TRENDS IN THE PREVALENCE OF TRACHOMA, SOUTH AUSTRALIA, 1976 TO 1990

The eye health of rural Aboriginal Australians is known to be poor. Ov er the past 20 years, Aboriginal communities in remote parts of Austra lia have had increasing access to eye health services through the Nati onal Trachoma and Eye Health Program (NTEHF). Using published and unpu blished data, we examined trends in the prevalence of inflammatory tra choma in the Anangu Pitjantjatjara of South Australia. Comparisons usi ng a generalised linear model of surveys in 1976, 1985 and 1990 indica te that there has been a significant reduction in the age-standardised prevalence of inflammatory trachoma in 0- to 20-year-olds. When the 1 990 survey was compared with 1976 interim report data from the NTEHP s urvey, the odds of inflammatory trachoma in 1990 were 0.25 (95 per cen t confidence interval (CI) 0.18 to 0.35). When the comparison was with data from the NTEHP survey of the Red Centre, the odds of follicular trachoma in 1990 were 0.51 (CI 0.42 to 0.62), and in comparison with t he 1985 NTEHP review data, the odds of inflammatory trachoma in 1990 w ere 0.28 (CI 0.20 to 0.39). In the older age groups (20 and over), an increase in the prevalence of inflammatory trachoma was found. Althoug h significant, the increase affected a small proportion of the populat ion and may have been because of difficulty in standardising the trach oma grading between surveys, or systematic grading error in the 1990 s urvey. This study therefore shows that the eye health of Aboriginal pe ople in Central Australia may be improving. The decline in trachoma is welcome and may be caused by improvements in socioeconomic conditions , community development and increasing access to medical care.