Optimizing trichiasis case finding to attain the elimination of trachoma as a public health problem
Background: As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managi...
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Published in | Tropical medicine and infectious disease Vol. 9; no. 7; pp. 1 - 8 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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01.07.2024
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Abstract | Background: As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases.
Methods: This was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches.
Results: The number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53-70%) and had surgery (79-85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4-6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used.
Discussion: This study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost. |
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AbstractList | As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases.BACKGROUNDAs national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases.This was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches.METHODSThis was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches.The number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53-70%) and had surgery (79-85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4-6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used.RESULTSThe number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53-70%) and had surgery (79-85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4-6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used.This study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost.DISCUSSIONThis study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost. Background: As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases. Methods: This was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches. Results: The number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53–70%) and had surgery (79–85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4–6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used. Discussion: This study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost. Background: As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases. Methods: This was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches. Results: The number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53-70%) and had surgery (79-85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4-6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used. Discussion: This study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost. As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases. This was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches. The number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53-70%) and had surgery (79-85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4-6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used. This study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost. |
Audience | Academic |
Author | Michaela Kelly Innocent Emereuwa Caleb Mpyet Joy Shu'aibu Abubakar Tafida Grace Ajege Sunday Isiyaku Paul Courtright Michael Dejene |
Author_xml | – sequence: 1 givenname: Joy surname: Shu'aibu fullname: Shu'aibu, Joy organization: Department of Family Medicine, Bingham University, Karu 961105, Nigeria – sequence: 2 givenname: Grace surname: Ajege fullname: Ajege, Grace organization: Sightsavers, Abuja 900231, Nigeria – sequence: 3 givenname: Caleb orcidid: 0000-0001-8558-9819 surname: Mpyet fullname: Mpyet, Caleb organization: Department of Ophthalmology, University of Jos, Jos 930003, Nigeria – sequence: 4 givenname: Michael surname: Dejene fullname: Dejene, Michael organization: Public Health Consultancy Services, Addis Ababa 1169, Ethiopia – sequence: 5 givenname: Sunday surname: Isiyaku fullname: Isiyaku, Sunday organization: Sightsavers, Abuja 900231, Nigeria – sequence: 6 givenname: Abubakar surname: Tafida fullname: Tafida, Abubakar organization: Ministry of Health Jigawa State, Dutse 720222, Nigeria – sequence: 7 givenname: Michaela orcidid: 0000-0002-0932-607X surname: Kelly fullname: Kelly, Michaela organization: Sightsavers, West Sussex RH16 4BX, UK – sequence: 8 givenname: Innocent surname: Emereuwa fullname: Emereuwa, Innocent organization: Health and Development Support Programme, Jos 930003, Nigeria – sequence: 9 givenname: Paul surname: Courtright fullname: Courtright, Paul organization: Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town 7925, South Africa |
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Cites_doi | 10.4269/ajtmh.2003.69.5_suppl_1.0690001 10.3201/eid1011.040353 10.1080/09286586.2018.1546876 10.1101/2020.03.13.990424 10.4103/0974-9233.167808 10.7196/SAMJ.4097 10.1371/journal.pntd.0000462 10.1080/09286586.2016.1265657 10.1093/trstmh/traa022 10.1136/bjo.2004.041657 10.1016/j.survophthal.2011.08.002 10.1016/j.trstmh.2009.03.012 10.1076/opep.6.4.257.4186 10.1093/inthealth/ihab086 |
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References | Mousa (ref_17) 2015; 22 Courtright (ref_3) 2004; 10 Rabiu (ref_7) 2011; 101 ref_13 ref_12 ref_11 ref_10 ref_21 Lynch (ref_19) 1999; 6 ref_1 Frick (ref_5) 2003; 69 Mpyet (ref_8) 2017; 24 ref_2 Kelly (ref_14) 2022; 14 Mpyet (ref_16) 2018; 25 Cromwell (ref_4) 2009; 103 ref_15 Sanders (ref_18) 2020; 114 West (ref_20) 2004; 88 ref_9 Rajak (ref_6) 2012; 57 |
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Snippet | Background: As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical... As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health... |
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SubjectTerms | Attitudes Blind case finding Case management Cataracts Causes and theories of causation Data entry Diseases gender Local government Nigeria Patients Prevention Public health Surgery Tetracycline Tetracyclines Trachoma trachomatous trichiasis Visual acuity Visual impairment |
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Title | Optimizing trichiasis case finding to attain the elimination of trachoma as a public health problem |
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