Australian Trachoma Surveillance Report 2014

Western Australia Results

Page last updated: 30 October 2015

Western Australian results – Figures

Western Australian results –Tables

Summary


Trachoma program coverage

  • In 2014 WA identified 59 communities in four regions as being at risk of trachoma (Table 4.1).
  • Of the 59 at-risk communities, 58 communities were determined to require screening for trachoma and one community was identified as requiring treatment without screening (see methodology).
  • Of the 59 at-risk communities, all received screening and treatment or both for trachoma according to the guidelines.
  • In 2014 WA aggregated 10 communities in the Goldfields region into one community due to small population size of communities and high mobility between communities.

Screening coverage

  • Population screening coverage of 5-9-year-old children in the 58 at-risk communities screened was 91%, ranging from 85% in the Midwest region to 100% in the Pilbara region (Table 4.2).

Clean face prevalence

  • Population screening coverage of 5-9-year-old children in the 58 at-risk communities screened was 91%, ranging from 85% in the Midwest region to 100% in the Pilbara region (Table 4.2).
  • The overall prevalence of clean faces among 5-9-year-old children was 79%, ranging from 59% in the Goldfields region to 91% in the Midwest and Pilbara regions (Table 4.2, Figure 4.5).

Trachoma prevalence

  • The observed prevalence of trachoma in children aged 5-9 years screened was 2%. Prevalence ranged from 0% in the Pilbara region to 11.5% in the Midwest region (Table 4.2, Figure 4.6).
  • No trachoma was reported in 45 communities (Figure 4.7).
  • Endemic levels of trachoma were reported in eight communities, including communities that screened for trachoma in 5-9-year-old children and that did not screen in accordance with guidelines (Figure 4.7).
  • Non endemic levels of trachoma have been reported for nine communities over a period of 5 years which may reclassify these communities as being not at risk for trachoma (Figure 4.8).

Treatment delivery and coverage

  • Trachoma treatment strategies were applied in 20 communities (Table 4.3).
  • Treatment was delivered to active cases and households in 18 communities, and to the whole of community in three communities as per guidelines (Table 4.3).
  • The overall treatment coverage in all regions was 98% with 1798 doses of azithromycin delivered (Table 4.4, Figure 4.9).

Trichiasis

  • Overall 2836 adults aged over 15 years were reported to be screened, with 11 cases of trichiasis reported (Table 4.5).
  • A large volume of trichiasis screening in WA is undertaken within the Medicare Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715). These data are not made available to the NTSRU.

Health promotion

  • Health promotion activities were reported to have occurred in 59 at-risk communities across all regions.
  • A total of 179 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).

Western Australia 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, Western Australia, 2014

Figure 4.1 is a map of WA, divided into the 5 regions, to illustrate the trachoma prevalence in children aged 5 to 9 years. The map indicates between 5% and 10% in the Goldfields, less than 5% in the Kimberley, between 10% to 20% trachoma in the Midwest, no trachoma in the Pilbara, and there was no data collected/no screening/not risk in the South West corner of WA.
The map also lists the number of communities per region that were screened and or treated; the remaining number of at-risk communities that did not require screening or treatment; and the percentage of trachoma prevalence in that region.
Goldfields screened 12 of 12 at-risk communities, and recorded 5.7% trachoma prevalence. Kimberley screened 30 of 30 at-risk communities, and recorded 1% trachoma prevalence. Pilbara screened 9 of 9  at-risk communities, and recorded 0% trachoma prevalence and the Midwest screened 8 of 8 at-risk communities, and recorded 11.5% trachoma prevalence.Top of page


Figure 4.2 Number of at-risk communities, by region, Western Australia, 2007 – 2014

Figure 4.2 is a Line graph illustrating the number of communities at-risk of trachoma for the years 2007 to 2014, by 4 regions (Goldfields, Kimberley, Midwest and Pilbara).
All regions indicate consistent data for 2007 to 2009 followed by a slight increase in 2010.  
Goldfields data indicates around 20 for 2007 to 2009, increasing to 24 in 2010, dips to 14 in 2011, up to 24 in 2012 and decreasing to 21 in 2013 and more steeply to 12 in 2014.
Kimberley data indicates 31 for 2007 to 2009, peaking at 37 in 2010 and has a decreasing trend to 28 in 2013 with a slight increase to 30 in 2014.
Midwest data indicates 6 in 2007 to 2009, increasing to 8 in 2010 to 2014.
Pilbara data indicates 16 for 2007 to 2009, increasing to 17 in 2010, 18 in 2011, decreasing to 15 in 2012, 14 in 2013 and 9 in 2014.

Figure 4.3 Number of at-risk communities, by region, according to trachoma control strategy implemented, Western Australia, 2014


Figure 4.3 is a Stacked bar graph illustrating the number of at-risk communities that were screened and/or treated under the Trachoma Control Strategy by 4 regions (Goldfields, Kimberley, Midwest and Pilbara).
Goldfields region data indicates that of 12 at-risk communities: 6 communities were screened; 5 were screened and treated; and 1 received treatment only.
Kimberley region data indicates that of 30 at-risk communities: 24 communities were screened; and 6 were screened and treated.
For the Midwest region data indicates that of 8 at-risk communities: 3 communities were screened: and 5 were screened and treated.
In the Pilbara region data indicates that of 7 at-risk communities: 3 communities were screened; and 4 communities were screened and treated.

Figure 4.4 Population screening coverage in children aged 5-9 years in communities that required screening for trachoma, by region, Western Australia, 2014

Top of pageFigure 4.4 is a Bar graph illustrating coverage by percentage of children aged 5 to 9 years in communities that required screening in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields indicates 97%, Kimberley indicates 89%, Midwest indicates 85% and Pilbara 100%.

Figure 4.5 Proportion of screened children aged 5-9 years who had a clean face, by region, Western Australia, 2007 – 2014

Figure 4.5 is a Line graph indicating the proportion of screened children aged 5 to 9 years who had a clean face for the years 2007 to 2014 in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields data indicates 98% in 2007 followed by a declining trend to 49% in 2011, increasing sharply to 77% in 2012 and decreasing to 63% in 2013 and 59% in 2014. 
Kimberley data indicates a stable trend of above 80% from 2007 to 2012, a slight decrease to 74% in 2013 and increase to 83% in 2014.  
Midwest data indicates 88% in 2007, 93% in 2008, 84% in 2009, 89% in 2010 and 2011, a sharp dip to 67% in 2012, followed by 91% in 2013 and 2014.  
Pilbara indicates data around 80% from 2007 to 2011, peaking at 94% in 2012, decreasing to 82% in 2013, and increasing to 91% in 2014.

Figure 4.6a Trachoma prevalence among children aged 5-9 years in communities that were screened, by region, Western Australia, 2007 – 2014

Figure 4.6a is a Line graph illustrating the trachoma prevalence in children aged 5 to 9 years in communities that were screened in the years 2007 to 2014 in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields data indicates an increase from 3% in 2007, to 14% in 2009, and decreasing trend to 2.6% in 2014.
Kimberley data indicates a gradual decreasing trend from 17% in 2007 to 2% in 2012 followed by a slight increase in to 2.4 % in 2013 and decrease to 1% in 2014.
Midwest data indicates 20% in 2007, dipping to 14% in 2008, up to 17% in 2009, dipping to 7% in 2010, 9% in 2011, decreases to 4% in 2012, then increases slightly to 4.7% in 2013 and more steeply to 11.5% in 2014.
Pilbara data indicates 15% in 2007, a peak at 26% in 2008, 12% in 2009, and incremental decrease to 0% in 2014.

Figure 4.6b Trachoma prevalence among children aged 5-9 years, by region, Western Australia with projected values,* 2007 – 2014

Top of page Figure 4.6b is a Line graph illustrating the trachoma prevalence in children aged 5 to 9 years in communities that were screened in the years 2007 to 2014 in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields data indicates an increase from 3% in 2007, to 14% in 2009, and decreasing trend to 5.7% in 2014.
Kimberley data indicates a gradual decreasing trend from 17% in 2007 to 2% in 2012 followed by a slight increase in to 2.4 % in 2013 and decrease to 1% in 2014.
Midwest data indicates 20% in 2007, dipping to 14% in 2008, up to 17% in 2009, dipping to 7% in 2010, 9% in 2011, decreases to 4% in 2012, then increases slightly to 4.7% in 2013 and more steeply to 11.5% in 2014.
Pilbara data indicates 15% in 2007, a peak at 26% in 2008, 12% in 2009, and incremental decrease to 0% in 2014.

* Including communities that screened in 2014 and those that were not required to screen in 2014, in accordance with 2014 guideline instructions (see methodology)


Figure 4.7 Number of at-risk communities* according to level of trachoma prevalence in children aged 5-9, by region, Western Australia, 2014

Figure 4.7 is a Stacked bar graph indicating prevalence in the number of screened at-risk communities by region in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields column indicates that of 12 communities: 2 had greater than or equal to 10%  but less than 20%;2 had greater than or equal to 5% but less than 10%;1 had greater than 0% but less than 5%; and 7 had no trachoma,
Kimberley column indicates that of 30 communities: 1 had greater than or equal to 10% but less than 20%;5 had less than 5%; and24 had no trachoma.
Midwest column indicates that of 8 communities: 2 had greater than or equal to 20%;1 had greater than or equal to 10% but less than 20%; and5 had no trachoma.
Pilbara column indicates that of 9 communities: 9 had no trachoma.

* Including communities that screened in 2014 and those that were not required to screen in 2014, in accordance with 2014 guideline instructions (see methodology

Figure 4.8 Communities according to number of years* of trachoma prevalence under 5%, by region, Western Australia, 2014

Figure 4.8 is a Stacked bar graph indicating trachoma prevalence kept under 5% over 5+ years in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields column indicates that from a total of 7 communities: 2 communities for 2 years; 4 communities for 3 years; and 1 community for 4 years.
Kimberley column indicates that from a total of 28 communities: 3 communities for 1 year; 7 communities for 2 years;4 communities for 3 years;8 communities for 4 years; and 6 communities for 5 years.
Midwest column indicates that from a total of 5 communities: 2 communities for 1 year; 1 community for 2 years;1 community for 4 years; and 1 community for 5 years.
Pilbara column indicates that from a total of 9 communities: 4 communities for 1 year; 3 communities for 3 years; and 2 community for 5 years.

* 5 years with a prevalence below 5% may classify a community as being not at risk of trachoma

Figure 4.9 Number of doses of azithromycin administered for the treatment of trachoma, by region, Western Australia, 2007 – 2014

Top of pageFigure 4.9 is a line graph indicating the number of doses of azithromycin administered for the treatment of trachoma in Goldfields, Kimberley, Midwest and Pilbara.
Goldfields data indicates 70 in 2007, 95 in 2008, 147 in 2009, increases to 328 in 2010, 359 in 2011, dips to 219 in 2012, 373 in 2013, and increases steeply to 1101 in 2014.  
Kimberley data indicates 1096 in 2007, peaks at 2333 in 2008, 864 in 2009, followed by a decreasing trend to 278 in 2013, rising to 351 in 2014.  
Midwest data indicates 52 in 2007, 69 in 2008, 182 in 2009, dropping to 26 in 2010, 125 in 2011, 10 in 2012, 57 in 2013 and increases to 324 in 2014.    
The Pilbara data indicates 183 in 2007, peaks at 420 in 2008, 266 in 2009, 142 in 2010, 210 in 2011, 73 in 2012, 51 in 2013 and 22 in 2014.

* Treatment 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 Australia results - Tables

Table 4.1 Trachoma control delivery, Western Australia, 2014
Number of communities
Goldfields*
Kimberley
Midwest
Pilbara
Total
* WA aggregated 10 communities in the Goldfield region into one community
† Communities treated without screening in 2014 as per guideline instructions
At risk* (A)
12
30
8
9
59
Requiring screening for trachoma (B)
11
30
8
9
58
Screened for trachoma (C)
11
30
8
9
58
Requiring treatment only (D)
1
0
0
0
1
Treated (E)
1
0
0
0
1
Screened and/or treated for trachoma (F = C+E)
12
30
8
9
59
Requiring neither screening or treatment for trachoma (G=A-B-D)
0
0
0
0
0
Top of page
Table 4.2 Trachoma screening coverage, trachoma prevalence and clean face prevalence in children, by age group, by region, in Western Australia, 2014
Goldfields
Kimberley
Midwest
Pilbara
Total
* Jurisdictional estimate
† In communities that were screened for trachoma
Number of communities screened
11
30
8
9
58
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
174
344
277
795
61
1073
287
1421
28
131
106
265
39
137
94
270
302
1685
764
2751
Children with clean face
58
203
212
473
42
886
273
1201
26
119
105
250
26
125
80
231
152
1333
670
2155
Clean face prevalence (%)
33
59
77
59
69
83
95
85
93
91
99
94
67
91
85
86
50
79
88
78
Estimated number* of Aboriginal children in communities
80
238
201
519
96
1195
461
1752
41
154
145
340
39
137
94
270
256
1724
901
2881
Children examined for trachoma
78
231
187
496
60
1066
288
1414
28
131
106
265
39
137
94
270
205
1565
675
2445
Trachoma screening coverage (%)
98
97
93
96
63
89
62
81
68
85
73
78
100
100
100
100
80
91
75
85
Children with active trachoma
1
6
4
11
1
11
2
14
7
15
4
26
0
0
2
2
9
32
12
53
Active trachoma prevalence (%)
1.3
2.6
2.1
2.2
1.7
1.0
0.7
1.0
25.0
11.5
3.8
9.8
0.0
0.0
2.1
0.7
4.4
2.0
1.8
2.2
Active trachoma prevalence using projected data
..
5.7
..
..
..
1.0
..
..
..
11.5
..
..
..
0.0
..
..
..
2.9
..
..
Top of page
Table 4.3 Treatment strategies, by region, Western Australia, 2014
Number of communities
Goldfields
Kimberley
Midwest
Pilbara
Total
Required treatment for trachoma
6
6
4
4
20
Treated for trachoma
6
6
4
4
20
Screened and treated
5
6
4
4
19
Received treatment only
1
0
0
0
0
Received 6-monthly treatment
0
0
0
0
0
Did not require treatment
6
24
4
5
39
Treated active cases and households
5
5
4
4
18
Treated the whole of community
1
1
1
0
3
Not treated according to CDNA guidelines
0
0
0
0
0
Top of page
Table 4.4 Trachoma treatment coverage, by region, Western Australia, 2014
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
1
6
4
..
11
1
11
2
..
14
7
15
4
..
26
0
0
2
..
2
9
32
12
..
53
Active cases who received treatment
1
6
3
..
10
1
11
2
..
14
3
14
3
..
20
0
0
2
..
2
5
31
10
..
46
Active cases who received treatment (%)
100
100
75
..
91
100
100
100
..
100
43
93
75
..
77
..
..
100
..
100
56
97
83
..
87
Estimated contacts requiring treatment
109
126
105
777
1117
47
49
45
196
337
36
43
51
174
304
1
2
6
13
22
193
220
207
1160
1780
Number of contacts who received treatment
107
124
100
760
1091
1091
47
49
45
196
337
36
43
51
174
304
1
2
5
12
20
191
201
1142
1752
Estimated contacts who received treatment (%)
98
98
95
98
98
100
100
100
100
100
100
100
100
100
100
100
100
83
92
91
99
99
97
98
98
Total number of doses of azithromycin delivered
108
130
103
760
1101
48
60
47
196
351
39
57
54
174
324
1
2
7
12
22
196
249
211
1142
1798
Estimated overall treatment coverage (%)
98
98
94
98
98
100
100
100
100
100
91
98
98
100
98
100
100
88
92
92
97
99
96
98
98
Top of page
Table 4.5 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults, by region, Western Australia, 2014
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
11
No data
No data
No data
No data
Age group (years)
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15+
Estimated population in region*
2248
818
5591
1699
356
274
2517
747
10712
3538
14250
Adults examined
569
412
No data
1159
487
101
No data
108
1056
1780
2836
With trichiasis (% of adults examined)
0
1 (0.2)
No data
9 (0.7)
0
0
No data
1 (0.9)
0
11 (0.6)
11 (0.4)
Offered ophthalmic consultation
0
1
No data
9
0
0
No data
1
0
11
11
Declined ophthalmic consultation
0
1
No data
1
0
0
No data.
1
0
3
3
Surgery in past 12 months
0
0
No data
1
0
0
No data
0
0
1
1
Top of page
Table 4.6 Health promotion activities, by region, Western Australia, 2014
Goldfields
Kimberley
Midwest
Pilbara
Total
* 2-4 times per year
† 5-12 times per year
Number of communities at risk
12
30
8
9
59
Number of communities who reported health promotion activities
12
30
8
9
59
Number of programs reported
63
92
8
16
179
Methods of Health Promotion
One-on-one discussion
20
15
0
5
40
Presentation to group
4
76
0
4
84
Interactive group session
15
40
0
4
59
Social marketing
0
1
0
0
1
Print material/mass media
22
82
0
9
113
Sporting/community events
10
9
0
4
23
Other
22
0
0
0
22
Target audience
Health professionals/staff
12
4
4
9
29
Children
53
80
8
9
150
Youth
38
1
0
2
41
Teachers/childcare/preschool staff
53
73
8
9
143
Caregivers/parents
50
2
0
9
61
Community members
3
71
0
9
83
Community educators/health promoters
0
1
0
9
10
Interagency members
0
2
0
9
11
Frequency of health promotion activities
Once
0
7
0
0
7
Occasional*
61
74
8
5
148
Regular
0
1
0
3
4
Ongoing/routine
2
10
0
8
20
Top of page

Health promotion summary

The promotion of facial cleanliness is an important strategy for health promotion activity across the WA endemic regions. 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. Health promotion resources such as stickers, water bottles, wrist bands and pamphlets were developed in collaboration between Aboriginal Medical Services, Environmental Health Officers and WA Country Health Service (WACHS) to promote the trachoma prevention message. In addition to health promotion materials, a range of interactive education sessions were used including:

  • soap making
  • face washing demonstrations
  • creating personalised pillow cases and fridge magnets
  • a puppet show illustrating transmission vectors

The school sessions incorporated community education in a number of communities to further reinforce the prevention messages, where parents and carers were provided with information about trachoma prevention. Health-care workers including Aboriginal Health Workers and Community Health Nurses were also supported to deliver regular hand and face washing promotion throughout the year.

Local media and Aboriginal media outlets have been successfully used to deliver culturally appropriate messages targeting communities across the Kimberley. Key messages were provided to local radio stations to script and record prevention messages and regular community announcements to be played on local radio stations to complement other related health and environmental health promotion messages and raise awareness in the community in the lead up to screening.