Prevalence of trachoma in a single community, 1975-2007.

BACKGROUND

To determine the change in the prevalence in active trachoma in children in a remote Aboriginal community over a 32-year period.

DESIGN

Data used from two cross-sectional studies repeated in the same community 32 years apart.

PARTICIPANTS OR SAMPLES: Children aged 5-13 years living in the community.

METHODS

Thirty-five mm photographs of the everted upper lid taken in 1975 and digital photographs taken in 2007 were graded using a fine trachoma-grading scheme.

MAIN OUTCOME MEASURE: The age-specific prevalence and severity of trachoma was compared at the two time points.

RESULTS

Images were available from 82 children in 1975 and from 92 children in 2007. The overall prevalence of active trachoma (trachomatous inflammation follicular and or trachomatous inflammation intense) was 59% in 1975 and in 2007 was significantly lower at 23% (P<0.001). The overall severity grades of active trachoma had also decreased significantly for each sign from 1975 to 2007 (all P values from the rank-sum test were less than 0.001). However, in 2007, there were still some children with severe active trachoma and severe scarring still occurred.

CONCLUSION

Although the prevalence and severity of active trachoma in children have decreased significantly over the last 30 years in this community, trachoma still remains a significant public health problem. One third of the children have active trachoma, a figure in excess of the threshold set as a public health problem by the World Health Organization.