Australian Trachoma Surveillance Report 2024.

Trachoma is the world's leading infectious cause of preventable blindness and is linked to poor living conditions. In Australia, trachoma has remained a public health problem in remote Indigenous communities in northern, central, and western regions. To seek formal validation by the World Health Organization (WHO) of the elimination of trachoma as a public health problem, Australia has needed to maintain levels of overall trachoma prevalence below 5% in children for at least two years in each formerly endemic state or territory. Australia must also demonstrate that the prevalence of previously undiagnosed trachomatous trichiasis (TT), the severe advanced blinding stage caused by repeated infection, remains below 0.2% in people aged 15 years and over. Australia first reached elimination thresholds in 2022, with 2024 the final year of pre-validation monitoring. In 2024, screening staff assessed trachoma according to WHO grading criteria in 86 communities. Overall prevalence of trachoma was 2.1% in the Northern Territory; 0% in South Australia; and 1.3% in Western Australia. Only nine previously unknown TT cases were reported throughout the Northern Territory, Queensland, South Australia and Western Australia. Based on 2024 surveillance data, Australia is eligible to apply for validation of elimination as a public health problem. Maintaining this achievement will require ongoing improvements to remote housing and environmental conditions; supporting communities to manage remaining disease pockets or risk of resurgence; and continuing accessible TT diagnosis and surgery pathways to address long-term disease impacts. Indigenous leadership is critical to ensure local ownership and accountability to communities.