Australian Trachoma Surveillance Report 2014

Executive summary

Page last updated: 30 October 2015

Trachoma screening and management data for 2014 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 regions), SA (4 regions), WA (4 regions) and NSW (2 regions). Jurisdictional authorities designated 160 remote Aboriginal communities as being at risk or potentially at risk of endemic trachoma in 2014. In 2014 all jurisdictions were guided by the revised 2014 CDNA National guidelines for the public healthmanagement of trachoma in Australia. (reference 1).

Trachoma program coverage

  • Jurisdictions identified 160 communities as being at risk or potentially at risk of trachoma (Table 1.1).
  • The number of communities designated as being at risk has decreased marginally in the NT, and substantially decreased in SA and WA since 2012 (Figure 1.2).
  • Of 160 at-risk or potentially at-risk communities, 125 communities were determined to require screening for trachoma, a further 20 were identified to require treatment without screening (see methodology), leading to 145 communities that were determined to require screening, treatment or both screening and treatment for trachoma (Table 1.1).
  • Of these 145 communities, all received screening, treatment or both screening and treatment (Table 1.1).
  • The remaining 15 at-risk communities did not require screening or treatment as their previous year’s prevalence was under 5% (see methodology).
  • Four communities deemed not at risk were screened for trachoma in 2014 (Table 1.1).
  • In WA 10 previously distinct communities were aggregated as one community for the presentation of data due to small population sizes and frequent mobility between communities.
  • In SA 9 previously distinct communities were aggregated as one community for the presentation of data due to small population sizes and frequent mobility between communities

Screening coverage

  • Jurisdictions identified 125 communities in the four states and territory requiring screening for trachoma in 2014 and all 125 were screened for trachoma in 2014 (Table 1.1, Table 1.2).
  • Within these communities, 4284 (89%) of an estimated 4840 resident children aged 5-9 years were screened (Table 1.2).
  • Screening coverage in children aged 5-9 years in at-risk communities was 92% for the NT, 87% for SA, 91% for WA and 63% for NSW (Table 1.2, Figure 1.4).

Clean face prevalence

  • A total of 4241 children aged 5-9 years in 125 at-risk communities were assessed for clean faces during 2014 (Table 1.2).
  • The overall prevalence of clean faces in children aged 5-9 years was 83%, with 86% in the NT, 84% in SA , 79% in WA, and 100% 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 4.7%, with 5.9% in the NT, 4% in SA, 2.9% in WA and 0% in NSW (Table 1.2).
  • The observed trachoma prevalence in communities that screened in 2014 was 5.5% in the NT, 4% in SA, 2% in WA and 0% in NSW.
  • There has been a small increase in the prevalence of trachoma in 5-9-year-old children in the NT and SA in 2014 after a decreasing trend in all jurisdictions since 2009 (Figure 1.6).
  • From 2013 to 2014 the prevalence of trachoma in 5-9-year-old children decreased in WA and NSW ( Figure 1.6).
  • No trachoma was reported or detected in children aged between 5 and 9 years in 99 (62%) communities in 2014, including communities that screened for trachoma in 5-9-year-old children and communities that were not required to screen, in accordance with the guidelines (Figure 1.7).
  • Endemic levels of trachoma (> 5%) were reported in 48 (30%) communities in 2014 including communities that screened for trachoma in 5-9-year-old children and communities that were not required to screen, in accordance with the guidelines (Figure 1.7).
  • The small increase in trachoma prevalence in Australia from 2013 to 2014, after a number of years of decrease, must be interpreted cautiously, due to the nature of the mechanism of the surveillance procedures. The communities surveyed differ from year to year, and the assessment of trachoma is subject to error, as with any clinical technique. The continued need for improvements in promotion of facial cleanliness and environmental improvements may also be contributing factors. Nevertheless, the increment serves as a timely reminder of the need for all jurisdictions to maintain their commitment to the full implementation the national guidelines for trachoma control.

Treatment delivery and coverage

  • Trachoma treatment strategies were applied in 66 communities, 100% of those requiring treatment, including communities designated as not at risk of endemic trachoma (Table 1.3).
  • One community in the NT did not treat according to CDNA guidelines due to resource limitations (Table 1.3).
  • Of all cases detected that required treatment, 92% received treatment (Table 1.4).
  • Treatment was delivered to active cases and households in 38 communities, and to the whole of community in 29 communities according to the guidelines (Table 1.3).
  • Treatment coverage in all jurisdictions was 90%, with 89% in the NT and 98% in SA and WA (Table 1.4).
  • A total of 9803 doses of azithromycin were delivered for trachoma treatment (Table 1.4).

Trichiasis

  • Overall 9497 adults aged over 15 years were screened.
  • It is acknowledged that the data provided do not include trichiasis screening undertaken as part of the Adult Health Check MBS Item 715. These data are not available to the National Trachoma Surveillance and Reporting Unit.
  • The prevalence of trichiasis in adults aged 15 years and over was 0.05% and 0.9% in adults aged 40 years and over.
  • Surgery for trichiasis was reported to be undertaken for 17 adults in 2014 (Table 1.5).

Health promotion activities

  • Health promotion activities were reported to have occurred in 123 communities, including at-risk and not at-risk communities.
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