Australian Trachoma Surveillance Report 2013

Western Australia results

Page last updated: 2015

Western Australian results – Figures

Western Australian results –Tables

Summary


Trachoma program coverage

  • In 2013 WA identified 71 communities in four regions as being at risk of trachoma (Table 4.1).
  • All 71 at-risk communities were screened for trachoma (Table 4.1).
  • WA also screened two not at-risk communities in the Kimberley Region.

Screening coverage

  • Population screening coverage of 5-9-year-old children in the 71 at-risk communities screened was 90%, ranging from 87% in the Goldfields region to 97% in the Pilbara region (Table 4.2).

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 74%, ranging from 63% in the Goldfields region, to 91% in the Midwest Region (Table 4.2, Figure 4.5).

Trachoma prevalence

  • The prevalence of trachoma in children aged 5-9 years screened was 3.8%. Prevalence ranged from 2.4% in the Kimberley region to 6.9% in the Goldfields region (Table 4.2, Figure 4.6).
  • No trachoma was reported in 41 communities (Figure 4.7).
  • Endemic levels of trachoma were reported in 20 communities (Figure 4.7).
  • Non endemic levels of trachoma have been reported for three communities over a period of 5 years which would reclassify these communities as being not at risk for trachoma (Figure 4.8).

Treatment delivery and coverage

  • Trachoma treatment strategies were applied in 34 communities (Table 4.3).
  • Treatment was delivered to active cases and households in 27 communities, and to the whole of community in seven communities as per guidelines (Table 4.3).
  • The overall treatment coverage in all regions was 94% with 759 of azithromycin delivered (Table 4.4, Figure 4.9).

Trichiasis

  • Screening for trichiasis was undertaken in 64 communities.
  • Overall 1,817 adults aged over 15 years were screened (Table 4.5).
  • The prevalence of trichiasis in adults aged 15 years and over was 0.4%, and 0.5% in adults aged 40 years and over.
  • Surgery for trichiasis was reported to be undertaken for six adults (Table 4.5).

Health promotion

  • Health promotion activities were reported to have occurred in all 71 at-risk communities in all regions.
  • A total of 169 health promotion activities were reported.
  • The majority of the health promotion activities were delivered to children, teachers, childcare or preschool staff members (Table 4.6)
  • Top of page

Western Australian results Figures

Figure 4.1 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 Western Australia, 2013

Figure 4.1 is a map illustrating the Western Australia (WA) regions, with shading legend advising of the trachoma prevalence by the number of communities screened, treated or both, in children aged 5-9 years. In the Goldfields region there was less than/or equal to 5% but less than 10% of trachoma prevalence and for the the Kimberley, Pilbara and Midwest there was less than 5 % of trachoma prevalence. 
Further data for these regions indicates:
Goldfields screened 21 of 21 at-risk communities and had 6.9% trachoma prevalence
Kimberley screened 28 of 28 at-risk communities and had 2.4% trachoma prevalence
Pilbara screened 14 of 14 at-risk communities and had 3.1% trachoma prevalence
Midwest screened 8 of 8 at-risk communities and had 4.7% trachoma prevalence.Top of page

Figure 4.2 Number of communities at risk, by region, in Western Australia, 2007 – 2013

Figure 4.2 is a line graph demonstrating the number of at-risk communities in Goldfields, Kimberley, Midwest and Pilbara regions, between 2007 to 2013. All regions show and a plateauing trend from 2007 to 2009 followed by a slight increase in 2010.  The Kimberley has a decreasing trend from 2010 to 2013; Goldfields dips in 2011, increases in 2012 and decreases slightly in 2013; Pilbara increases slightly in 2011 followed by a decreasing trend to 2013; and the Midwest region maintain a plateauing trend from 2010.

Figure 4.3 Number of at-risk communities, by region, according to trachoma control strategy implemented, Western Australia, 2013

Figure 4.3 is a histogram graph illustrating the number of at-risk communities in the Goldfields, Kimberley, Midwest and Pilbara regions according to trachoma control strategy implemented. In the Goldfields 7 communities were screened and 14 communities screened and treated, the Kimberley region shows 18 communities were screened and 10 communities screened and treated, and the Midwest region shows 2 communities were screened and 6 communities were screened and treated and the Pilbara shows 10 communities were screened and 4 communities were screened and treated. Top of page

Figure 4.4 Population screening coverage in children aged 5-9 years in communities that required screening for trachoma, by region, in Western Australia in 2013

Figure 4.4 is a bar graph illustrating the population screening coverage in children aged 5-9 years by communities in the Goldfields, Kimberley, Midwest and Pilbara regions. The Goldfield region recorded 87% of the population were screened, the Kimberley region recorded 88% of the population screened, the Midwest region recorded 94% of the population screened and Pilbara 97% of the population screened.

Figure 4.5 Proportion of screened children aged 5-9 years who had a clean face, by region, in Western Australia, 2007 – 2013

Figure 4.5 is a line graph illustrating the proportion of screened children aged 5-9 years who had a clean face, by Goldfields, Kimberley, Midwest and Pilbara regions between 2007 to 2013.  The lineal graph shows the Goldfields region at 98% in 2007, dropping sharply to 76% in 2008, 86% in 2009, 81% in 2010, 76% in 2011, 94% in 2012 and 82% in 2013, the Kimberley region shows a stable trend of above 80% from 2007 to 2012 with a slight decrease to 74% in 2013, the Midwest region shows 88% in 2007, 93% in 2008, 84% in 2009, 89% in 2010 and 2011, 67% in 2012 and 91% in 2013 and the Pilbara region trend hovers around 80% from 2007 to 2011, increases to 92% in 2012 and then 82% in 2013.Top of page

Figure 4.6 Trachoma prevalence among children aged 5-9 year in communities that were screened, by region, in Western Australia, 2007 – 2013

Figure 4.6 is a line graph that shows trachoma prevalence trends for the Goldfields, Kimberley, Midwest and Pilbara regions between 2007 to 2013. The trend in the Goldfields region increased from 3% in 2007, peaked at 14% in 2009, and decreasing trend to 6.9 in 2013, the Kimberley region shows a gradual decreasing trend from 17% in 2007 to 2% in 2012 followed by a slight increase in to 2.4 % in 2013, the Midwest trend was inconsistent with a prevalence of 20% in 2007, dipping to 14% in 2008, increasing to 17% in 2009, dipping to 7% in 2010, increasing to 9% in 2011, decreasing to 4% in 2012 and increasing slightly to 4.7% in 2013 and the trend in the Pilbara peaked at 26% in 2008 and decreased from that time to 3.1% in 2013.

Figure 4.7 Number of at-risk communities according to level of trachoma prevalence in 5-9-year-old children in 2013, by region, in Western Australia

Figure 4.7 is a histogram graph illustrating the number of screened at-risk communities according to level of trachoma prevalence in the Goldfields, Kimberley, Midwest and Pilbara region. The data recorded shows: 
The Goldfields’region had 9 communities with no trachoma, 2 communities had less than 0% but greater than 5%, 5 communities had less than or equal to 5% but greater than 10%, and 5 communities had less than or equal to 20%.
For the Kimberley’s communities 19 had no trachoma, 5 communities had less than 0% but greater than 5%, 2 communities had less than or equal to 5% but greater than 10%, 1 community had less than or equal to 10% but greater than 20%, and 1 community less than or equal to 20%.
For the Midwest region 4 communities (approx.) had no trachoma, and 1 community had 0% had less than 0% but greater than 5%, 1 community had less than or equal to 5% but greater than 10%, 1 community had less than or equal to 10% but greater than 20%, and 1 community had less than or equal to 20%.
For the Pilbara’s communities 9 had no trachoma, 1 community had less than 0% but greater than 5%, 2 communities had less than or equal to 5% but greater than 10%, and 1 community had less than or equal to 10% but greater than 20%.Top of page

Figure 4.8 Communities according to number of years* of trachoma prevalence under 5% by region, in Western Australia, 2013

Figure 4.8 is a histogram graph illustrating the number of communities according to number of years of trachoma prevalence (under 5% ) by the Goldfields, Kimberley, Midwest and Pilbara regions. The data shows: The Goldfield regions has 3 communities for 1 year, 4 communities for 2 years and 1 community for 4 years of trachoma prevalence under 5%, the Kimberley region has 5 communities for 1 year, 7 communities for 2 years, and 5 communities for 3 and 4 years and 2 communities for 5 years of trachoma prevalence under 5%, the Midwest region has 2 communities for 1 year and 1 community each in 2, 3 and 4 years of trachoma prevalence under 5% and tje Pilbara has 1 community in 1 year, 3 communities in 2 years, 2 communities in 3 years, 3 communities in 4 years and 1 community in 5 years of trachoma prevalence under 5%.

* 5 years with a prevalence below 5% classifies a community as not at risk of trachoma

Figure 4.9 Number of doses of azithromycin administered for the treatment of trachoma by Western Australia region, 2007 – 2013

Figure 4.9 is a line graph showing the number of doses of azithromycin administered for the treatment of trachoma by the Goldfields, Kimberley, Midwest and Pilbara regions between 2007 to 2013. The Goldfields shows 70 doses in 2007, 95 doses in 2008, 147 doses in 2009, 328 doses in 2010, 359 doses in 2011, 219 doses in 2012 and 373 doses in 2013, the Kimberley region shows 1096 doses in 2007, peaks at 2333 doses in 2008, 864 doses in 2009, 685 doses in 2010, 570 doses in 2011, 398 doses in 2012 and 278 doses in 2013, the Midwest region shows 52 doses in 2007, 69 doses in 2008, 182 doses in 2009, 26 doses in 2010, 125 doses in 2011, 10 doses in 2012 and 57 doses in 2013 and the Pilbara region shows 183 doses in 2007, 420 doses in 2008, 266 doses in 2009, 142 doses in 2010, 210 doses in 2011, 73 doses in 2012 and 51 doses in 2013.Top of page

* Treatments administered in the Kimberley in 2007 are likely to have been under-reported, as treatment data were not received from several communities
† In the Kimberley in 2008, 17 communities were reported to have received ‘community-based treatment’, compared with only seven in 2009

Western Australian results Tables

Table 4.1 Trachoma control delivery in Western Australia in 2013
Number of communities
Goldfields
Kimberley
Midwest
Pilbara
Total
Not at-risk
* Communities treated without screening in 2013 as per guideline instructions
At risk* (A)
21
28
8
14
71
..
Requiring screening for trachoma (B)
21
28
8
14
71
..
Screened for trachoma (C)
21
28
8
14
71
2
Requiring treatment only (D)
N/A
N/A
N/A
N/A
N/A
N/A
Treated (E)
N/A
N/A
N/A
N/A
N/A
N/A
Screened and/or treated for trachoma (F = C+E)
21
28
8
14
71
2
Requiring neither screening or treatment for trachoma (G=A-B-D)
N/A
N/A
N/A
N/A
N/A
N/A
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Table 4.2 Trachoma screening coverage, trachoma prevalence and clean face prevalence in children (0-14 years old), by region, in Western Australia in 2013
Goldfields
Kimberley
Midwest
Pilbara
Total
Not at-risk
* Jurisdictional estimate
Number of communities screened
21
28
8
14
71
2
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
0-4
5-9
10-14
0-14
Children examined for clean face
94
364
259
717
77
825
264
1166
29
129
126
284
53
192
162
407
253
1510
811
2574
3
36
13
52
Children with clean face
38
231
233
502
33
607
243
883
20
117
124
261
32
157
149
338
123
1112
749
1984
3
29
13
45
Clean face prevalence (%)
40
63
90
70
43
74
92
76
69
91
98
92
60
82
92
83
49
74
92
77
100
81
100
87
Estimated number* of Aboriginal children in communities
105
418
334
857
102
932
369
1403
37
137
132
306
57
197
178
432
301
1684
1013
2998
5
62
42
109
Children examined for trachoma
94
364
259
717
75
823
270
1168
29
129
126
284
53
192
162
407
251
1508
817
2576
3
35
12
50
Trachoma screening coverage (%)
90
87
78
84
74
88
73
83
78
94
95
93
93
97
91
94
83
90
81
86
60
56
29
46
Children with active trachoma
9
25
15
49
1
20
4
25
2
6
3
11
3
6
0
9
15
57
22
94
0
0
0
0
Active trachoma prevalence (%)
10
6.9
5.8
6.8
1.3
2.4
1.5
2.1
6.9
4.7
2.4
3.9
5.7
3.1
0.0
2.2
6.0
3.8
2.7
3.6
0.0
0.0
0.0
0.0
Top of page
Table 4.3 Treatment strategies, by region, in Western Australia in 2013
Number of communities
Goldfields
Kimberley
Midwest
Pilbara
Total
*Communicable Diseases Network Australia. Guidelines for the public health management of trachoma in Australia. March 2006
Three communities in both Goldfield and Midwest regions did not provide estimates for contacts requiring treatment, and active cases only were treated
At risk
21
28
8
14
71
Treated for trachoma
14
10
6
4
34
Screened and treated
14
10
6
4
34
Received treatment only
N/A
N/A
N/A
N/A
N/A
Received 6-monthly treatment
N/A
N/A
N/A
N/A
N/A
Did not require treatment
7
18
2
10
37
Treated active cases and households
9
8
6
4
27
Treated the whole of community
5
2
0
0
7
Not treated according to CDNA guidelines
0
0
0
0
0
Top of page
Table 4.4 Trachoma treatment coverage in Western Australia in 2013
Goldfields
Kimberley
Midwest
Pilbara
Total
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
9
25
15
..
49
1
20
4
..
25
2
6
3
..
11
3
6
0
..
9
15
57
22
..
94
Active cases who received treatment
9
24
15
..
48
1
20
4
..
25
2
6
3
..
11
3
6
0
..
9
15
56
22
..
93
Active cases who received treatment (%)
100
96
100
..
98
100
100
100
..
100
100
100
100
..
100
100
100
N/A
..
100
100
98
100
..
99
Estimated contacts requiring treatment
34
60
49
183
326
62
79
73
89
303
2
9
9
26
46
4
10
9
19
42
102
158
140
317
717
Number of contacts who received treatment
34
60
49
182
325
41
63
61
88
253
2
9
9
26
46
4
10
9
19
42
81
142
128
315
666
Estimated contacts who received treatment (%)
100
100
100
99
100
66
80
84
99
83
100
100
100
100
100
100
100
100
100
100
79
90
91
99
93
Total number of doses of azithromycin delivered
43
84
64
182
373
42
83
65
88
278
4
15
12
26
57
7
16
9
19
51
96
198
150
315
759
Estimated overall treatment coverage (%)
100
99
100
99%
99
67
84
84
99
85
100
100
100
100
100
100
100
100
100
100
82
92
93
99
94
Top of page
Table 4.5 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults, by region, in Western Australia in 2013
Goldfields
Kimberley
Midwest
Pilbara
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 adults examined limited to numbers reported.This number does not account for adults who may be examined in routine adult health checks, and may also include multiple screening
Number of communities screened for trichiasis
19
25
6
14
64
Age group (years)
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15+
Estimated population in region
1243
803
2906
1639
356
274
1393
734
5898
3450
9348
Adults examined
149
289
..
1010
12
92
..
265
161
1656
1817
With trichiasis (% of adults examined)
0
1 (0.3%)
..
7 (0.7%)
0
0
..
0
0
8 (0.5%)
8 (0.4%)
Offered ophthalmic consultation
0
1
..
6
0
0
..
0
0
7
7
Declined ophthalmic consultation
0
1
..
0
0
0
..
0
0
1
1
Surgery in past 12 months
0
0
..
6
0
0
..
0
0
6
6
Top of page
Table 4.6 Health promotion activities, by region, in Western Australia in 2013
Goldfields
Kimberley
Midwest
Pilbara
Total
* 2-4 times per year
5-12 times per year
Number of communities at risk
21
28
8
14
71
Number of communities who reported health promotion activities
21
28
8
14
71
Total number of programs
68
59
8
34
169
Methods of Health Promotion
One-on-one discussion
17
6
..
14
37
Presentation to group
21
29
8
1
59
Interactive group session
18
18
8
9
53
Social marketing
..
5
..
..
5
Print material/mass media
20
24
8
10
62
Sporting/community events
1
..
..
..
1
Other
5
1
..
..
6
Target audience
Health professionals/staff
20
..
..
4
24
Children
22
30
8
12
72
Youth
2
5
..
8
15
Teachers/childcare/preschool staff
18
19
8
10
55
Caregivers/parents
3
9
7
11
30
Community members
2
14
8
9
33
Community educators/health promoters
1
1
1
1
4
Interagency members
..
..
..
1
1
Frequency of health promotion activities
Once
41
9
8
11
69
Occasional*
11
38
..
1
50
Regular
..
6
..
5
11
Ongoing/routine
18
6
..
17
41
Top of page

Health promotion summary

The promotion of facial cleanliness was the key strategy for health promotion activity across the endemic regions. Numerous school education sessions were conducted using the ‘No Germs on Me’ trachoma resources, the ‘Clean Faces, Strong Eyes’ story kits and interactive displays to demonstrate trachoma transmission and the importance of clean faces and hands in preventing trachoma infection. Puppet shows were developed to illustrate transmission vectors and were used in education sessions. The school sessions incorporated community education in a number of communities to further reinforce the prevention messages.

Considerable work has been undertaken in the Pilbara to increase the levels of health promotion around facial cleanliness and hygiene. This approach has included working with Aboriginal Medical Services, schools and communities across the region to ensure that consistent messaging about facial cleanliness was available all year round. Education sessions with mums and families took place at Football Carnivals three times per year and resources were left with different stakeholders to be used at different times. Desert sinks were used to encourage children to wash their hands and faces and clown doctors used clown humour to communicate the message. Following screening, community level results were presented to communities in a visual way to encourage ownership of health outcomes

Work with schools in ensuring adequate facilities for hand washing was an important strategy for the Health Promotion Officer in the Goldfields. Advocating for the installation of hand-washing stations, provision of disposable paper towels and soap-making activities were seen as particularly successful. The provision of face packs (containing a face washer, tissues and soap) for each child screened in the Goldfields encouraged greater levels of facial cleanliness and an increased awareness in education staff about the importance of personal hygiene.

In addition to school education sessions, local media in the Kimberley were used to promote the trachoma prevention message. Community service announcements in local languages were developed for radio to reinforce messages about trachoma prevention, transmission and treatment, as well as raise awareness about upcoming screening in communities. Pamphlets were also produced with key messages and local contact information for distribution across the region. Additionally, sponsorship of events such as the King of the Kimberley basketball carnival and a Clean Yard Competition provided further opportunities for promotion of the trachoma prevention message.

Community barbeques were held in Halls Creek Shire communities to give communities the screening results, further increasing the engagement of these communities with the program messages.