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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...

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Autores principales: Bickley, Ryan J., Mkocha, Harran, Munoz, Beatriz, West, Sheila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
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.
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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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