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

Hugh R Taylor, Sarah S Fox, Jing Xie, Ross A Dunn, Anna-Lena M R Arnold and Jill E Keeffe
Med J Aust 2010; 192 (5): 248-253.

Summary

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 (≥ 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.

  • Hugh R Taylor1,2
  • Sarah S Fox2,3
  • Jing Xie2,3
  • Ross A Dunn2,3
  • Anna-Lena M R Arnold2,3
  • Jill E Keeffe2,3

  • 1 Melbourne School of Population Health, University of Melbourne, Melbourne, VIC.
  • 2 Vision Cooperative Research Centre, Sydney, NSW.
  • 3 Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC.

Correspondence: h.taylor@unimelb.edu.au

Acknowledgements: 

We acknowledge the contributions of the National Indigenous Eye Health Survey Advisory Committee (Professor Michael Wooldridge, Professor Ian Anderson, Sandra Bailey, Stephanie Bell, Joe Chakman, Amanda Davis, Dr William Glasson, Mick Gooda, Elissa Greenham, Belinda Sullivan, Professor Debbie Sweeney), the Steering Committee (Dr Robert Casson, Rowan Churchill, Associate Professor Mark Gillies, Dr William Glasson, Dr Timothy Henderson, Professor Brian Layland, Dr Mark Loane, Associate Professor Ian McAllister, Dr Tharmalingam Mahendrarjah, Dr Richard Mills, Dr Nigel Morlet, Helen Morrissey, Dr Henry Newland, Dr Richard Rawson, Gerd Schlenther), and thank Mitasha Marolia, Anthea Burnett, Dr Tomer Shemesh, the many Aboriginal health workers and eye health coordinators who assisted with this, especially Barbara O’Connor, Desley Culpin and Phyllis Tighe; and the many volunteers who helped with the field work, including Dr Jan Lovie Kitchen, Nora Ley and Carmel McInally.

Competing interests:

None identified.

  • 1. Barrett JW, Orr WF. Trachoma in the state of Victoria. Intercolonial Med J 1909; 20 Sep 20: 450-455.
  • 2. Taylor HR. Trachoma: a blinding scourge from the bronze age to the twenty-first century. Melbourne: Centre for Eye Research Australia, 2008.
  • 3. Flynn F. Trachoma among natives of the Northern Territory of Australia. Med J Aust 1957; 11: 269-277.
  • 4. Mann I. Culture, race, climate and eye disease. Springfield, Ill: Charles C Thomas, 1966.
  • 5. Royal Australian College of Ophthalmologists. The National Trachoma and Eye Health Program of the Royal Australian College of Ophthalmologists. Sydney: RACO, 1980.
  • 6. Taylor HR. Eye health in Aboriginal and Torres Strait Islander communities. Canberra: Commonwealth of Australia, 1997.
  • 7. Stocks NP, Hiller JE, Newland H, McGilchrist CA. Trends in the prevalence of trachoma, South Australia, 1976 to 1990. Aust N Z J Public Health 1996; 20: 375-381.
  • 8. Mak DB, O’Neill LM, Herceg A, McFarlane H. Prevalence and control of trachoma in Australia, 1997–2004. Commun Dis Intell 2006; 30: 236-247.
  • 9. Tellis B, Keeffe JE, Taylor HR. Surveillance report for active trachoma, 2006: National Trachoma Surveillance and Reporting Unit. Commun Dis Intell 2007; 31: 366-374.
  • 10. Tellis B, Keeffe JE, Taylor HR. Surveillance report for active trachoma, 2007: National Trachoma Surveillance and Reporting Unit. Commun Dis Intell 2008; 32: 388-399.
  • 11. Taylor HR. Trachoma in Australia. Med J Aust 2001; 175: 371-372. <MJA full text>
  • 12. Mak D. Guidelines for the public health management of trachoma in Australia. Canberra: Communicable Disease Network Australia, 2006.
  • 13. Fox SS, Arnold A-L, Keeffe JE, Taylor HR. Sampling and recruitment methodology for a National Eye Health Survey of Indigenous Australians. Aust N Z J Public Health 2010. In press.
  • 14. Australian Bureau of Statistics. Australian Standard Geographical Classification (ASGC) — electronic publication, 2005. (ABS Cat. No. 1216.0.) http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/0D204FD3DCD90564CA256 F19001303A2?opendocument (accessed Jan 2010).
  • 15. Australian Bureau of Statistics. Experimental estimates of Aboriginal and Torres Strait Islander Australians, Jun 2006. (ABS Cat. No. 3238.0.55.001.) http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/3238.0.55.001Main+ Features1Jun%202006? (accessed Jan 2010).
  • 16. Negrel AD, Taylor HR, West S. Guidelines for the rapid assessment for blinding trachoma. Geneva: World Health Organization, 2001. (Report No. WHO/PBD/GET/00.8.)
  • 17. Thylefors B, Dawson CR, Jones BR, et al. A simple system for the assessment of trachoma and its complications. Bull World Health Organ 1987; 65: 477-483.
  • 18. Wright HR, McDonnell C, Squire S, et al. Trachoma grading — self directed learning [CD-ROM]. Melbourne: Centre for Eye Research Australia, 2007.
  • 19. Roper KG, Taylor HR. Comparison of clinical and photographic assessment of trachoma. Br J Ophthalmol 2009; 93: 811-814.
  • 20. Taylor HR, Fox SS. Ethical hurdles in Indigenous research. Aust N Z J Public Health 2008; 32: 489-490.
  • 21. Kirby T. Nicola Roxon: Australia’s Minister for Health and Ageing. Lancet 2009; 373: 1073.
  • 22. World Health Organization. Report of the 2nd Global Scientific Meeting on Trachoma. 2003; Aug 25-27; Geneva.
  • 23. Taylor HR. Trichiasis: out of mind, out of sight. Aust J Rural Health 2009; 17: 171.

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