Australian Trachoma Surveillance Report 2013

South Australia results

Page last updated: 2015

South Australian results – Figures

South Australian results –Tables

Summary

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Trachoma program coverage

  • In 2013 SA identified 22 communities in three regions as being at risk of trachoma (Table 3.1).
  • Of the 22 communities at risk, 16 were screened for trachoma (Table 3.1).
  • Screening of only 3 of the 9 at-risk communities in the APY Lands occurred because practicalities in finalising contracts resulted in delays.
  • SA also screened 11 not at-risk communities in the York and Mid North region.

Screening coverage

  • Population screening coverage of 5-9-year-old children in the 16 at-risk communities screened was 90%, ranging from 78% in the APY Lands to 96% in the Far North region (Table 3.2, Figure 3.4)

Clean face prevalence

  • Clean face prevalence was assessed in all communities that were screened.
  • The overall prevalence of clean faces among 5-9-year-old children in the screened communities was 87%, ranging from 71% in the APY Lands, to 100% in the Far North region (Table 3.2, Figure 3.5).

Trachoma prevalence

  • The prevalence of trachoma in children aged 5-9 years screened was 3.5%. Prevalence ranged from 0.3% in the Far North region to 11% in the APY Lands (Table 3.2, Figure 3.6).
  • No trachoma was reported in 10 communities (Figure 3.7).
  • Endemic levels of trachoma were reported in six communities (Figure 3.7).
  • Non endemic levels of trachoma have been reported for four communities over a period of 5 years which would reclassify these communities as being not at risk for trachoma (Figure 3.8)

Treatment delivery and coverage

  • Trachoma treatment strategies were applied in six communities (Table 3.3)
  • Treatment was delivered to active cases and households in five communities, and to the whole of community in one community as per guidelines (Table 3.3)
  • The overall treatment coverage in all regions was 99% with 203 doses of azithromycin delivered (Table 3.4)

Trichiasis

  • Screening for trichiasis was undertaken in 23 communities.
  • Overall 1,834 adults aged over 15 years were screened.
  • The prevalence of trichiasis in adults aged 15 years and over was 0.4%, and 0.6% in adults aged 40 years and over.
  • Surgery for trichiasis was reported to be undertaken for two adults (Table 3.5).

Health promotion

  • Health promotion activities were reported to have occurred in 26 communities in all regions.
  • A total of 37 health promotion activities were reported.
  • The majority of the health promotion activities were delivered to children and health professional staff members (Table 3.6).
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South Australian results Figures

Figure 3.1 Trachoma prevalence in children aged 5-9 years, number of communities that were screened, treated or both for trachoma and number of at-risk communities in South Australia, 2013

Figure 3.1 is a map illustrating the South Australian (SA) regions, with shading advising the trachoma prevalence in by the number of communities (screened, treated or both) in children aged 5-9 years . The Far North region and the York and Mid North region had no trachoma identified; the Eyre and Western region had less than 5 % Trachoma prevalence; and the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands had greater than 10 % but less than 20 % trachoma prevalence. 
Further data for this region indicates:
Far North 8/8 at risk communities screened showing 0.3% trachoma prevalence.
APY lands 3/9 at risk communities screened showing 11% trachoma prevalence.
Eyre and Western 5/5 at risk communities screened showing 4.8% trachoma prevalence.
York and Mid North 14 not at risk communities screened showing 0% trachoma prevalence.

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Figure 3.2 Number of communities at risk, by region, in South Australia, 2007 – 2013

Figure 3.2 is a line graph illustrating the number of at-risk communities in Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western, Far North and York/Mid North) during 2007 to 2013. APY Lands shows a plateaued trend from 2007-2011 decreasing slightly in 2012, Eyre and Western shows a plateaued trend from 2007-2011 decreasing dramatically in 2012, Far North shows a plateaued trend from 2007-2010, increasing slightly in 2011 a decreasing slightly in 2012 amd York/Mid North region increased slightly in 2008, plateaued to 2010 with a steady decreasing trend to 0 in 2013.

* APY: Anangu Pitjantjatjara Yankunytjatjara

Figure 3.3 Number of at-risk communities, by region, according to trachoma control strategy implemented, South Australia, 2013

Figure 3.3 is a histogram graph illustrating the number of at-risk communities (Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western and Far North) that were screened and/or treated under the Trachoma Control Strategy in 2013. The APY Lands region recorded 6 communities were not screened or treated  and 3 communities screened and treated.
In the Eyre and Western region 3 communities were screened and 2 communities screened and treated, the Far North region recorded 7 communities screened and 1 community screened and treated.

* APY: Anangu Pitjantjatjara Yankunytjatjara

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Figure 3.4 Population screening coverage of children aged 5-9 years in at-risk communities that required screening for trachoma, by region, in South Australia in 2013

Figure 3.4 is a bar graph illustrating the population screening coverage in children aged 5-9 years by communities (in Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western and Far North regions). APY Lands shows 78% of the population were screened, Eyre and Western shows 88% of the population were screened and Far North shows 96% of the population were screened.

* APY: Anangu Pitjantjatjara Yankunytjatjara

Figure 3.5 Proportion of screened children* aged 5-9 years who had a clean face, by region, in South Australia, 2007 – 2013

Figure 3.5 is a line graph illustrating the proportion of screened children aged 5-9 years who had a clean face, 
by regions (Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western region and Far North) between 2007 to 2013. The lineal graph shows APY Lands decreases from 78% to 53% in 2008 gradually increases to 89% in 2011 and decreases to 71% in 2013. Eyre and Western has a decreasing trend from 100% in 2007 to 47% in 2011 followed by a sharp increase to 91% and a decrease to 77% in 2013.  Far North trends plateau at100% from 2007 to 2012.

* In at-risk communities
APY: Anangu Pitjantjatjara Yankunytjatjara

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Figure 3.6 Trachoma prevalence among children aged 5-9 year in at-risk communities that were screened, by region, in South Australia, 2007 – 2013

Figure 3.6 is a line graph illustrating trachoma prevalence trends in children aged 5-9 years in at-risk communicies, by regions (Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western and Far North) between 2007 to 2013. The data shows APY Lands had 14% in 2007, 3 % in 2008, 15% in 2009, no data for 2010, 9% in 2011, 4% in 2012 and 11% in 2013. 
Eyre and Western had 15% in 2007, 1% in 2008, 11% in 2009, no data for 2010, 7% in 2011, 1% in 2012 and 4.8% in 2013.
Far North had 0% in years 2007, 2008, 2011 and 2002; no data in years 2009 and 2010 and 0.3% in 2013.

APY: Anangu Pitjantjatjara Yankunytjatjara

Figure 3.7 Number of at-risk communities according to level of trachoma prevalence in 5-9-year-old children, by region, South Australia, 2013

Figure 3.7 is a histogram graph illustrating the number of screened at-risk communities according to level of trachoma prevalence by regions (Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western and Far North.) The data shows:
APY Lands region has 1 community with less than or equal to 5% but greater than 10% and 2 communities with less than or equal to 10% but greater than 20%, Eyre and Western had 3 communities with no trachoma and 1 community each less than or equal to 10%, less than or equal to 20% and the Far North region has 7 communities with no trachoma and 1  community with less than or equal to 5% but greater than 10%.

* APY: Anangu Pitjantjatjara Yankunytjatjara

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Figure 3.8 At-risk communities according to number of years* of trachoma prevalence under 5% by region, South Australia, 2013

Figure 3.8 is a histogram graph illustrating the number of communities according to number of years of trachoma prevalence, by regions (Eyre and Western and Far North).  The data shows: Eyre and Western region has 1 community with 1 year and 2 communities with 5 years of trachoma prevalence under 5% and the Far North region has 1 community with 2 years, 4 with 3 years and 2 with 5 years of trachoma prevalence under 5%.

* 5 years with a prevalence below 5% classifies a community as not at risk of trachoma
APY: Anangu Pitjantjatjara Yankunytjatjara

Figure 3.9 Number of doses of azithromycin administered for the treatment of trachoma, by region, South Australia, 2007 – 2013

Figure 3.9 is a line graph showing the number of doses of azithromycin administered for the treatment of trachoma, by regions (Anangu Pitjantjatjara Yankunytjatjara Lands (APY Lands), Eyre and Western and Far North) between 2007-2013. The data shows: APY Lands has 12 doses in 2007, 4 doses in 2008, 13 doses in 2009, no data in 2010, 146  doses in 2011, 90 doses in 2012 and 93 doses in 2013, Eyre and Western regions has 8  doses in 2007, 3 doses in 2008, 6 doses in 2009, no data in 2010, 322  doses in 2011, 22  doses in 2012 and 106 doses in 2013 and the Far North region has 0 doses in years between 2007 to 2012 and 4  doses in 2013.

APY: Anangu Pitjantjatjara Yankunytjatjara

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South Australia results Tables

Table 3.1 Trachoma control delivery in South Australia in 2013
At risk
Not at risk
Number of communities
APY Lands
Eyre and Western
Far North
Total
York and Mid North

*Communities treated without screening in 2013 as per guideline instructions
APY: Anangu Pitjantjatjara Yankunytjatjara

At risk* (A)
9
5
8
22
0
Requiring screening for trachoma (B)
9
5
8
22
0
Screened for trachoma (C)
3
5
8
16
11
Requiring treatment only (D)
N/A
N/A
N/A
N/A
N/A
Treated (E)
N/A
N/A
N/A
N/A
N/A
Screened and/or treated for trachoma (F = C+E)
3
5
8
16
11
Requiring neither screening or treatment for trachoma (G=A-B-D)
N/A
N/A
N/A
N/A
N/A
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Table 3.2 Trachoma screening coverage, trachoma prevalence and clean face prevalence in children (0-14 years old), by region, in South Australia in 2013
APY Lands
Eyre and Western
Far North
Total
York and Mid North
*ABS estimate
In communities that were screened for trachoma
APY: Anangu Pitjantjatjara Yankunytjatjara
Number of communities screened
3
5
8
16
11
Age group (years)
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
Children examined for clean face
0
121
0
..
12
270
105
387
36
377
274
687
..
768
..
..
1
116
86
203
Children with clean face
..
86
..
..
11
208
68
287
33
377
274
684
..
671
..
..
1
116
86
203
Clean face prevalence (%)
..
71
..
..
92
77
65
74
92
100
100
100
..
87
..
..
100
100
100
100
Estimated number* of Aboriginal children in communities
..
156
..
..
258
308
207
773
334
393
388
1115
..
857
..
..
143
151
126
420
Children examined for trachoma
0
121
0
..
12
270
105
387
36
377
274
687
..
768
..
..
1
116
86
203
Trachoma screening coverage (%)
..
78
..
..
5
88
51
50
11
96
71
62
..
90
..
..
1
77
68
48
Children with active trachoma
..
13
..
..
1
13
5
19
0
1
0
1
..
27
..
..
0
0
0
0
Active trachoma prevalence (%)
..
11
..
..
8.3
4.8
4.8
4.9
0.0
0.3
0.0
0.1
..
3.5
..
..
0.0
0.0
0.0
0.0
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Table 3.3 Treatment strategies, by region, in South Australia in 2013
Number of communities
APY Lands
Eyre and Western
Far North
Yorke and Mid North
Total
APY: Anangu Pitjantjatjara Yankunytjatjara
Required treatment for trachoma
3
2
1
0
6
Treated for trachoma
3
2
1
0
6
Screened and treated
3
2
1
0
6
Received treatment only
N/A
N/A
N/A
N/A
0
Received 6-monthly treatment
N/A
N/A
N/A
N/A
0
Did not require treatment
0
3
7
0
10
Treated active cases and households
3
1
1
0
5
Treated the whole of community
0
1
0
0
1
Not treated according to CDNA guidelines
0
0
0
0
0
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Table 3.4 Trachoma treatment coverage, by region, in South Australia in 2013
APY Lands
Eyre and Western
Far North
York and Mid North (Not at-risk)
Total
APY: Anangu Pitjantjatjara Yankunytjatjara
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
..
13
..
..
13
1
13
5
..
19
0
1
0
..
1
N/A
N/A
N/A
..
N/A
1
27
5
0
33
Active cases who received treatment
..
13
..
..
13
1
13
5
..
19
0
1
0
..
1
..
..
..
..
..
1
27
5
0
33
Active cases who received treatment (%)
..
100
..
..
100
100
100
100
..
100
..
100
..
..
100
..
..
..
..
..
100
100
100
..
100
Estimated contacts requiring treatment
13
14
11
45
83
11
26
18
32
87
1
1
0
1
3
N/A
N/A
N/A
N/A
N/A
25
41
29
78
173
Number of contacts who received treatment
13
14
10
43
80
11
26
18
32
87
1
1
0
1
3
..
..
..
..
..
25
41
28
76
170
Estimated contacts who received treatment (%)
100
100
91
96
96
100
100
100
100
100
100
100
..
100
100
..
..
..
..
..
100
100
97
97
98
Total number of doses of azithromycin delivered
13
27
10
43
93
12
39
23
32
106
1
2
0
1
4
..
..
..
..
..
26
68
33
76
203
Estimated overall treatment coverage (%)
100
100
91
96
97
100
100
100
100
100
100
100
..
100
100
..
..
..
..
..
100
100
97
97
99
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Table 3.5 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults aged over 40 years, by region, in South Australia in 2013
APY Lands
Eyre and Western
Far North
Yorke and Mid North
Total
*Population estimate limited to trachoma endemic regions and does not take into account changing endemic regions over time and transiency between regions
Number of communities screened for trichiasis
9
5
7
2
23
Age group (years)
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15+
Estimated population in region*
1020
495
639
340
1189
850
537
436
3385
2121
5506
Adults examined
411
333
..
452
82
508
19
29
512
1322
1834
With trichiasis (% of adults examined)
0
4 (1%)
..
0
0
3 (0.6%)
0
1 (3%)
0
8 (0.6%)
8 (0.4%)
Offered ophthalmic consultation
0
4
..
0
..
3
..
1
..
8
8
Declined ophthalmic consultation
0
0
..
0
..
0
..
0
..
0
0
Surgery in past 12 months
0
2
..
0
..
0
..
0
..
2
2
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Table 3.6 Health promotion activities, by region in South Australia in 2013
APY Lands
Eyre and Western
Far North
York and Midnorth
Total
*2-4 times per year
5-12 times per year
Number of communities at risk
9
5
8
..
22
Number of communities who reported health promotion activities
3
5
8
10
26
Total number of programs reported
3
9
13
12
37
Methods of Health Promotion
One-on-one discussion
3
8
13
12
36
Presentation to group
..
9
1
1
11
Interactive group session
..
7
1
..
8
Social marketing
..
6
..
..
6
Print material/mass media
3
6
12
1
22
Sporting/community events
..
7
1
..
8
Other
..
5
..
..
5
Target audience
Health professionals/staff
1
7
13
2
23
Children
3
9
13
12
37
Youth
..
..
..
..
0
Teachers/childcare/preschool staff
3
8
2
..
13
Caregivers/parents
..
8
..
..
8
Community members
3
7
1
..
11
Community educators/health promoters
3
7
1
..
11
Interagency members
..
6
1
2
9
Frequency of health promotion activities
Once
..
..
..
..
..
Occasional*
3
4
13
12
32
Regular
..
5
..
..
5
Ongoing/routine
..
..
..
..
..
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Health promotion summary

South Australian agencies that undertake screening and treatment work also undertake health promotion activities including community education with regard to the importance of clean faces. The clean face message is communicated with the clean hand message. Information is provided to teachers, health workers, families and children with the aim of achieving a social norm in which clean faces are expected, and unclean faces are rarely observed. Environmental changes are also being focused on. Mirrors at schools are being fixed to walls at the eye level of younger children, house maintenance officers are being encouraged to fix household taps in short time frames. Environmental health officers working in remote communities have received training to improve their knowledge of the factors impacting on trachoma transmission and the SAFE strategy (Surgery, Antibiotics, Facial Cleanliness and Environment). Country Health SA is monitoring the housing upgrades and housing maintenance in remote communities of the state, recognising that working taps are health hardware in housing and are essential both to improving general health and reducing the prevalence of trachoma.