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 identi...
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ftdoajarticles:oai:doaj.org/article:aad40dac5241457cb5c83b52d4429a6e 2023-05-15T15:14:15+02:00 Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania. Ryan J Bickley Harran Mkocha Beatriz Munoz Sheila West 2017-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005211 https://doaj.org/article/aad40dac5241457cb5c83b52d4429a6e EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5215731?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005211 https://doaj.org/article/aad40dac5241457cb5c83b52d4429a6e PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e0005211 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005211 2022-12-31T12:26:55Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 1 e0005211 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Ryan J Bickley Harran Mkocha Beatriz Munoz Sheila West Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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 |
Article in Journal/Newspaper |
author |
Ryan J Bickley Harran Mkocha Beatriz Munoz Sheila West |
author_facet |
Ryan J Bickley Harran Mkocha Beatriz Munoz Sheila West |
author_sort |
Ryan J Bickley |
title |
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_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_sort |
identifying patient perceived barriers to trichiasis surgery in kongwa district, tanzania. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005211 https://doaj.org/article/aad40dac5241457cb5c83b52d4429a6e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 1, p e0005211 (2017) |
op_relation |
http://europepmc.org/articles/PMC5215731?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005211 https://doaj.org/article/aad40dac5241457cb5c83b52d4429a6e |
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https://doi.org/10.1371/journal.pntd.0005211 |
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PLOS Neglected Tropical Diseases |
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11 |
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1 |
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e0005211 |
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