• Comprehensive Ophthalmology

    This article reports on the progress and status of trachoma control in Australia, the only developed country where blinding trachoma still exists.

    The authors say that this progress has been somewhat glacial, especially compared with the rapid changes being made in "undeveloped" parts of the world.

    Trachoma is still common in outback communities in Australia, although it has decreased over time in the worst affected communities.

    The World Health Organization has developed the SAFE strategy for controlling trachoma. It involves: Surgery for trichiasis, Antibiotic (azithromycin treatment to reduce infection), Facial cleanliness (to reduce the exchange of infection between children) and Environmental improvements (aimed at addressing the barriers to children washing and keeping their faces clean).

    The article's authors report that in 2009, as part of the $58.3 million Indigenous Eye and Ear Health Initiative, the Australian government made an initial four-year commitment of $16 million to eliminate trachoma in indigenous communities.

    They say that the implementation of this program has been disappointingly slow, although significant progress has been made, especially in the Northern Territory and in Western Australia. More communities have been screened, more children have been examined, treatment coverage has improved and, particularly in the Northern Territory, a wide range of health education materials and social marketing methods have been used to promote clean faces.

    They say that the successful programs in the Northern Territory and Western Australia need to be expanded so that all endemic areas are clearly identified, and continued until the goal of eliminating blinding trachoma in Australia is achieved.

    They say that in at-risk communities, all children aged 5 to 9 years old need to be screened. Treatment coverage needs to exceed 80 percent of those requiring treatment, with either mass drug distribution or treatment of all households with children.