Comparison of clinical and photographic assessment of trachoma

Aims: The aim of the study was to determine the rates of trachoma in Aboriginal communities and to compare clinical assessment with photographic assessment for the presence of signs of trachoma. Methods: Five Aboriginal communities in the Katherine region of the Northern Territory, Australia, were assessed for the presence of trachoma. Trachoma was diagnosed by clinical eye examination using a fine grading based on the World Health Organization (WHO) simplified grading system. Photographs were taken of the left eye of every person and graded using the fine grading system. The clinical assessment was compared with the photographic assessment for each person using the fine grading system. Results: A total of 1316 people out of 1545 (85.2%) were screened for trachoma from five communities, with 1254 photographs being compared with clinical assessment scores. The overall prevalence of active trachoma was greater than 10% across the five communities, and greater than 20% in two communities. Conclusion: Active trachoma in young people and scarring in older people remain as problems in Aboriginal communities. Photographic assessment is a useful technique, but in comparison with clinical assessment it can result in overestimation of scoring for trachoma for inflammation.