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.