Use of validated community-based trachoma trichiasis (TT) case finders to measure the total backlog and detect when elimination threshold is achieved: a TT methodology paper

Karimurio, J; Rono, Hillary; Njomo, Doris W.; Sironka, John; Kareko, Catherine; Gichangi, Michael; Barasa, E; Mwangi, Alice; Ronald, Kefa; Kiio, Francis

doi:10.11604/pamj.2017.27.84.11266

Cited by 4 publications

(5 citation statements)

References 7 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A cheaper alternative option may be to further strengthen the community volunteer surveillance network to identify TT cases and simultaneously determine if TT elimination thresholds have been achieved, as shown in Kenya [19], Tanzania [20] and elsewhere. There is merit in suggesting that Ghana would have been better placed to have strengthened the passive surveillance system by focusing on TT only and potentially better incentivise the community volunteers to identify and refer TT cases.…”

Section: Discussionmentioning

confidence: 99%

Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges

Senyonjo

Aboe²,

Bailey

et al. 2019

Infect Dis Poverty

View full text Add to dashboard Cite

Background In 2009 Ghana began to design a trachoma pre-validation surveillance plan, based on then-current WHO recommendations. The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases, through both active and passive surveillance approaches. This paper outlines and reviews the adaptations made by Ghana between 2011 and 2016. The assessment will provide a learning opportunity for a number of countries as they progress towards elimination status. Methods A mixed methods approach was taken, comprising in-depth interviews and documents review. Between January and April 2016, 20 in-depth interviews were conducted with persons involved in the operationalisation of the trachoma surveillance system from across all levels of the health system. A three-tier thematic coding framework was developed using a primarily inductive approach but also allowed for a more iterative approach, which drew on aspects of grounded theory. Results During the operationalisation of the Ghana surveillance plan there were a number of adaptations (as compared to the WHO recommendations), these included: (i) Inclusion of surveillance of active trachoma in the passive surveillance approach, as compared to trichiasis alone. Issues with case identification, challenges in implementation coverage and a non-specific reporting structure hampered effectiveness; (ii) Random selection and increase in number of sites selected for the active surveillance component. This likely lacked the spatiotemporal power to be able to identify recrudescence in a timely manner; (iii) Targeted trichiasis door-to-door case searches, led by ophthalmic nurses. An effective methodology to identify trichiasis cases but resource intensive; (iv) A buddy system between ophthalmic nurses to support technical skills in an elimination setting where it is difficult to attain diagnostic and surgical skills, due to a lack of cases. The strategy did not take into account the loss of proficiency within experienced personnel. Conclusions Ghana developed a comprehensive surveillance system that exceeded the WHO recommendations but issues with sensitivity and specificity likely led to an inefficient use of resources. Improved targeted surveillance strategies for identification of recrudescence and trichiasis case searches, need to be evaluated. Strategies must address the contextual changes that arise because of transmission decline, such as loss of surgical skills. Electronic supplementary material The online version of this article (10.1186/s40249-019-0585-x) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges

Senyonjo

Aboe²,

Bailey

et al. 2019

Infect Dis Poverty

View full text Add to dashboard Cite

show abstract

“…For example, limited availability of teachers to conduct vision screenings in rural schools in Peru [20] or specialist teachers to provide training to parents of vision impaired children in rural Malawi [53]; created barriers to interventions targeting child eye health. In a schoolbased eye health intervention in India, time-poor teachers refused to participate in the • Conduct disease surveillance including measles [26] • Defaulter tracing of missed vaccinations [28] • Detect trachomatous trichiasis [44,78] • Clear vegetation for vector control [79] • Conduct surveillance of Simulian fly vectors [80] • Detect individuals requiring eye care [81] • Contribute to designing routine health and eye care [82] Community and religious leaders • Select volunteers to be trained in detecting childhood vision impairment [41] School principals • Select teacher to be trained in vision screening [24,83] Teachers • Provide vision screening to detect eye and vision problems in children [17,20,24,[83][84][85] • Coordinate vision screening [22] Vector collectors • Conduct surveillance of Simulian fly vectors [86] https://doi.org/10.1371/journal.pone.0278969.t005…”

Section: Surveillance Screening and Detectionmentioning

confidence: 99%

“…• Prepare lists and recommend appointments for those requiring immunization [28,54] • Refer community members requiring eye care [29,73,87] Volunteers • Refer children requiring eye care [29,39,75] • Arrange transport for referred children requiring eye care [39] • Refer cases of trachomatis trichiasis to surgeons [78] Children • Provide information to parents regarding own vision impairment https://doi.org/10.1371/journal.pone.0278969.t006…”

Section: Teachersmentioning

confidence: 99%

Integrated people-centered eye care: A scoping review on engaging communities in eye care in low- and middle-income settings

Lee

Moo²,

Angelopoulos³

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Background Community engagement has been endorsed as a key strategy to achieving integrated people-centered eye care that enables people and communities to receive a full spectrum of eye care across their life-course. Understanding the ways communities are engaged in eye care, to what degree participation is achieved, and the factors associated with intervention implementation is currently limited. Objective The scoping review aimed to assess how community engagement is approached and implemented in eye care interventions in low- and middle-income countries, and to identify the barriers and facilitators associated with intervention implementation. Methods Searches were conducted across five databases for peer-reviewed research on eye care interventions engaging communities published in the last ten years (January 2011 to September 2021). Studies were screened, reviewed and appraised according to Cochrane Rapid Reviews methodology. A hybrid deductive-inductive iterative analysis approach was used. Results Of 4315 potential studies screened, 73 were included in the review. Studies were conducted across 28 countries and 55 targeted populations across more than one life-course stage. A variety of community actors were engaged in implementation, in four main domains of eye care: health promotion and education; drug and supplement distribution and immunization campaigns; surveillance, screening and detection activities; and referral and pathway navigation. With the approaches and level of participation, the majority of studies were community-based and at best, involved communities, respectively. Involving community actors alone does not guarantee community trust and therefore can impact eye care uptake. Community actors can be integrated into eye care programs, although with varying success. Using volunteers highlighted sustainability issues with maintaining motivation and involvement when resources are limited. Conclusion This scoping review provides researchers and policy makers contextual evidence on the breadth of eye care interventions and the factors to be considered when engaging and empowering communities in integrated people-centered eye care programs.

show abstract

“…Community-based door-to-door TT case finding has also been utilised in trachoma programmes and although this approach is expensive (compared to a passive surveillance or survey approach) and time-consuming, it has the advantage of finding the majority of TT cases and allows for immediate case management [44,45]. A community-based randomized controlled trial was conducted in Tanzania and compared the utility of community treatment assistants (CTA), facilitated with training and use of TT screening cards, to usual care provision.…”

Section: Target Group In Humansmentioning

confidence: 99%

Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review

et al. 2021

View full text Add to dashboard Cite

Introduction A number of neglected tropical diseases are targeted for elimination or eradication. An effective surveillance system is critical to determine if these goals have been achieved and maintained. Trachoma has two related but morphologically different presentations that are monitored for elimination, the active infectious form of trachoma and trachomatous trichiasis (TT), the progression of the disease. There are a number of lessons learnt from the Guinea worm surveillance system that are particularly compatible for TT surveillance and the onchocerciasis surveillance system which can provide insights for surveillance of the infectious form of trachoma. Methods/Principal findings A literature search of peer-reviewed published papers and grey literature was conducted using PUBMED and Google Scholar for articles relating to dracunculiasis or Guinea worm, onchocerciasis and trachoma, along with surveillance or elimination or eradication. The abstracts of relevant papers were read and inclusion was determined based on specified inclusion and exclusion criteria. The credibility and bias of relevant papers were also critically assessed using published criteria. A total of 41 papers were identified that were eligible for inclusion into the review. The Guinea worm programme is designed around a surveillance-containment strategy and combines both active and passive surveillance approaches, with a focus on village-based surveillance and reporting. Although rumour reporting and a monetary incentive for the identification of confirmed Guinea worm cases have been reported as successful for identifying previously unknown transmission there is little unbiased evidence to support this conclusion. More rigorous evidence through a randomised controlled trial, influenced by motivational factors identified through formative research, would be necessary in order to consider applicability for TT case finding in an elimination setting. The onchocerciasis surveillance strategy focuses on active surveillance through sentinel surveillance of villages and breeding sites. It relies on an entomological component, monitoring infectivity rates of black flies and an epidemiological component, tracking exposure to infection in humans. Challenges have included the introduction of relatively complex diagnostics that are not readily available in onchocerciasis endemic countries and target thresholds, which are practically unattainable with current diagnostic tests. Although there is utility in monitoring for infection and serological markers in trachoma surveillance, it is important that adequate considerations are made to ensure evidence-based and achievable guidelines for their utility are put in place. Conclusions/Significance The experiences of both the Guinea worm and onchocerciasis surveillance strategies have very useful lessons for trachoma surveillance, pre- and post-validation. The use of a monetary reward for identification of TT cases and further exploration into the use of infection and serological indicators particularly in a post-validation setting to assist in identifying recrudescence would be of particular relevance. The next step would be a real-world evaluation of their relative applicability for trachoma surveillance.

show abstract

Use of validated community-based trachoma trichiasis (TT) case finders to measure the total backlog and detect when elimination threshold is achieved: a TT methodology paper

Cited by 4 publications

References 7 publications

Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges

Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana: a qualitative assessment of successes and challenges

Integrated people-centered eye care: A scoping review on engaging communities in eye care in low- and middle-income settings

Lessons learned for surveillance strategies for trachoma elimination as a public health problem, from the evaluation of approaches utilised by Guinea worm and onchocerciasis programmes: A literature review

Contact Info

Product

Resources

About