Cargando…

Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?

BACKGROUND: The inclusion of primary eye care (PEC) in the scope of services provided by general primary health care (PHC) workers is a ‘task shifting’ strategy to help increase access to eye care in Africa. PEC training, in theory, teaches PHC workers to recognize specific symptoms and signs and to...

Descripción completa

Detalles Bibliográficos
Autores principales: Andriamanjato, Hery Harimanitra, Mathenge, Wanjiku, Kalua, Khumbo, Courtright, Paul, Lewallen, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108919/
https://www.ncbi.nlm.nih.gov/pubmed/25860992
http://dx.doi.org/10.1186/1478-4491-12-S1-S3
_version_ 1782327810031878144
author Andriamanjato, Hery Harimanitra
Mathenge, Wanjiku
Kalua, Khumbo
Courtright, Paul
Lewallen, Susan
author_facet Andriamanjato, Hery Harimanitra
Mathenge, Wanjiku
Kalua, Khumbo
Courtright, Paul
Lewallen, Susan
author_sort Andriamanjato, Hery Harimanitra
collection PubMed
description BACKGROUND: The inclusion of primary eye care (PEC) in the scope of services provided by general primary health care (PHC) workers is a ‘task shifting’ strategy to help increase access to eye care in Africa. PEC training, in theory, teaches PHC workers to recognize specific symptoms and signs and to treat or refer according to these. We tested the sensitivity of these symptoms and signs at identifying significant eye pathology. METHODS: Specialized eye care personnel in three African countries evaluated specific symptoms and signs, using a torch alone, in patients who presented to eye clinics. Following this, they conducted a more thorough examination necessary to make a definite diagnosis and manage the patient. The sensitivities and specificities of the symptoms and signs for identifying eyes with conditions requiring referral or threatening sight were calculated. RESULTS: Sensitivities of individual symptoms and signs to detect sight threatening pathology ranged from 6.0% to 55.1%; specificities ranged from 8.6 to 98.9. Using a combination of symptoms or signs increased the sensitivity to 80.8 but specificity was 53.2. CONCLUSIONS: In this study, the sensitivity and specificity of commonly used symptoms and signs were too low to be useful in guiding PHC workers to accurately identify and refer patients with eye complaints. This raises the question of whether this task shifting strategy is likely to contribute to reducing visual loss or to providing an acceptable quality service.
format Online
Article
Text
id pubmed-4108919
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-41089192014-08-04 Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel? Andriamanjato, Hery Harimanitra Mathenge, Wanjiku Kalua, Khumbo Courtright, Paul Lewallen, Susan Hum Resour Health Research BACKGROUND: The inclusion of primary eye care (PEC) in the scope of services provided by general primary health care (PHC) workers is a ‘task shifting’ strategy to help increase access to eye care in Africa. PEC training, in theory, teaches PHC workers to recognize specific symptoms and signs and to treat or refer according to these. We tested the sensitivity of these symptoms and signs at identifying significant eye pathology. METHODS: Specialized eye care personnel in three African countries evaluated specific symptoms and signs, using a torch alone, in patients who presented to eye clinics. Following this, they conducted a more thorough examination necessary to make a definite diagnosis and manage the patient. The sensitivities and specificities of the symptoms and signs for identifying eyes with conditions requiring referral or threatening sight were calculated. RESULTS: Sensitivities of individual symptoms and signs to detect sight threatening pathology ranged from 6.0% to 55.1%; specificities ranged from 8.6 to 98.9. Using a combination of symptoms or signs increased the sensitivity to 80.8 but specificity was 53.2. CONCLUSIONS: In this study, the sensitivity and specificity of commonly used symptoms and signs were too low to be useful in guiding PHC workers to accurately identify and refer patients with eye complaints. This raises the question of whether this task shifting strategy is likely to contribute to reducing visual loss or to providing an acceptable quality service. BioMed Central 2014-05-12 /pmc/articles/PMC4108919/ /pubmed/25860992 http://dx.doi.org/10.1186/1478-4491-12-S1-S3 Text en Copyright © 2014 Andriamanjato et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Andriamanjato, Hery Harimanitra
Mathenge, Wanjiku
Kalua, Khumbo
Courtright, Paul
Lewallen, Susan
Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
title Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
title_full Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
title_fullStr Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
title_full_unstemmed Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
title_short Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
title_sort task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108919/
https://www.ncbi.nlm.nih.gov/pubmed/25860992
http://dx.doi.org/10.1186/1478-4491-12-S1-S3
work_keys_str_mv AT andriamanjatoheryharimanitra taskshiftinginprimaryeyecarehowsensitiveandspecificarecommonsignsandsymptomstopredictconditionsrequiringreferraltospecialisteyepersonnel
AT mathengewanjiku taskshiftinginprimaryeyecarehowsensitiveandspecificarecommonsignsandsymptomstopredictconditionsrequiringreferraltospecialisteyepersonnel
AT kaluakhumbo taskshiftinginprimaryeyecarehowsensitiveandspecificarecommonsignsandsymptomstopredictconditionsrequiringreferraltospecialisteyepersonnel
AT courtrightpaul taskshiftinginprimaryeyecarehowsensitiveandspecificarecommonsignsandsymptomstopredictconditionsrequiringreferraltospecialisteyepersonnel
AT lewallensusan taskshiftinginprimaryeyecarehowsensitiveandspecificarecommonsignsandsymptomstopredictconditionsrequiringreferraltospecialisteyepersonnel