Abstract
Objective: Recent surveys identified trachomatous inflammation – follicular (TF) at endemic levels in the Torres Strait Islands; however, local health staff do not report trachomatous trichiasis (TT) in adults. We undertook a cross-sectional survey involving eye examination and microbiological testing to better understand this disconnect.
Methods: We examined 169 of 207 (82%) residents and collected ocular swabs for polymerase chain reaction (PCR) testing for Chlamydia trachomatis. Other viral PCR tests and bacterial culture were also performed. Results: TF prevalence in children aged 5–9 years was 23% (7/30). No ocular C. trachomatis was identified by PCR. For the 72 participants (43%) with follicles, bacterial culture was positive for 11 (15%) individuals. No individual had trachomatous trichiasis.
Conclusions: Follicular conjunctivitis consistent with TF was prevalent but ocular C. trachomatis and cicatricial trachoma were absent. Non-chlamydial infections or environmental causes of follicular conjunctivitis may be causing TF in this community. Implications for public health: In similar settings, reliance on simplified clinical assessment alone may lead to an overestimation of the public health problem posed by trachoma. Consideration should be given to incorporating C. trachomatis PCR, and in certain settings, a detailed clinical exam could be performed by an experienced ophthalmologist during prevalence surveys.
| Original language | English |
|---|---|
| Pages (from-to) | 155-160 |
| Number of pages | 6 |
| Journal | Australian and New Zealand Journal of Public Health |
| Volume | 46 |
| Issue number | 2 |
| Early online date | Jan 2022 |
| DOIs | |
| Publication status | Published - Apr 2022 |
Bibliographical note
Funding Information:We are grateful to the Torres Strait Island Regional Council and Torres and Cape Hospital and Health Service for supporting the study and offer a special thanks to the community and participants for their involvement. We are also grateful to the laboratory staff at Pathology Queensland and the Queensland Paediatric Infectious Diseases Laboratory for the analysis of samples. LJW was supported by a National Health and Medical Research Early Career Fellowship (#1142035). This work was performed with funding support from Queensland Health and the Project Agreement on Improving Trachoma Control Services for Indigenous Australians.
