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A community-based eye care intervention in southern Egypt: impact on trachomatous trichiasis surgical coverage.

Abstract

PURPOSE: The purpose of this study was to measure the impact of a community-based intervention on uptake of trichiasis surgery in Southern Egypt.

METHODS: Four villages where trachoma is endemic were randomly selected in the Samalout district, Egypt. Two villages were selected for intervention (intervention villages) and two matched villages for nonintervention (nonintervention villages). The intervention model provided community information sessions, door-to-door health education, screening, and improvements in the clinical capacity of eye care providers. The intervention was evaluated through two pre- and post-intervention community-based surveys that included the prevalence of trachoma and the utilization of eye care services at local hospitals. All patients with trichiasis answered a questionnaire regarding surgical utilization and barriers.

RESULTS: In the baseline survey, the trachomatous trichiasis (TT) surgical coverage was 22.7% (38.9% males, 16.7% females) in all villages. Following the intervention, the TT surgical coverage increased to 68% in villages that received the intervention (81.5% males, 60% females). Nonintervention villages had a TT surgical coverage of 26.1% (37.5% males, 20% females). In the intervention villages, the prevalence of TT significantly decreased from 9.4% (5.7% males, 11.8% females) to 3.8% (1.9% males, 5.1% females) (P = 0.013), in 2008. In nonintervention villages, there was a slight, but insignificant decrease in TT from 10.1% (3.1% males, 14.4% females) to 8.2% (3% males, 11.5% females) (P = 0.580). The major barriers to uptake of TT surgical services were: "Feeling no problem" (17.3%), "fear of surgery" (12.7%) and "cost" (12.7%).

CONCLUSION: A community-based eye health education program with door-to-door screening significantly increased the uptake of TT surgical services. Although improvements to the delivery of surgical service are essential, they did not lead to any significant improvements in the nonintervention villages.

More information

Type
Journal Article
Author
Mousa A
Courtright P
Kazanjian A
Bassett K
Year of Publication
2015
Journal
Middle East African journal of ophthalmology
Volume
22
Issue
4
Number of Pages
478-83
Language
eng
ISSN Number
0975-1599
DOI
10.4103/0974-9233.167808
Alternate Journal
Middle East Afr J Ophthalmol
Publication Language
eng