Australian Trachoma Surveillance Report 2013

Executive summary

Page last updated: 2015

Trachoma screening and management data for 2013 were provided to the National Trachoma Surveillance and Reporting Unit by the Northern Territory (NT), South Australia (SA), Western Australia (WA) and New South Wales (NSW). Data were analysed by region in the NT (5), SA (4), WA (4) and NSW (1). Jurisdictional authorities designated 173 remote Aboriginal communities as being at risk of endemic trachoma in 2013. NSW undertook a mapping exercise in 2013 screening 10 communities and data were aggregated for analysis. In 2013 WA, SA and NSW were guided by the 2006 Communicable Diseases Network Australia (CDNA) Guidelines for the public health management of trachoma in Australia (reference 1), and the NT was guided by the recently revised 2014 CDNA National guidelines for the public health management of trachoma in Australia (reference 2).

Trachoma program coverage

  • Jurisdictions identified 183 communities as being at risk of trachoma, or potentially at risk for the purposes of a mapping exercise in NSW (Table 1.1).
  • The number of communities designated as being at risk has plateaued in the NT, marginally decreased in WA and substantially decreased in SA since 2012 (Figure 1.2).
  • Of 183 at-risk/potentially at-risk communities, 145 communities were determined to require screening for trachoma, a further 18 were identified to require treatment without screening (see methodology), leading to a total of 163 communities that were determined to require screening, treatment or both screening and treatment for trachoma (Table 1.1).
  • Of these 163 communities, 144 (88%) received screening, treatment or both screening and treatment. (Table 1.1).
  • The remaining 20 at-risk communities did not require screening or treatment as their previous year’s prevalence was under 5% (see methodology section).
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  • A total of 15 communities deemed not at risk were screened for trachoma in 2013 (Table 1.1).

Screening coverage

  • Jurisdictions identified 145 communities in the four states and territory requiring screening for trachoma in 2013 and of these 127 (88%) were screened for trachoma in 2013 (Table 1.1, Table 1.2).
  • Within these communities 4213 (84%) of an estimated 5017 resident children aged 5-9 years were screened (Table 1.2).
  • Screening coverage in children aged 5-9 years in at-risk communities was 81% for the NT, 90% for SA and WA and 72% for NSW (Table 1.2, Figure 1.4).

Clean face prevalence

  • A total of 4244 children aged 5-9 years in 127 at-risk communities were assessed for clean faces during 2013 (Table 1.2).
  • The overall prevalence of clean faces in children aged 5-9 years was 81%, with 78% in the NT, 87% in SA, 74% in WA and 96% in NSW (Table 1.2, Figure 1.5).

Trachoma prevalence

  • The overall prevalence of active trachoma among children aged 5-9 years in screened communities (using projected data, see methodology) was 4%, with 5% in the NT, 3.8% in WA, 3.5% in SA, and 0.5% in NSW (Table 1.2).
  • The observed trachoma prevalence in communities that screened in 2013 in the NT was 2%.
  • Since 2009, the prevalence of trachoma in 5-9-year-old children has decreased significantly in all studied jurisdictions, with the projected national trachoma prevalence dropping from 14% in 2009 to 4% in 2013. From 2012 to 2013 the prevalence of trachoma in 5-9-year-old children has remained steady in WA, and increased in the NT and SA (Figure 1.6).
  • No trachoma was reported or detected in children aged between 5-9 years in 91 (50%) communities in 2013, including communities that screened for trachoma in 5-9-year-old children and communities in the NT that did not screen in accordance with guidelines (Figure 1.7).
  • Endemic levels of trachoma (> 5%) were reported in 55 (33%) communities in 2013 including communities that screened for trachoma in 5-9-year-old children and communities in the NT that did not screen in accordance with guidelines (Figure 1.7).
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Treatment delivery and coverage

  • Trachoma treatment strategies were applied in 73 communities, 99% of those requiring treatment (Table 1.3).
  • Three communities, all in the NT did not treat according to CDNA guidelines (Table1.3).
  • Of all cases detected that required treatment, 99% received treatment (Table 1.4).
  • Treatment was delivered to active cases and households in 45 communities, and to the whole of community in 29 communities according to the guidelines (Table 1.3).
  • Treatment coverage in all jurisdictions was 81%, with 79% in the NT, 99% in SA, 94% in WA and 100% in NSW (Table 1.4).
  • A total of 10 219 doses of azithromycin was delivered (Table 1.4).

Trichiasis

  • Screening for trichiasis was undertaken in 143 communities (Table 1.5).
  • Overall 5635 adults aged over 15 years were screened.
  • The prevalence of trichiasis in adults aged 15 years and over was 1% (55/5635), and 1% (49/3856) in adults aged 40 years and over.
  • Surgery for trichiasis was reported to be undertaken for 31 adults in 2013 (Table 1.5).

Health promotion activities

  • Health promotion activities were reported to have occurred in 128 communities, including at-risk and not at-risk communities.
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