Indigenous comedian Sean Choolburra and Milpa the trachoma goanna providing trachoma education to schools in the Utopia region, NT Photo: Indigenous Eye Health, University of Melbourne
By Helen Carter
Experts involved in programs to eradicate trachoma in Australia are aiming to follow the example of Mexico which is free of trachoma.
Optometrist and senior research fellow with Indigenous Eye Health, the University of Melbourne, Mitchell Anjou said Australia remained the only high-income country in the world to still have trachoma.
‘Trachoma persists in Australia in some remote Aboriginal communities that still lack safe washing facilities and have poor and overcrowded housing,’ Mr Anjou said.
‘Trachoma is the world’s leading infectious cause of blindness and globally, in 2016 an estimated 200 million people were considered at risk of trachoma in 42 countries.’
The World Health Organization and the Pan American Health Organization announced on 1 May that Mexico was the first country in the Americas to eliminate trachoma as a public health issue and the third country worldwide, behind Oman and Morocco, to receive WHO validation for eliminating the disease.
Mr Anjou said 10 countries had reported elimination over the past decade.
The international criteria for elimination of trachoma as a public health problem includes prevalence of less than five per cent in children aged one to nine, and less than one case of trachomatous trichiasis per 1,000 inhabitants.
The WHO global goal is to eliminate trachoma by 2020 through the SAFE strategy which includes surgery for trichiasis (S), antibiotics to reduce levels of infection (A), promotion of facial cleanliness to stop transmission (F) and environmental improvements in water and sanitation (E).
In Mexico, the Trachoma Brigades of doctors, nurses and other health workers worked locally to reduce cases from 1,794 in 2004 to zero cases in 2016.
‘This is a historic moment for public health in Mexico and the Americas,’ Carissa Etienne, director of the WHO regional office for the Americas, the Pan American Health Organization, said in a media release.
She acknowledged the decades-long efforts of Mexican authorities, health workers and communities to improve their health and quality of life, and end this disease of poverty.
Progress in Australia
Mr Anjou said Australia was making progress in its fight against trachoma.
‘Disease rates were between 15 per cent and 20 per cent in 2009, and data from 2015 show a continuing drop with the national average for children in endemic areas at 4.6 per cent,’ he said.
Rates are prevalence of trachoma in children aged one to nine years in communities that are screened for trachoma.
‘More than 200 communities were considered at risk in 2008 and this is now less than 50 communities,’ Mr Anjou said.
‘The essential and sustainable preventative approach to eliminate trachoma is to keep children’s faces clean, and this goes with ongoing access to safe and functional bathrooms and washing facilities.’
He said Indigenous Eye Health at the University of Melbourne, under the leadership of Melbourne Laureate Professor Hugh Taylor, was working closely with community groups and supporting effective trachoma health promotion activities in Australia with messages such as ‘Clean Faces, Strong Eyes.’
AFLW players Aliesha Newman (L) and Mia-Rae Clifford from Melbourne Football Club with Milpa the trachoma goanna promoting ‘Clean Faces, Strong Eyes’ Photo: Indigenous Eye Health, University of Melbourne
Milpa, the trachoma goanna, features in educational materials and is involved in community activities with music, art and sport to encourage and reinforce the importance of clean faces for children.
Trachoma elimination is supported by Australian Government funding and the work of state and territory governments, the Indigenous health sector and a range of non-government organisations.
Brisbane MP Dr Andrew Laming, who trained in ophthalmology, spoke at AVC in April about how close Australia was to eradicating trachoma.