The prevalence of trachoma in Australia: the National Indigenous Eye Health Survey

Abstract

Objective: To determine the prevalence of trachoma among Indigenous Australians.

Design, setting and participants: A national, stratified, random cluster sample survey of Indigenous children (5-15 years) and adults (>or= 40 years) in 30 communities across Australia. Data collection was undertaken in 2008.

Main outcome measures: Results based on a standardised protocol that included trachoma grading and double grading of photographs of the tarsus.

Results: 1694 Indigenous children and 1189 Indigenous adults were examined. Recruitment rates were 84% for children and 72% for adults. The overall rate of follicular trachomatous inflammation among children was 3.8%, ranging from 0.6% in major cities to 7.3% in very remote areas; 50% of communities in very remote areas had endemic rates (> 5%). Trachomatous scarring (TS) occurred among 15.7% of adults, trachomatous trichiasis (TT) among 1.4% and corneal opacity (CO) among 0.3%. TS was found in all regions and TT in all except major cities and inner regional areas. The highest community rates for TS were 58.3%; for TT, 14.6%; and for CO, 3.3%.

Conclusion: 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 Australian Government's recent commitment to eliminate blinding trachoma is welcomed and much needed.