Why do people not attend for treatment for trachomatous trichiasis in Ethiopia? A study of barriers to surgery
Trachomatous trichiasis (TT) surgery is provided free or subsidised in most trachoma endemic settings. However, only 18-66% of TT patients attend for surgery. This study analyses barriers to attendance among TT patients in Ethiopia, the country with the highest prevalence of TT in the world. Partici...
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| creator | Rajak, Saul N Habtamu, Esmael Weiss, Helen A Bedri, Amir Zerihun, Mulat Gebre, Teshome Gilbert, Clare E Emerson, Paul M Burton, Matthew J |
| description | Trachomatous trichiasis (TT) surgery is provided free or subsidised in most trachoma endemic settings. However, only 18-66% of TT patients attend for surgery. This study analyses barriers to attendance among TT patients in Ethiopia, the country with the highest prevalence of TT in the world.
Participants with previously un-operated TT were recruited at 17 surgical outreach campaigns in Amhara Region, Ethiopia. An interview was conducted to ascertain why they had not attended for surgery previously. A trachoma eye examination was performed by an ophthalmologist. 2591 consecutive individuals were interviewed. The most frequently cited barriers to previous attendance for surgery were lack of time (45.3%), financial constraints (42.9%) and lack of an escort (35.5% in females, 19.6% in males). Women were more likely to report a fear of surgery (7.7% vs 3.2%, p |
| doi_str_mv | 10.1371/journal.pntd.0001766 |
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Participants with previously un-operated TT were recruited at 17 surgical outreach campaigns in Amhara Region, Ethiopia. An interview was conducted to ascertain why they had not attended for surgery previously. A trachoma eye examination was performed by an ophthalmologist. 2591 consecutive individuals were interviewed. The most frequently cited barriers to previous attendance for surgery were lack of time (45.3%), financial constraints (42.9%) and lack of an escort (35.5% in females, 19.6% in males). Women were more likely to report a fear of surgery (7.7% vs 3.2%, p<0.001) or be unaware of how to access services (4.5% vs 1.0% p<0.001); men were more frequently asymptomatic (19.6% vs 10.1%, p<0.001). Women were also less likely to have been previously offered TT surgery than men (OR = 0.70, 95%CI 0.53-0.94).
The major barriers to accessing surgery from the patients' perspective are the direct and indirect costs of surgery. These can to a large extent be reduced or overcome through the provision of free or low cost surgery at the community level.
ClinicalTrials.gov NCT00522860 and NCT00522912.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0001766</identifier><identifier>PMID: 22953007</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Care and treatment ; Ethiopia - epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility - economics ; Health Services Accessibility - statistics & numerical data ; Humans ; Interviews ; Interviews as Topic ; Male ; Management ; Medicine ; Middle Aged ; Patients ; Rural areas ; Services ; Sex Factors ; Surgery ; Surgical clinics ; Trachoma ; Trachoma - complications ; Trachoma - epidemiology ; Trichiasis - epidemiology ; Trichiasis - surgery ; Tropical diseases ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2012-08, Vol.6 (8), p.e1766-e1766</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>Rajak et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Rajak SN, Habtamu E, Weiss HA, Bedri A, Zerihun M, et al. (2012) Why Do People Not Attend for Treatment for Trachomatous Trichiasis in Ethiopia? A Study of Barriers to Surgery. PLoS Negl Trop Dis 6(8): e1766. doi:10.1371/journal.pntd.0001766</rights><rights>2012 Rajak et al 2012 Rajak et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-49fbdcc0ac9ca818c4060347dadac15675bc00af0c0bc6fe2225eb8ecebf363d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3429389/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3429389/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23870,27928,27929,53795,53797</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22953007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ngondi, Jeremiah M.</contributor><creatorcontrib>Rajak, Saul N</creatorcontrib><creatorcontrib>Habtamu, Esmael</creatorcontrib><creatorcontrib>Weiss, Helen A</creatorcontrib><creatorcontrib>Bedri, Amir</creatorcontrib><creatorcontrib>Zerihun, Mulat</creatorcontrib><creatorcontrib>Gebre, Teshome</creatorcontrib><creatorcontrib>Gilbert, Clare E</creatorcontrib><creatorcontrib>Emerson, Paul M</creatorcontrib><creatorcontrib>Burton, Matthew J</creatorcontrib><title>Why do people not attend for treatment for trachomatous trichiasis in Ethiopia? A study of barriers to surgery</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Trachomatous trichiasis (TT) surgery is provided free or subsidised in most trachoma endemic settings. However, only 18-66% of TT patients attend for surgery. This study analyses barriers to attendance among TT patients in Ethiopia, the country with the highest prevalence of TT in the world.
Participants with previously un-operated TT were recruited at 17 surgical outreach campaigns in Amhara Region, Ethiopia. An interview was conducted to ascertain why they had not attended for surgery previously. A trachoma eye examination was performed by an ophthalmologist. 2591 consecutive individuals were interviewed. The most frequently cited barriers to previous attendance for surgery were lack of time (45.3%), financial constraints (42.9%) and lack of an escort (35.5% in females, 19.6% in males). Women were more likely to report a fear of surgery (7.7% vs 3.2%, p<0.001) or be unaware of how to access services (4.5% vs 1.0% p<0.001); men were more frequently asymptomatic (19.6% vs 10.1%, p<0.001). Women were also less likely to have been previously offered TT surgery than men (OR = 0.70, 95%CI 0.53-0.94).
The major barriers to accessing surgery from the patients' perspective are the direct and indirect costs of surgery. These can to a large extent be reduced or overcome through the provision of free or low cost surgery at the community level.
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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rajak, Saul N</au><au>Habtamu, Esmael</au><au>Weiss, Helen A</au><au>Bedri, Amir</au><au>Zerihun, Mulat</au><au>Gebre, Teshome</au><au>Gilbert, Clare E</au><au>Emerson, Paul M</au><au>Burton, Matthew J</au><au>Ngondi, Jeremiah M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Why do people not attend for treatment for trachomatous trichiasis in Ethiopia? A study of barriers to surgery</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>6</volume><issue>8</issue><spage>e1766</spage><epage>e1766</epage><pages>e1766-e1766</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Trachomatous trichiasis (TT) surgery is provided free or subsidised in most trachoma endemic settings. However, only 18-66% of TT patients attend for surgery. This study analyses barriers to attendance among TT patients in Ethiopia, the country with the highest prevalence of TT in the world.
Participants with previously un-operated TT were recruited at 17 surgical outreach campaigns in Amhara Region, Ethiopia. An interview was conducted to ascertain why they had not attended for surgery previously. A trachoma eye examination was performed by an ophthalmologist. 2591 consecutive individuals were interviewed. The most frequently cited barriers to previous attendance for surgery were lack of time (45.3%), financial constraints (42.9%) and lack of an escort (35.5% in females, 19.6% in males). Women were more likely to report a fear of surgery (7.7% vs 3.2%, p<0.001) or be unaware of how to access services (4.5% vs 1.0% p<0.001); men were more frequently asymptomatic (19.6% vs 10.1%, p<0.001). Women were also less likely to have been previously offered TT surgery than men (OR = 0.70, 95%CI 0.53-0.94).
The major barriers to accessing surgery from the patients' perspective are the direct and indirect costs of surgery. These can to a large extent be reduced or overcome through the provision of free or low cost surgery at the community level.
ClinicalTrials.gov NCT00522860 and NCT00522912.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22953007</pmid><doi>10.1371/journal.pntd.0001766</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Care and treatment Ethiopia - epidemiology Female Health Knowledge, Attitudes, Practice Health Services Accessibility - economics Health Services Accessibility - statistics & numerical data Humans Interviews Interviews as Topic Male Management Medicine Middle Aged Patients Rural areas Services Sex Factors Surgery Surgical clinics Trachoma Trachoma - complications Trachoma - epidemiology Trichiasis - epidemiology Trichiasis - surgery Tropical diseases Young Adult |
| title | Why do people not attend for treatment for trachomatous trichiasis in Ethiopia? A study of barriers to surgery |
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