Australian Trachoma Surveillance Report 2013

Data Collection Form—Trichiasis

Page last updated: 2015

Summary form 3—Trichiasis

The completed form was forwarded from the jurisdictional co-ordinators to the National Trachoma Surveillance & Reporting Unit (NTSRU) for checking and analysis.

The Trichiasis form allowed data to be collected at the community level to assess males and females in age groups (15-29, 30-39, 40-49, 50+ years and totals) with screening questions on:

  • Number of Aboriginal adults in age group
  • Number of Aboriginal adults examined for trichiasis
  • Number of Aboriginal adults with trichiasis
  • Number of Aboriginal adults with trichiasis who were offered ophthalmological
  • consultation within 6 months of the previous screening
  • Number of Aboriginal adults with trichiasis who declined ophthalmological consultation within 6 months of the previous screening
  • Number of Aboriginal adults who underwent trichiasis surgery in the last year

Note the below image is a sample only. For further information, refer to the PDF document Australian Trachoma Surveillance Report 2013

alternative text for the Trachoma Screening Form 3, Trichiasis is available on the page. (This form was developed by the National Trachoma Surveillance & Reporting Unit and used for data collection by jurisdictions). Top of page