Prevalence and control of trachoma in Australia, 1997-2004

This study aimed to document the prevalence of active trachoma and trichiasis from 1997 to 2003 and from 1987 to 2004, respectively, and to provide an overview of trachoma control activities in Australia in 2004. Prevalence data were obtained from state, territory and regional population health units and unpublished surveys. Information about trachoma control programs and activities currently implemented in Australia was obtained through structured interviews with staff involved in trachoma control. Active trachoma prevalence in Aboriginal and Torres Strait Islander children, ranging from 0-40 per cent, were reported from the Eastern Goldfields, Midwest-Murchison and Kimberley Population Health Units in Western Australia and the Northern Territory's Centre for Disease Control. Large differences in trachoma prevalence were reported within and between different regions and from different years in the same region. Recent surveys of trichiasis in Kimberley and Central Australian Aboriginal and Torres Strait Islander adults demonstrated a prevalence of 9-12 per cent in inland, desert areas. In contrast with developing countries where active trachoma and trichiasis are more common among adult women than men, Australian surveys have identified equal prevalence in both sexes. Interpretation of trachoma prevalence and inter-regional/state/national comparisons were hampered by lack of a uniform method of data collection and analysis. Trachoma control programs were implemented consistently in some communities, and irregularly and/or in piecemeal fashion in others. Trachoma control programs led by regional population health units working in collaboration with primary health care services were more likely to be consistently implemented over long periods of time. Trachoma is a significant public health issue in some Aboriginal communities within Australia. The Communicable Diseases Network Australia has developed guidelines for the public health management of trachoma which provide recommendations on trachoma screening, control and data collection trachoma for affected states and territories.