Blinding endemic trachoma remains a major public health problem in many Aboriginal and Torres Strait Islander communities. Although active trachoma is predominantly seen in very remote communities, scarring and blinding sequelae occur among Indigenous people across the country. The recent Australian Government commitment to eliminating trachoma within a finite timeframe substantiates the need for an effective trachoma surveillance system in order to track the prevalence of trachoma in Australia to measure the impact of control programs.

There is a mixed view amongst eye experts as to whether the current trachoma screening program is the most appropriate investment of resources. There are those that argue that all remote communities need to be screened to appreciate the full extent of active trachoma and trichiasis prevalence and establish the best baseline in order to design an appropriate strategy to eradicate the disease. In contrast, there are those that believe that resources invested in trachoma surveillance should be diverted to address other problems such as the poor environmental conditions in which remote communities live and to provide basic preventative health education with the result that trachoma will be eradicated.

The current trachoma surveillance system demonstrates vast variability amongst the jurisdictions where trachoma screening takes place. SA and NT integrate active trachoma screening with the screening of other eye health programs, whereas WA undertakes it as a stand-alone activity. WA undertakes active trachoma screening in a restricted time period (two weeks) across the entire state, where NT and SA perform screening throughout the year. Most stakeholders argue that regardless of the mechanism by which the data are gathered, as long as a standardised data set is obtained that is comparable across Australia, that is all that is required for an effective national surveillance system.

The establishment of the NTSRU has assisted in the standardisation of the data collected about trachoma. However more work is still needed to improve the consistency of the data collection process. The last three years since the establishment of the NTSRU has been important in terms of allowing data from the jurisdictions to be transferred, analysed and reported, providing for the first time a national picture of the prevalence of active trachoma and trichiasis. The system is still at the ‘baseline’ level, and implementation of the results of this review should generate valuable improvements.
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