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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Explaining the continuing high prevalence of trachomatous trichiasis unknown to the health system in evaluation units: a mixed methods explanatory study in four trachoma-endemic countries
International health, Volume 15, No. 2, Year 2023
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Description
BACKGROUND: We explored reasons for continuing higher-than-anticipated prevalence of trachomatous trichiasis (TT) unknown to the health system in population-based prevalence surveys in evaluation units where full geographical coverage of TT case finding was reported. METHODS: A mixed-methods study in Ethiopia, Kenya, Nigeria and Tanzania was conducted. We compared data from clinical examination, campaign documentation and interviews with original trachoma impact survey (TIS) results. RESULTS: Of 169 TT cases identified by TIS teams, 130 (77%) were examined in this study. Of those, 90 (69%) were a match (both TIS and study teams agreed on TT classification) and 40 (31%) were a mismatch. Of the 40 mismatches, 22 (55%) were identified as unknown to the health system by the study team but as known to the health system by the TIS team; 12 (30%) were identified as not having TT by the study team but as having TT by the TIS team; and six (15%) were identified as unknown to the health system in the TIS team but as known to the health system by the study team based on documentation reviewed. CONCLUSIONS: Incorrectly reported geographical coverage of case-finding activities, and discrepancies in TT status between TIS results and more detailed assessments, are the key reasons identified for continuing high TT prevalence. © The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Mwangi, Grace
Tanzania, Moshi
Kilimanjaro Centre for Community Ophthalmology
Harding-Esch, Emma Michele
United Kingdom, London
London School of Hygiene & Tropical Medicine
Kabona, George E.
Tanzania, Dar es Salaam
Ministry of Health and Social Welfare Dar es Salaam
Watitu, Titus K.
Kenya, Nairobi
Ministry of Health Nairobi
Mpyet, Caleb D.
United Kingdom, Chippenham
Sightsavers, United Kingdom
Nigeria, Jos
University of Jos
Gemechu, Alemu
Australia, Sydney
Fred Hollows Foundation, Australia
Wamyil-Mshelia, Teyil
United Kingdom, Chippenham
Sightsavers, United Kingdom
Kelly, Michaela
United Kingdom, Chippenham
Sightsavers, United Kingdom
Abony, Maurice
United Kingdom, Chippenham
Sightsavers, United Kingdom
Chege, Moses
United Kingdom, Chippenham
Sightsavers, United Kingdom
Courtright, Paul D.
Tanzania, Moshi
Kilimanjaro Centre for Community Ophthalmology
United Kingdom, Chippenham
Sightsavers, United Kingdom
South Africa, Cape Town
University of Cape Town
Geneau, Robert
Tanzania, Moshi
Kilimanjaro Centre for Community Ophthalmology
South Africa, Cape Town
University of Cape Town
Statistics
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1093/inthealth/ihad085
ISSN:
18763405
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Study Approach
Quantitative
Mixed-methods
Study Locations
Ethiopia
Kenya
Nigeria
Tanzania