Gender differences in the surgical management of trachomatous trichiasis: an exploratory analysis of global trachoma survey data, 2015–2019

• Published in: International health Vol. 15; no. Supplement_2; pp. ii58 - ii67
• Main Authors: Sullivan, Kristin M, Harding-Esch, Emma M, Batcho, Wilfrid E, Issifou, Amadou A Bio, Lopes, Maria de Fátima Costa, Szwarcwald, Celia Landmann, Vaz Ferreira Gomez, Daniela, Bougouma, Clarisse, Christophe, Nassa, Kabore, Martin, Bucumi, Victor, Bella, Assumpta L, Epee, Emilienne, Yaya, Georges, Trujillo-Trujillo, Julian, Dejene, Michael, Gebretsadik, Fikre Seife, Gebru, Genet, Kebede, Fikreab, Mathewos, Tsedeke, Cassama, Eunice Texiera de Silva, Sanha, Salimato, Barasa, Ernest, Sultani, Hadley Matendechero, Watitu, Titus, Tekeraoi, Rabebe, Kalua, Khumbo M, Masika, Michael P, Traoré, Lamine, Minnih, Abdallahi O, Abdala, Mariamo, Massangaie, Marília E, Win, Ye, Apadinuwe, Sue-Chen, Mishra, Sailesh Kumar, Sharma, Shekhar, Amza, Abdou, Kadri, Boubacar, Nassirou, Beido, Mpyet, Caleb D, Olobio, Nicholas, Hussain, Arif, Khan, Asad Aslam, Jambi, Garap, Ko, Robert, Kello, Amir B, Badiane, Mouctar D, Sarr, Boubacar, Dalmar, Abdi, Elshafie, Balgesa E, Kabona, George E, Kaitaba, Oscar, Mwingira, Upendo, Simon, Alistidia, Kanyi, Sarjo, Awoussi, Marcel S, Togbey, Kwamy, Baayenda, Gilbert, Francis, Mugume, Tukahebwa, Edridah M, Bakhtiari, Ana, Keil, Alexander P, Maselko, Joanna, Westreich, Daniel, Garae, Mackline, Taleo, Fasiah, Al-Khateeb, Tawfik Q, Mwale, Consity, Solomon, Anthony W, Gower, Emily W
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 04.12.2023
• Subjects: Cross-Sectional Studies; Female; Humans; Male; Original; Prevalence; Risk Factors; Sex Factors; Trachoma - epidemiology; Trachoma - surgery; Trichiasis - epidemiology; Trichiasis - etiology; Trichiasis - surgery; trachoma; gender; elimination; trichiasis; surgery; Chlamydia trachomatis
• ISSN: 1876-3413; 1876-3405
• DOI: 10.1093/inthealth/ihad067

Abstract Background Trachomatous trichiasis (TT) is a painful, potentially blinding eye condition that can be managed through epilation or surgery. Women are affected by TT approximately twice as often as men and are believed to face gendered barriers to receiving surgical care to prevent vision loss. Methods We used data from 817 cross-sectional surveys conducted during 2015–2019 in 20 African countries to estimate the prevalence difference (PD) between female and male eyes for four outcomes potentially indicating gender-related differences in TT management: (1) received surgery and developed postoperative TT (PTT), (2) never offered surgery, (3) offered surgery but declined it, and (4) offered epilation but never offered surgery. Results The prevalence was modestly elevated among female eyes compared with male eyes for having PTT (PD:1.8 [95% confidence limits (CL): 0.6, 3.0]) and having declined surgery for the eye (PD: 6.2 [95% CL: 1.8, 10.7]). The proportion offered epilation was similar by gender (PD:0.5 [95% CL: −0.4, 1.3]), while never having been offered surgery was somewhat more prevalent among male eyes (PD: −2.1 [95% CL: −3.5, −0.7]). Conclusions Our results suggest potential gender differences in TT management. More research is needed to determine the causes and implications of the observed differences.