Australian Trachoma Surveillance Report 2013

Northern Territory results

Page last updated: 2015

Northern Territory results - Figures

Northern Territory results -Tables

Summary

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Trachoma program coverage

  • In 2013, the NT identified 80 communities in five regions as being at risk of trachoma (Table 2.1).
  • Of 80 at-risk communities, 42 communities were determined to require screening for trachoma and a further 18 communities were identified as requiring treatment without screening (see methodology) leading to a total of 60 communities were determined to require screening, treatment or both screening and treatment for trachoma (Table 2.1).
  • Of these 61 communities, 47 received screening, treatment or both screening and treatment according to the guidelines (Table 2.1, Table 2.3).
  • The remaining 20 at-risk communities did not require screening or treatment as their previous year’s prevalence was under 5% (see methodology section).
  • In some regions, the NT did not conduct screening or treatment according to the guidelines due to financial and human resource constraints.

Screening coverage

  • In 2013, the NT identified 42 communities in the five regions requiring screening for trachoma and, of these, 30 were screened for trachoma (Table 2.1).
  • Barkly region had the highest community screening coverage with all 12 communities requiring screening being screened (Table 2.1).
  • Katherine region had the lowest community screening coverage with only 3 communities screened of the 13 communities requiring screening (Table 2.1).
  • The proportion of children aged 5-9 years screened in the 30 communities was 81%, ranging from 67% in East Arnhem region, to 94% in Katherine region (Table 2.2, Figure 2.4).

Clean face prevalence

  • Clean face prevalence was assessed in all communities that were screened.
  • The overall prevalence of clean faces among 5-9-year-old children in the screened communities was 78%, ranging from 40% in Alice Springs Remote region, to 83% in the East Arnhem Region (Table 2.2, Figure 2.5).

Trachoma prevalence

  • The prevalence of trachoma in children aged 5-9 years screened in 2013 was 2.4%. Prevalence ranged from 0.9% in Darwin Rural region to 7.6% in Alice Springs Remote region (Table 2.2, Figure 2.6a).
  • Projecting from the previous year's data in communities that did not screen due to new guideline implementation (see methodology), the prevalence of trachoma was 5%, ranging from 1.4% in East Arnhem region to 10% in Alice Springs Remote region (Table 2.2, Figure 2.6b).
  • No trachoma was reported in 31 communities in 2013, including communities that screened for trachoma in 5-9-year-old children and that did not screen in accordance with guidelines (Figure 2.7).
  • Endemic levels of trachoma were reported in 28 communities in 2013 including communities that screened for trachoma in 5-9-year-old children that did not screen in accordance with guidelines (Figure 2.7).
  • Non endemic levels of trachoma have been reported for 11 communities over a period of 5 years which would reclassify these communities as being not at risk for trachoma (Figure 2.8).

Treatment delivery and coverage

  • Trachoma treatment strategies were applied in 33 communities (Table 2.3).
  • Treatment was delivered to active cases and households in 12 communities, and to the whole of community in 21 communities as per guidelines (Table 2.3).
  • The overall treatment coverage in all regions was 79% with 9232 doses of azithromycin delivered (Table 2.4).
  • Three communities did not treat according to CDNA guidelines (Table 2.3).

Trichiasis

  • Screening for trichiasis was undertaken in 56 communities (Table 2.5).
  • Overall 1984 adults aged over 15 years were screened.
  • The prevalence of trichiasis in adults aged 15 years and over was 2%, and 4% in adults aged 40 years and over.
  • Surgery for trichiasis was reported to be undertaken for 23 adults in 2013 (Table 2.5).

Health promotion

  • Health promotion activities were reported to have occurred in 32 communities in the Alice Springs Remote, Darwin Rural, East Arnhem and Katherine regions.
  • A total of 82 health promotion activities were reported.
  • The majority of the health promotion activities were delivered to children, teachers and childcare or preschool staff members (Table 2.6).
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Northern Territory results - Figures

Figure 2.1 Trachoma prevalence in children aged 5-9 years, number of communities that were screened, treated or both for trachoma and number of at-risk communities in the Northern Territory, 2013

Figure 2.1 is a map illustrating the Northern Territory (NT) regions with shading advising of the trachoma prevalence (screened and treated) in children aged 5-9 years. Darwin rural, East Arnhem, Katherine and Barkly regions there was less than 5 % of trachoma prevalence and for the Alice Springs remote region there was less than/or equal to 5% but less than 10% of trachoma prevalence. Further data for these regions indicates: Darwin Rural screened and/or treated 5 of 12 at-risk communities, 7 at-risk communities did not require screening or treatment, and the trachoma prevalence rate was 1%. East Arnhem screened and/or treated 6 of 12 at-risk communities, 3 at-risk communities did not require screening and the trachoma prevalence rate was 2%. Katherine screened and/or treated 6 of 19 at-risk communities, 2 at-risk communities did not require screening or treatment and the trachoma prevalence rate was 3%. Barkley screened and/or treated 12 of 12 at-risk communities and the trachoma prevalence rate was 4%. Alice Springs Remote screened and/or treated 19 of 27 at-risk communities, 8 at-risk communities did not require screening or treatment and the trachoma prevalence rate was 8%.

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Figure 2.2 Number of communities at risk, by region, in the Northern Territory, 2007-2013

Figure 2.2 is a line graph demonstrating the number of communities at–risk by (5) regions in the Northern Territory (NT) from 2007 to 2013. The 5 at-risk regions are Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine. The graph shows a plateauing trend for all regions with a slight decrease in the Barkly region in 2012 followed by an increase in 2013.

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Figure 2.3 Number of at-risk communities by region, according to trachoma control strategy implemented, Northern Territory, 2013

Figure 2.3 is a histogram which demonstrates the number of at-risk communities in the Northern Territory (NT) by (5) regions according to the type of Trachoma Control Strategy implemented. The 5 regions are Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine. The data for NT regions are: Alice Springs remote region recorded 13 communities who received treatment only, 3 communities who were screened and treated, 2 communities who were screened, 8 communities who did not require screening or treatment and 1 community which was not screened or treated. Barkly region recorded 7 communities who were screened and treated and 5 communities who were screened. Darwin Rural region recorded 1 community who received treatment only, 2 communities who were screened and treated, 2 communities who were screened, and 7 communities who were not requiring screening or treatment. East Arnhem region recorded 2 communities who were screened and treated, 4 communities who were screened, 2 who were not requiring screening or treatment, and 1 community which was not screened or treated. The Katherine region recorded 4 communities who received treatment only, 2 communities who were screened and treated, 1 community which was screened, 2 communities who were not requiring screening or treatment and 10 communities who were not screened or treated.

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Figure 2.4 Population screening coverage of children aged 5-9 years in communities that required screening for trachoma, by region, in the Northern Territory, 2013

Figure 2.4 is a bar graph showing the screening coverage of children aged 5-9 years in Northern Territory (NT) communities by (5) regions. The Alice Springs remote region recorded 93%, Barkly region 91%, Darwin Rural region 84%, East Arnhem region 67% and Katherine region 94% trachoma screening coverage.

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Figure 2.5 Proportion of screened children aged 5-9 years who had a clean face, by region, in the Northern Territory, 2007-2013

<Figure 2.5 is a line graph showing the proportion of screened children aged 5-9 years who had a clean face by (5) regions in the Northern Territory (NT) for 2007 to 2013. All NT regions showed an inconsistent trend except in the Alice Remote region which shows a decreasing trend from 2009 to 2013.

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Figure 2.6a Trachoma prevalence among children aged 5-9 years in communities that were screened, by region, in the Northern Territory, 2007–2013

Figure 2.6a is a line graph showing trachoma prevalence in children aged 5 to 9 years by (5) regions in Northern Territory (NT) communities from 2007 to 2013. The trend for all regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine) spiked in 2008 and then decreased (with a plateau in the Darwin Rural region in 2009 and 2010, a slight increase in 2011 in the East Arnhem region), all regions plateauing in 2013.

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Figure 2.6b Trachoma prevalence among children aged 5-9 years, by region, in the Northern Territory with projected values,* 2007–2013

Figure 2.6b is a line graph showing trachoma prevalence in children aged 5 to 9 years by (5) regions in the Northern Territory (NT) for 2007 to 2013. The trend for all regions (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine) spikes in 2008 and then decreases (with a plateau in Darwin Rural in 2009 and 2010, and a slight increase in 2011 in East Arnhem), and a slight increase in Alice Springs Remote, Darwin Rural and Katherine regions in 2013.

* Including communities that screened in 2013 and those that did not screen in 2013 in accordance with revised guideline instructions (see methodology)

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Figure 2.7 Number of at-risk communities according to level of trachoma prevalence* in 5-9-year-old children, by region, in the Northern Territory in 2013

Figure 2.7 is a histogram that shows the number of screened at-risk communities according to level of trachoma prevalence in 5 to 9 year old children by (5) regions in the Northern Territory (NT). For Alice Springs Remote 9 communities had no trachoma, 5 communities had greater than or equal to 5% but less than 10%, 8 communities had greater than or equal to 10% but less than or equal to 20% and 3 communities had or greater than or equal to 20%. For Barkly 6 communities had no trachoma, 1 community each had had greater than 0% but less than 5%; greater than or equal to 5% but less than 10%, and 4 communities had greater than or equal to 10% but less than 20%. For East Arnhem 6 communities had no trachoma and 4 communities had greater than 0% but less than 5%. For Darwin Rural 8 communities had no trachoma, 3 communities had greater than 0% but less than 5% and 1 community had had greater than or equal to 10%. For Katherine 2 communities had no trachoma and 1 had greater than 0% but less than 5%, 3 communities had greater than or equal to 5% but less than 10%, 1 community had greater than or equal to 10%; and 2 communities had greater than or equal to 20%.

* Including communities that screened in 2013 and those that did not screen in 2013 in accordance with revised guideline instructions (see methodology)

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Figure 2.8 Communities according to number of years* of trachoma prevalence under 5%, by region†, in the Northern Territory, 2013

Figure 2.8 is a histogram showing the number of screened at-risk communities according to the number of years of having trachoma prevalence under 5% by (Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine) regions. Trachoma prevalence under 5% was recorded for: Alice Springs Remote for 1 community for 4 years, 7 communities for 3 years and 2 communities for 2 years. Barkly for 1 community for 3 years, 4 communities for 2 years and 3 communities for 1 year. Darwin Rural for 7 communities for 5 years, 1 community for 4 years, 2 communities for 3 years and 1 community for 2 years. East Arnhem for 4 communities for 5 years, 1 community for 4 years and 2 communities for 1 and 2 years. Katherine for 1 community for 4 years and 3 communities for 3 years.

* 5 years with a prevalence below 5% classifies a community as not at risk of trachoma
† Including communities in the Northern Territory that screened in 2013 and those that did not screen in 2013 in accordance with guideline instructions
(see methodology)

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Figure 2.9 Number of doses of azithromycin administered for the treatment of trachoma, by region, in the Northern Territory, 2007–2013

Figure 2.9 is a line graph showing the number of doses of azithromycin administered for the treatment of trachoma in Alice Springs remote, Barkly, Darwin Rural, East Arnhem and Katherine regions. The data is represented as: Alice Springs Remote shows 78 doses in 2007 increasing sharply to 1871 doses in 2008, 1938 doses in 2009, 2901 doses in 2010, 3179 doses in 2011, 2863 doses in 2012 and 4206 doses in 2013. Barkly shows 51 doses in 2007, 424 doses in 2008, 479 doses in 2009, 130 doses in 2010, 205 doses in 2011, 124 doses in 2012 and 220 doses in 2013. Darwin Rural shows 622 doses in 2008, 53 doses in 2009, 765 doses in 2010, 1659 doses in 2011, 3402 doses in 2012 and 3553 doses in 2013. East Arnhem shows 10 doses in 2008, 54 doses in 2009, 1 223 doses in 2010, 147 doses in 2012 and 81doses in 2013. Katherine shows 188 doses in 2007, 913 doses in 2008, 746 doses in 2009, 547 doses in 2010, 649 doses in 2011, 867 doses in 2012 and 1172 doses in 2013.

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Northern Territory results - Tables

Table 2.1 Trachoma control delivery in the Northern Territory in 2013
Number of communities
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
Not at-risk
*Communities treated without screening in 2013 as per guideline instructions
At risk* (A)
27
12
12
10
19
80
N/A
Requiring screening for trachoma (B)
6
12
4
7
13
42
0
Screened for trachoma (C)
5
12
4
6
3
30
2
Requiring treatment only (D)
13
0
1
0
4
18
N/A
Treated† (E)
13
0
1
0
3
17
N/A
Screened and/or treated for trachoma (F = C+E)
18
12
5
6
6
47
2
Requiring neither screening or treatment for trachoma (G=A-B-D)
8
0
7
3
2
20
N/A
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Table 2.2 Trachoma screening coverage, trachoma prevalence and clean face prevalence in children (0-14 years old) in the Northern Territory in 2013
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
Not at-risk
*Jurisdictional estimate
†In communities that were screened for trachoma
Number of communities screened
5
12
4
6
3
30
2
Age group (years)
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
0-4
5-9
10-14
0-14
Children examined for clean face
12
110
56
178
45
285
203
533
81
462
208
751
20
383
180
583
22
118
27
167
180
1358
674
2212
22
114
41
177
Children with clean face
1
44
23
68
34
226
199
459
67
374
203
644
12
316
163
491
13
97
26
136
127
1057
614
1798
22
96
41
159
Clean face prevalence (%)
8
40
41
38
76
79
98
86
83
81
98
86
60
83
91
84
59
82
96
81
71
78
91
81
100
84
100
90
Estimated number* of Aboriginal children in communities†
94
113
83
290
71
313
239
623
356
548
562
1466
613
581
715
1909
136
126
178
440
1270
1681
1777
4728
27
167
72
266
Children examined for trachoma
11
105
29
145
40
285
203
528
84
463
212
759
17
390
182
589
15
119
25
159
167
1362
651
2180
0
114
41
155
Trachoma screening coverage (%)
12
93
35
50
56
91
85
85
24
84
38
52
3
67
25
31
11
94
14
36
13
81
37
46
0
68
57
58
Children with active trachoma
0
8
0
8
2
12
3
17
0
4
5
9
1
6
3
10
0
3
1
4
3
33
12
48
0
3
0
3
Active trachoma prevalence (%)
0.0
7.6
0.0
5.5
5.0
4.2
1.5
3.2
0.0
0.9
2.4
1.2
5.9
1.5
1.6
1.7
0.0
2.5
4.0
2.5
1.8
2.4
1.8
2.2
..
2.6
0.0
1.9
Active trachoma prevalence using projected data
10
4.2
2.1
1.4
7.8
5.0
..
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Table 2.3 Treatment strategies by region in the Northern Territory in 2013
Number of communities
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
Required treatment for trachoma
16
7
3
2
6
34
Treated for trachoma
16
7
3
2
5
33
Screened and treated
3
7
2
2
2
16
Received treatment only
13
0
1
0
3
17
Received 6-monthly treatment
4
0
1
0
0
5
Did not require treatment
10
5
9
7
3
34
Treated active cases and households
2
5
2
2
1
12
Treated the whole of community
14
2
1
0
4
21
Not treated according to CDNA guidelines
1
0
0
0
2
3
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Table 2.4 Trachoma treatment coverage in the Northern Territory in 2013
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
Age group (years)
0-4
5-9
10-14
15+
All
0-4
5-9
10-14
15+
All
0-4
5-9
10-14
15+
All
0-4
5-9
10-14
15+
All
0-4
5-9
10-14
15+
All
0-4
5-9
10-14
15+
All
Active cases requiring treatment
0
8
0
..
8
2
12
3
..
17
0
4
5
..
9
1
6
1
..
8
0
3
1
..
4
3
33
10
..
46
Active cases who received treatment
0
8
0
..
8
2
12
3
..
17
0
4
5
..
9
1
6
1
..
8
0
3
1
..
4
3
33
10
..
46
Active cases who received treatment (%)
..
100
..
..
100
100
100
100
..
100
..
100
100
..
100
100
100
100
..
100
..
100
100
..
100
100
100
100
..
100
Estimated contacts requiring treatment
510
668
487
3131
4796
18
52
32
108
210
448
585
605
3522
5160
14
14
8
37
73
194
178
174
799
1345
1184
1497
1306
7597
11584
Number of contacts who received treatment
432
628
437
2701
4198
18
52
32
101
203
412
433
430
2269
3544
14
14
8
37
73
157
170
150
691
1168
1033
1297
1057
5799
9186
Estimated contacts who received treatment (%)
85
94
90
86
88
100
100
100
94
97
92
74
71
64
69
100
100
100
100
100
81
96
86
86
87
87
87
81
76
79
Total number of doses of azithromycin delivered
432
636
437
2701
4206
20
64
35
101
220
412
437
435
2269
3553
15
20
9
37
81
157
173
151
691
1172
1036
1330
1067
5799
9232
Estimated overall treatment coverage (%)
85
94
90
86
88
100
100
100
94
97
92
74
71
64
69
100
100
100
100
100
81
96
86
86
87
87
87
81
76
79
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Table 2.5 Trichiasis screening coverage, prevalence and treatment among Aboriginal adults aged over 40 years in the Northern Territory in 2013
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
* Population estimate limited to trachoma endemic regions and does not take into account changing endemic regions over time and transiency between regions
† Number of adults examined limited to numbers reported. This number does not account for adults who may be examined in routine adult health checks, and may also include multiple screening
Number of communities screened for trichiasis
21
5
16
4
10
56
Age group (years)
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15-39
40+
15+
Estimated population in region*
3367
1801
645
281
4245
2124
3529
1838
2301
1101
14087
7146
21233
Adults examined†
467
388
152
11
34
68
18
36
435
375
1106
878
1984
With trichiasis (% of adults examined)
4
(0.9%)
19
(5%)
0
3
(27%)
1 (3%)
3 (4%)
0
0
1 (0.2%)
8 (2%)
6 (0.05%)
33 (4%)
39 (2%)
Offered ophthalmic consultation
0
3
0
3
0
0
0
0
0
7
0
13
13
Declined ophthalmic consultation
0
0
0
0
0
0
0
0
0
2
0
2
2
Surgery in past 12 months
0
17
0
3
0
0
0
0
0
3
0
23
23
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Table 2.6 Health promotion activities by region in the Northern Territory in 2013
Alice Springs Remote
Barkly
Darwin Rural
East Arnhem
Katherine
Total
* 2-4 times per year
† 5-12 times per year
Number of communities at risk
27
12
12
10
19
80
Number of communities that reported health promotion activities
18
0
5
4
5
32
Total number of programs reported
51
0
13
9
9
82
Methods of Health Promotion
One-on-one discussion
9
..
5
3
2
..
Presentation to group
14
..
4
2
5
25
Interactive group session
16
..
1
1
..
18
Social marketing
1
..
..
..
..
1
Print material/mass media
..
..
1
..
..
1
Sporting/community events
3
..
..
1
..
4
Other
2
..
..
..
..
2
Target audience
Health professionals/staff
14
..
4
2
2
22
Children
19
..
5
4
5
33
Youth
2
..
..
..
..
2
Teachers/childcare/preschool staff
14
..
3
3
5
25
Caregivers/parents
8
..
..
2
..
10
Community members
11
..
2
1
..
14
Community educators/health promoters
2
..
1
..
..
3
Interagency members
4
..
1
1
1
7
Frequency of health promotion activities
Once
1
..
..
..
..
1
Occasional*
41
..
13
9
9
72
Regular†
3
..
..
..
..
3
Ongoing/routine
6
..
..
..
..
6
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Health promotion summary

Health promotion in the NT in 2013 followed a comprehensive approach. The Indigenous Eye Health Unit based at the University of Melbourne continued to provide support for health promotion. Territory-wide coverage of the Melbourne Football Club ambassadors’ promotion of trachoma elimination and the presence of the mascot, Milpa the goanna, and the team at clinics and games raised awareness among decision-makers and the public. The Clean Faces, Strong Eyes campaign messages developed by the Indigenous Eye Health Unit and the supporting materials and activities were consistently reinforced during screening and treatment visits to communities and Milpa made frequent appearances. In Central Australia the Health Promotion team led by the Central Australian Aboriginal Congress and the Fred Hollows Foundation continued working on a settings-based approach in schools, clinics and the community to promote face washing and personal hygiene messages. A four-step facial hygiene poster has been developed as part of a Clean Faces – Healthy Places program which complements the Clean Faces, Strong Eyes campaign. These messages have been supported by other agencies and programs that promote personal hygiene, so the messages received by communities are consistent. A pilot Trachoma Story Book in a local language has been developed and was showcased at the 2013 National Aboriginal and Torres Strait Islander Environmental Health Conference held in Adelaide. Work to engage and collaborate with the housing and education sectors to improve environmental conditions and support good hygiene is ongoing.

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