Australian Trachoma Surveillance Report 2023

Area of Science:

• Public Health
• Infectious Diseases
• Ophthalmology

Background:

• Trachoma is the leading infectious cause of preventable blindness globally, strongly associated with poor living conditions.
• Australia is the only high-income nation with endemic trachoma, affecting remote Indigenous communities in the Northern Territory, South Australia, and Western Australia.

Purpose of the Study:

• To assess Australia's progress towards the World Health Organization (WHO) criteria for the elimination of trachoma as a public health problem.
• To evaluate current trachoma prevalence and new trachomatous trichiasis cases in at-risk Indigenous communities.

Main Methods:

• Annual analysis of surveillance data by the National Trachoma Surveillance and Reporting Unit.
• Application of WHO grading criteria by screening staff in 67 at-risk communities in 2023.
• Assessment of prevalence of trachomatous inflammation-follicular (<5% in children 1-9 years) and trachomatous trichiasis ('unknown to health system' <0.2% in adults >=15 years).

Main Results:

• Overall trachoma prevalence remained below 5% in 2023: 2.3% (Northern Territory), 0% (South Australia), and 1.6% (Western Australia).
• Proportion of new trachomatous trichiasis cases was 0.01% (Northern Territory), 0% (South Australia), and 0.2% (Western Australia).
• Australia met WHO elimination thresholds in 2022 and is on track for validation, provided these levels are maintained.

Conclusions:

• Australia is progressing towards eliminating trachoma as a public health problem, meeting key WHO surveillance criteria.
• Sustained efforts are crucial to maintain elimination status and address ongoing health challenges in some remote Indigenous communities.