Predicting surgical compliance in a cohort of women with trichiasis

Abstract

Trichiasis/Entropion are the severe consequences of chronic trachoma during early life. Blindness and vision loss is preventable with timely lid surgery to correct trichiasis. In a trachoma hyperendemic region of Central Tanzania, a two year follow-up survey was conducted among 205 women with trichiasis to determine the proportion who had had surgery and the barriers to having surgery. Only 18% of the women had undergone surgery by the 2 year follow-up. Those who had surgery tended to report more eye problems at baseline and have more corneal opacities at baseline. Barriers preventing women from going to surgery were costs, problem of children left at home alone, and difficulties in identifying someone to accompany them to the health center. Over 2/3 of those who had surgery reported a significant decrease in pain, improvement of vision, and improved ability to carry out activities of daily life. Ways to improve compliance with recommendations for trichiasis surgery need to be developed.

Trachoma: The Forgotten Cause of Blindness

“…In Tanzania, even after patients were aware that surgery was available and could prevent vision loss, compliance with surgery was very low: Only 18 percent of women with trichiasis to whom surgery was offered opted to have the operation in a 2-year period. The main barriers were perceived cost and lack of accessibility to the health facilities (102). In this environment, cost includes transportation, food, and expenses of an accompanying person who acts as a caretaker.…”

Gender equity and trichiasis surgery in the Vietnam and Tanzania national trachoma control programmes

“…These gender equity concerns can be based on women having less access to money (for surgery or for travel or hospital expenses), less time from chores to get surgery, more fear of the procedure and any unsightly after effects. [4][5][6] Gender inequity has been discussed in a myriad of arenas, including food distribution, mortality, mental health, reproductive health, education, and in the context of health sector reform. [7][8][9][10][11][12][13] In ophthalmology, there are limited data that address gender equity in access to services, particularly in low and middle income countries.…”

Community-based transconjunctival marginal rotation for cicatricial trachoma in Indians from the Upper Rio Negro basin

“…Acceptance of surgery depends on economic and cultural factors that change from one community to another (16)(17)(18)(19)(20). The population operated upon here was composed mainly of Makus, one of the most primitive group of Indians in the region (21).…”