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Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania
BACKGROUND: Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we ident...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215731/ https://www.ncbi.nlm.nih.gov/pubmed/28052070 http://dx.doi.org/10.1371/journal.pntd.0005211 |
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author | Bickley, Ryan J. Mkocha, Harran Munoz, Beatriz West, Sheila |
author_facet | Bickley, Ryan J. Mkocha, Harran Munoz, Beatriz West, Sheila |
author_sort | Bickley, Ryan J. |
collection | PubMed |
description | BACKGROUND: Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we identify barriers that prevent TT patients from receiving sight-saving surgery. METHODOLOGY/PRINCIPAL FINDINGS: Participants were selected from a database of TT cases who did (acceptors) and did not (non-acceptors) have surgery as of August 2015. We developed an in-home interview questionnaire, using open and closed-ended questions on perceived barriers to accessing surgical services. We compared responses between the acceptors and non-acceptors, examining differences in reasons for and against surgery, sources of TT information, and suggestions for improving surgical delivery. 167 participants (mean age 61 years, 79.7% females) were interviewed. Compared to acceptors, non-acceptors were more likely to report they had no one to accompany them to surgery (75.3% vs. 42.6%, p<0.0001), they could manage TT on their own (69.9% vs. 31.5%, p<0.0001), and the surgery camp was too far (53.4% vs. 28.7%, p = 0.001). Over 90% of both acceptors and non-acceptors agreed on the benefits of having surgery. Fear of surgery was the biggest barrier stated by both groups. Despite this fear, acceptors were more likely than non-acceptors to also report fear of losing further vision without surgery. CONCLUSIONS/SIGNIFICANCE: Barriers included access issues, familial and/or work responsibilities, the perception that self-management was sufficient, and lack of education about surgery. Fear of surgery was the biggest barrier facing both acceptors and non-acceptors. Increasing uptake will require addressing how surgery is presented to community residents, including outlining treatment logistics, surgical outcomes, and stressing the risk of vision loss. |
format | Online Article Text |
id | pubmed-5215731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-52157312017-01-19 Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania Bickley, Ryan J. Mkocha, Harran Munoz, Beatriz West, Sheila PLoS Negl Trop Dis Research Article BACKGROUND: Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we identify barriers that prevent TT patients from receiving sight-saving surgery. METHODOLOGY/PRINCIPAL FINDINGS: Participants were selected from a database of TT cases who did (acceptors) and did not (non-acceptors) have surgery as of August 2015. We developed an in-home interview questionnaire, using open and closed-ended questions on perceived barriers to accessing surgical services. We compared responses between the acceptors and non-acceptors, examining differences in reasons for and against surgery, sources of TT information, and suggestions for improving surgical delivery. 167 participants (mean age 61 years, 79.7% females) were interviewed. Compared to acceptors, non-acceptors were more likely to report they had no one to accompany them to surgery (75.3% vs. 42.6%, p<0.0001), they could manage TT on their own (69.9% vs. 31.5%, p<0.0001), and the surgery camp was too far (53.4% vs. 28.7%, p = 0.001). Over 90% of both acceptors and non-acceptors agreed on the benefits of having surgery. Fear of surgery was the biggest barrier stated by both groups. Despite this fear, acceptors were more likely than non-acceptors to also report fear of losing further vision without surgery. CONCLUSIONS/SIGNIFICANCE: Barriers included access issues, familial and/or work responsibilities, the perception that self-management was sufficient, and lack of education about surgery. Fear of surgery was the biggest barrier facing both acceptors and non-acceptors. Increasing uptake will require addressing how surgery is presented to community residents, including outlining treatment logistics, surgical outcomes, and stressing the risk of vision loss. Public Library of Science 2017-01-04 /pmc/articles/PMC5215731/ /pubmed/28052070 http://dx.doi.org/10.1371/journal.pntd.0005211 Text en © 2017 Bickley et al 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 author and source are credited. |
spellingShingle | Research Article Bickley, Ryan J. Mkocha, Harran Munoz, Beatriz West, Sheila Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
title | Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
title_full | Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
title_fullStr | Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
title_full_unstemmed | Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
title_short | Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
title_sort | identifying patient perceived barriers to trichiasis surgery in kongwa district, tanzania |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215731/ https://www.ncbi.nlm.nih.gov/pubmed/28052070 http://dx.doi.org/10.1371/journal.pntd.0005211 |
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