk communities screened and 47% (1,061/2,246) of adults in these communities screened (Table 3.3).
  • Trichiasis was detected in 1% (11/1,061) of adults screened (Table 3.3).

Health promotion

  • Health promotion activities were reported in 92% (35/38) of at-risk communities, with an overall 112 health promotion initiatives reported.
  • Of the health promotion programs reported, 44% (49/112) of activities were directed at children and 44% (49/112) used a one-on-one discussion method.
  • Of the health promotion programs reported, 48% (54/112) of programs were delivered once only, 48% (54/112) of programs were delivered 2-4 times throughout the year, and 4% (4/112) reported that programs were delivered 5-12 times throughout 2012 (Table 3.4).
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Figure 3.1 Trachoma prevalence in children aged 5‑9 years, number of communities screened and number of communities at‑risk in 2012 in South Australia


Map of South Australia, with shaded legend distinguishing the trachoma prevalence in 2012.  Far North 8 out of 8 at-risk communities screened showing 0% trachoma prevalence. APY lands 8 out of 9 at-risk communities screened showing 4% trachoma prevalence. Eyre and Western 6 out of 6 at risk communities screened showing 1% trachoma prevalence.York and Mid North 14 out of 15 at risk communities screened showing 0% trachoma prevalence.

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Figure 3.2 Number of communities screened* by year and region in South Australia, 2007 – 2012


Line graph shows trends by regions (APY Lands, Eyre/Western, Far North and York/Mid North). APY Lands has an increasing trend from 2007 to 2009, a decrease until 2011 and an increase again in 2012. Eyre/Western has an increasing trend from 2007-2009, then a dip in 2010 and an increase in 2011 and 2012. Far North has an increasing trend from 2007-2008, a decreasing trend from 2008 to 2010 and a major increase from 2010 to 2012. York/Mid North has a major increase from 2011 to 2012.

* Including communities screened but not at risk


Figure 3.3 Population screening coverage of children aged 5‑9 years over all regions containing at least one at‑risk community by year and region in South Australia, 2007 – 2012


Line graph shows trends by regions (APY Lands, Eyre/Western, Far North and York/Mid North).
APY Lands and York/Mid North have an inconsistent trend increasing from 2007-2008, dipping in 2009 and increasing to 2012. Far North increases from 2007 to 2011 and decreases in 2012. York and Mid North increases from 2011 to 2012


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Figure 3.4 Proportion of screened* children aged 5‑9 years who had a clean face by year and region in South Australia, 2007 – 2012


Line graph shows trends by regions (APY Lands, Eyre/Western, Far North and York/Mid North). APY Lands decreases in 2008 and then increases in 2011 before decreasing in 2012. There is a decreasing trend from 2007 to 2011 for Eyre/Western region and then increases in 2012. There is a consistent plateau at 100% from 2007 to 2012 for the Far North region. York/Mid North had 100% coverage in 2012.

* Including children in communities screened but not at risk
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Figure 3.5 Trachoma prevalence among screened* children aged 5‑9 years by year and region in South Australia, 2007 – 2012


Line graph shows trends by regions (APY Lands, Eyre/Western, Far North and York/Mid North).
APY Lands and Eyre/Western regions have an inconsistent trend with a dip in 2008, followed by a spike in 2009 with a gradual decreasing trend line to 2012. Far North trends plateau at 0% from 2007 to 2012. York/Mid North is 0% in 2012.

* Including children in communities screened but not at risk
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Figure 3.6 Trachoma prevalence among children aged 5‑9 years in screened at‑risk communities in 2012 by region in South Australia


Histogram  shows trends by regions (APY Lands, Eyre/Western, Far North and York/Mid North)
APY Lands had approx. 37% of communities each with no trachoma or >0% but <5% and approx. 12% with > or equal to 5% but <10% and > or equal to 10% but <20%. Eyre/Western had 66% communities with no trachoma and approx. 17% each with >0 but <5% and > or equal to 5% but <10%. Far North and York/Mid North regions found no trachoma.

* Number of communities


Figure 3.7 Trachoma prevalence of 5‑9 year old children in screened at‑risk communities in 2012 by sex and region in South Australia


Column graph by SA regions (APY Lands, Eyre/Western, Far North and York/Mid North). Boys had higher prevalence than girls in the APY Lands and Eyre/Western regions. Data for each region: APY lands recorded 2.5% for girls and 5% for boys. Eyre and Western recorded 0% for girls and 1.3% for boys . No prevalence was found in Far North and York/Mid North regions. SA total record was 1% for girls and 1.8% for boys.

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Table 3.1 Trachoma screening coverage, trachoma prevalence and clean face prevalence in South Australia 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

APY Lands Eyre/Western Far North York and Mid North Total
Number of communities at risk 9 6 8 15 38
Number of communities screened 8 6 8 14 36
Trachoma prevalence 1-9 years (weighted by population)* 1% 0% 0% 0% 1%
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
ABS estimated number of Aboriginal children at risk 190 228 173 591 313 317 289 919 208 202 168 578 231 214 225 670 942 961 855 2758
Jurisdiction Estimated number of Aboriginal children at risk 279 380 359 158 1176
Children examined for clean face 0 242 0 242 6 344 67 417 8 199 161 368 0 145 95 240 14 930 323 1267
Children with clean face 186 186 3 313 64 380 6 199 161 366 0 145 95 240 9 843 320 1172
Clean face prevalence 77% 77% 50% 91% 96% 91% 75% 100% 100% 99% 100% 100% 100% 75% 90% 99% 93%
Children examined for trachoma 0 242 0 242 6 344 67 417 8 202 161 371 0 145 94 239 14 933 322 1269
Trachoma screening coverage 87% 91% 56% 92% 79%
Children with active trachoma 10 10 0 3 0 3 0 0 0 0 0 0 1 1 0 13 1 14
Active trachoma prevalence 4% 4% 0% 1% 0% 1% 0% 0% 0% 0% 0% 0% 0.2% 0% 2% 0.3% 1%
Table 3.2 Treatment coverage in South Australia in 2012 by region

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

APY Lands Eyre/Western Far North York and Mid North Total
Number of communities at risk 9 6 8 15 38
Number of communities screened 8 6 8 14 36
Number of communities requiring treatment 6 2 0 1 9
Number of communities treated according to CDNA guidelines 5 2 N/A 1 8
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
Active cases requiring treatment 0 10 0 10 0 3 0 3 0 0 0 0 0 0 1 1 0 13 1 14
Active cases received treatment 0 10 0 10 0 3 0 3 0 0 0 0 0 0 1 1 0 13 1 14
% Active cases received treatment 100% 100% 100% 100% 100% 100% 100% 100%
Estimated contacts requiring treatment according to jurisdictional interpretation of the guidelines 8 12 8 55 83 1 9 2 7 19 0 0 0 0 0 0 0 1 1 9 21 10 63 103
Number of contacts who received treatment 8 11 8 53 80 1 9 2 7 19 0 0 0 0 0 0 0 1 1 9 20 10 61 100
% estimated contacts received treatment 100% 92% 100% 96% 96% 100% 100% 100% 100% 100% 100% 100% 100% 95% 100% 97% 97%
Estimated overall treatment coverage 100% 95% 100% 96% 97% 100% 100% 100% 100% 100% 100% 100% 100% 100% 97% 100% 97% 97%
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Table 3.3 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults aged over 40 years in 2012 in South Australia
APY Lands Eyre/Western Far North York and Mid North Total
Number of communities at risk 9 6 8 15 38
Number of communities screened for trichiasis 1 (11%) 4 (67%) 4 (50%) 5 (33%) 14 (37%)
Adult population of at-risk communities 485 436 832 493 2246
Adults examined (% of estimated population at risk) 287 (59%) 227 (52%) 350 (42%) 197 (40%) 1061 (47%)
With trichiasis (% of adults examined) 10 (3%) 0 (0%) 1 (0.3%) 0 (0%) 11 (1%)
Offered ophthalmic consultation 10 0 1 0 11
Surgery in past 12 months 2 0 0 0 2
Table 3.4 Health promotion activities in South Australia in 2012

* 2-4 times per year

† 5-12 times per year

APY Lands Eyre and Western Far North York and Midnorth Total
Number of communities at-risk 9 6 8 15 38
Number of communities who reported health promotion activities 8 5 8 14 35
Methods of Health Promotion
One-on-one discussion 8 50% 10 31% 12 43% 19 53% 49 44%
Presentation to group 0 0% 7 22% 4 14% 0 0% 11 10%
Interactive group session 0 0% 7 22% 1 4% 0 0% 8 7%
Social Marketing 0 0% 5 16% 0 0% 0 0% 5 4%
Print material 8 50% 2 6% 10 36% 17 47% 37 33%
Mass Media 0 0% 0 0% 0 0% 0 0% 0 0%
Sporting/community events 0 0% 1 3% 0 0% 0 0% 1 1%
Other 0 0% 0 0% 1 4% 0 0% 1 1%
Total number of programs 16 32 28 36 112
Target audience
Health professionals/staff 0 0% 6 19% 2 7% 33 92% 41 37%
Children 16 100% 11 34% 22 79% 0 0% 49 44%
Youth 0 0% 3 9% 2 7% 0 0% 5 4%
Teachers/childcare/preschool staff 0 0% 6 19% 2 7% 2 6% 10 9%
Caregivers/parents 0 0% 5 16% 0 0% 1 3% 6 5%
Community members 0 0% 1 3% 0 0% 0 0% 1 1%
Community educators/health promoters 0 0% 0 0% 0 0% 0 0% 0 0%
Interagency members 0 0% 0 0% 0 0% 0 0% 0 0%
Frequency of health promotion activities
Once 16 100% 4 13% 20 71% 14 39% 54 48%
Occasional * 0 0% 24 75% 8 29% 22 61% 54 48%
Regular† 0 0% 4 13% 0 0% 0 0% 4 4%
Ongoing/routine 0 0% 0 0% 0 0% 0 0% 0 0%
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