Endemic Trachoma Still a Major Problem in Indigenous Communities

Blinding endemic trachoma remains a major public health problem in many Indigenous communities, despite the knowledge that has been gathered about its control since the 1930s, according to the authors of a study published in the Medical Journal of Australia.

Prof Hugh Taylor, Harold Mitchell Chair of Indigenous Eye Health at the University of Melbourne, and his co-authors conducted a national, random cluster sample survey of eye health in Indigenous children (5-15 years) and adults (40 years and older) in 30 communities across Australia.

Based on their findings in these communities, they estimated that throughout Australia there are 4778 Indigenous children (5-9 years) with follicular trachoma (TF), 16,314 adults with trachomatous scarring (TS), 1488 adults with trachomatous trichiasis (TT) and 273 with corneal opacity (CO).

Prof Taylor said the study found the crude rate of TF in children was 3.8 per cent, with half of the communities in very remote areas reporting endemic rates (greater than five per cent).

TS was found to be uncommon in children compared with adults, and this, coupled with the infrequency of trachomatous inflammation (TI) in children (just 17.4 per cent of those with TF) suggested a decrease in the severity of trachoma in these communities.

“In some communities, specific trachoma control activities have been implemented and there have been obvious improvements in housing, water and sanitation and health care in general, including the ready availability and use of antibiotics to treat childhood infections,” Prof Taylor said.

“If the apparent decrease in severity of trachoma is real, it will make the recent Australian Government commitment to eliminate trachoma much more achievable.”

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Prof Taylor said the adjusted population rate of TT in adults was 0.2 per cent – double the World Health Organisation threshold. Participants with TS who were at risk of TT were found in 24 of the 30 communities, including major cities and regional areas, and participants with TT were found in all regions except major cities and inner regional areas.

“This emphasises the general and ongoing need to carefully check older Indigenous people for signs of past trachoma and TT,” Prof Taylor said.

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“Our study confirms that the Australian Government’s recent commitment to eliminate blinding trachoma in Australia is both necessary and timely.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source-MJA
SRM