A primary health care approach to trachoma control was implemented in two Central Australian Aboriginal communities in the Anangu Pitjantjatjara land, Pipalyatjara and Mimili based on the World Health Organization (WHO) SAFE strategy (Surgery, Antibiotics, Facial hygiene, and Environmental improvements). Baseline data was gathered for 18 months from March 1999 through September 2000 for trachoma prevalence, facial cleanliness, and nasal discharge parameters. A one-time dose of azithromycin was given in September 2000. The chief focus was children under 15 years of age, whose pre-intervention prevalence level of TF (Trachoma Follicular) was 42% in Pipalyatjara and 44% in Mimili. In the 1-9 year age group, the TF prevalence was 47% and 54%, respectively. For TI (Trachoma Intense), the pre-intervention prevalence was 8% in Pipalyatjara and 9% in Mimili. The TF prevalence, adjusted for clustering and using only individuals present at baseline and follow-up (3, 6, and 12 months post-intervention), was 41.5%, 21.2%, 20.0%, and 20.0% in Pipalyatjara respectively. In Mimili, the corresponding prevalence figures were 43.5%, 18.2%, 18.2%, and 30%.

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Van C. Lansingh, MD PhD: Studied medicine and ophthalmology, National Autonomous University of Mexico and public health ophthalmology, University (U.) of Melbourne. Regional Coordinator, Vision 2020 Latin America; Voluntary Assistant Professor of Ophthalmology, U. of Miami; Director of International Outreach in Ophthalmology, U. of Tennessee.