Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania
Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we identify barriers...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2017-01, Vol.11 (1), p.e0005211-e0005211 |
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| creator | Bickley, Ryan J Mkocha, Harran Munoz, Beatriz West, Sheila |
| description | Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we identify barriers that prevent TT patients from receiving sight-saving surgery.
Participants were selected from a database of TT cases who did (acceptors) and did not (non-acceptors) have surgery as of August 2015. We developed an in-home interview questionnaire, using open and closed-ended questions on perceived barriers to accessing surgical services. We compared responses between the acceptors and non-acceptors, examining differences in reasons for and against surgery, sources of TT information, and suggestions for improving surgical delivery. 167 participants (mean age 61 years, 79.7% females) were interviewed. Compared to acceptors, non-acceptors were more likely to report they had no one to accompany them to surgery (75.3% vs. 42.6%, p |
| doi_str_mv | 10.1371/journal.pntd.0005211 |
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Participants were selected from a database of TT cases who did (acceptors) and did not (non-acceptors) have surgery as of August 2015. We developed an in-home interview questionnaire, using open and closed-ended questions on perceived barriers to accessing surgical services. We compared responses between the acceptors and non-acceptors, examining differences in reasons for and against surgery, sources of TT information, and suggestions for improving surgical delivery. 167 participants (mean age 61 years, 79.7% females) were interviewed. Compared to acceptors, non-acceptors were more likely to report they had no one to accompany them to surgery (75.3% vs. 42.6%, p<0.0001), they could manage TT on their own (69.9% vs. 31.5%, p<0.0001), and the surgery camp was too far (53.4% vs. 28.7%, p = 0.001). Over 90% of both acceptors and non-acceptors agreed on the benefits of having surgery. Fear of surgery was the biggest barrier stated by both groups. Despite this fear, acceptors were more likely than non-acceptors to also report fear of losing further vision without surgery.
Barriers included access issues, familial and/or work responsibilities, the perception that self-management was sufficient, and lack of education about surgery. Fear of surgery was the biggest barrier facing both acceptors and non-acceptors. Increasing uptake will require addressing how surgery is presented to community residents, including outlining treatment logistics, surgical outcomes, and stressing the risk of vision loss.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0005211</identifier><identifier>PMID: 28052070</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Biology and Life Sciences ; Blindness - etiology ; Care and treatment ; Case-Control Studies ; Chlamydia trachomatis - pathogenicity ; Databases, Factual ; Education ; Female ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility - statistics & numerical data ; Humans ; Interviews ; Logistics ; Male ; Management ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Multivariate Analysis ; Patient Acceptance of Health Care - statistics & numerical data ; Patient care ; Patients ; People and Places ; Perceptions ; Prevention ; Self Care ; Sexually transmitted diseases ; Social Sciences ; STD ; Studies ; Surgery ; Surgical outcomes ; Surveys and Questionnaires ; Tanzania ; Trachoma - complications ; Trichiasis ; Trichiasis - etiology ; Trichiasis - surgery ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2017-01, Vol.11 (1), p.e0005211-e0005211</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Public Library of Science. 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: Bickley RJ, Mkocha H, Munoz B, West S (2017) Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania. PLoS Negl Trop Dis 11(1): e0005211. doi:10.1371/journal.pntd.0005211</rights><rights>2017 Bickley et al 2017 Bickley et al</rights><rights>2017 Public Library of Science. 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: Bickley RJ, Mkocha H, Munoz B, West S (2017) Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania. PLoS Negl Trop Dis 11(1): e0005211. doi:10.1371/journal.pntd.0005211</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-9bd2c70d33a0149fdfc4b9131a119320b157e2e5e17db38872719c9b7189e963</citedby><cites>FETCH-LOGICAL-c624t-9bd2c70d33a0149fdfc4b9131a119320b157e2e5e17db38872719c9b7189e963</cites><orcidid>0000-0003-0818-8100</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215731/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215731/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28052070$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bickley, Ryan J</creatorcontrib><creatorcontrib>Mkocha, Harran</creatorcontrib><creatorcontrib>Munoz, Beatriz</creatorcontrib><creatorcontrib>West, Sheila</creatorcontrib><title>Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we identify barriers that prevent TT patients from receiving sight-saving surgery.
Participants were selected from a database of TT cases who did (acceptors) and did not (non-acceptors) have surgery as of August 2015. We developed an in-home interview questionnaire, using open and closed-ended questions on perceived barriers to accessing surgical services. We compared responses between the acceptors and non-acceptors, examining differences in reasons for and against surgery, sources of TT information, and suggestions for improving surgical delivery. 167 participants (mean age 61 years, 79.7% females) were interviewed. Compared to acceptors, non-acceptors were more likely to report they had no one to accompany them to surgery (75.3% vs. 42.6%, p<0.0001), they could manage TT on their own (69.9% vs. 31.5%, p<0.0001), and the surgery camp was too far (53.4% vs. 28.7%, p = 0.001). Over 90% of both acceptors and non-acceptors agreed on the benefits of having surgery. Fear of surgery was the biggest barrier stated by both groups. Despite this fear, acceptors were more likely than non-acceptors to also report fear of losing further vision without surgery.
Barriers included access issues, familial and/or work responsibilities, the perception that self-management was sufficient, and lack of education about surgery. Fear of surgery was the biggest barrier facing both acceptors and non-acceptors. Increasing uptake will require addressing how surgery is presented to community residents, including outlining treatment logistics, surgical outcomes, and stressing the risk of vision loss.</description><subject>Adult</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Blindness - etiology</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>Chlamydia trachomatis - pathogenicity</subject><subject>Databases, Factual</subject><subject>Education</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Humans</subject><subject>Interviews</subject><subject>Logistics</subject><subject>Male</subject><subject>Management</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Patient care</subject><subject>Patients</subject><subject>People and Places</subject><subject>Perceptions</subject><subject>Prevention</subject><subject>Self Care</subject><subject>Sexually transmitted diseases</subject><subject>Social Sciences</subject><subject>STD</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surveys and Questionnaires</subject><subject>Tanzania</subject><subject>Trachoma - complications</subject><subject>Trichiasis</subject><subject>Trichiasis - etiology</subject><subject>Trichiasis - surgery</subject><subject>Tropical diseases</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNptkktvEzEQx1cIREvhGyBYCQlxIMGPdby-IJXyiqhEJXLhZM3a3o2jjR1sb6v00-OQbZWgygfb49_85-EpipcYTTHl-MPKD8FBP924pKcIIUYwflScYkHZhHDKHh-cT4pnMa4yI1iNnxYnpM444ui0-D3XxiXbbq3ryitINt_KKxOUsddGl58gBGtCLJMvF8GqpYVoY_lrCJ0J29K68od33Q2Un21M-T29LxfgbsFZeF48aaGP5sW4nxWLr18WF98nlz-_zS_OLydqRqo0EY0miiNNKSBciVa3qmoEphhwTp-gBjNuiGEGc93QuuaEY6FEw3EtjJjRs-L1XnbT-yjHpkSJ65lgpM7lZmK-J7SHldwEu4awlR6s_GfwoZMQklW9kQC6QhoUIxWuGFcNUzVtGNFVRQTMTNb6OEYbmrXRKncrQH8kevzi7FJ2_lrm32Gc7pJ5NwoE_2cwMcm1jcr0PTjjh13ejPGaz-oqo2_-Qx-ubqQ6yAVY1_ocV-1E5XklaI05YihT0weovLRZW-WdaW22Hzm8PXBYGujTMvp-SNa7eAxWe1AFH2Mw7X0zMJK7Qb3LWu4GVY6Dmt1eHTby3uluMulfV_nj4Q</recordid><startdate>20170104</startdate><enddate>20170104</enddate><creator>Bickley, Ryan J</creator><creator>Mkocha, Harran</creator><creator>Munoz, Beatriz</creator><creator>West, Sheila</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0818-8100</orcidid></search><sort><creationdate>20170104</creationdate><title>Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania</title><author>Bickley, Ryan J ; Mkocha, Harran ; Munoz, Beatriz ; West, Sheila</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-9bd2c70d33a0149fdfc4b9131a119320b157e2e5e17db38872719c9b7189e963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Blindness - etiology</topic><topic>Care and treatment</topic><topic>Case-Control Studies</topic><topic>Chlamydia trachomatis - pathogenicity</topic><topic>Databases, Factual</topic><topic>Education</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Humans</topic><topic>Interviews</topic><topic>Logistics</topic><topic>Male</topic><topic>Management</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Patient care</topic><topic>Patients</topic><topic>People and Places</topic><topic>Perceptions</topic><topic>Prevention</topic><topic>Self Care</topic><topic>Sexually transmitted diseases</topic><topic>Social Sciences</topic><topic>STD</topic><topic>Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surveys and Questionnaires</topic><topic>Tanzania</topic><topic>Trachoma - complications</topic><topic>Trichiasis</topic><topic>Trichiasis - etiology</topic><topic>Trichiasis - surgery</topic><topic>Tropical diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bickley, Ryan J</creatorcontrib><creatorcontrib>Mkocha, Harran</creatorcontrib><creatorcontrib>Munoz, Beatriz</creatorcontrib><creatorcontrib>West, Sheila</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - 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>Bickley, Ryan J</au><au>Mkocha, Harran</au><au>Munoz, Beatriz</au><au>West, Sheila</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2017-01-04</date><risdate>2017</risdate><volume>11</volume><issue>1</issue><spage>e0005211</spage><epage>e0005211</epage><pages>e0005211-e0005211</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Trachomatous trichiasis (TT), inturned eyelashes from repeated infection with Chlamydia trachomatis, is the leading infectious cause of blindness in the world. Though surgery will correct entropion caused by trachoma, uptake of TT surgery remains low. In this case-control study, we identify barriers that prevent TT patients from receiving sight-saving surgery.
Participants were selected from a database of TT cases who did (acceptors) and did not (non-acceptors) have surgery as of August 2015. We developed an in-home interview questionnaire, using open and closed-ended questions on perceived barriers to accessing surgical services. We compared responses between the acceptors and non-acceptors, examining differences in reasons for and against surgery, sources of TT information, and suggestions for improving surgical delivery. 167 participants (mean age 61 years, 79.7% females) were interviewed. Compared to acceptors, non-acceptors were more likely to report they had no one to accompany them to surgery (75.3% vs. 42.6%, p<0.0001), they could manage TT on their own (69.9% vs. 31.5%, p<0.0001), and the surgery camp was too far (53.4% vs. 28.7%, p = 0.001). Over 90% of both acceptors and non-acceptors agreed on the benefits of having surgery. Fear of surgery was the biggest barrier stated by both groups. Despite this fear, acceptors were more likely than non-acceptors to also report fear of losing further vision without surgery.
Barriers included access issues, familial and/or work responsibilities, the perception that self-management was sufficient, and lack of education about surgery. Fear of surgery was the biggest barrier facing both acceptors and non-acceptors. Increasing uptake will require addressing how surgery is presented to community residents, including outlining treatment logistics, surgical outcomes, and stressing the risk of vision loss.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28052070</pmid><doi>10.1371/journal.pntd.0005211</doi><orcidid>https://orcid.org/0000-0003-0818-8100</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biology and Life Sciences Blindness - etiology Care and treatment Case-Control Studies Chlamydia trachomatis - pathogenicity Databases, Factual Education Female Health Knowledge, Attitudes, Practice Health Services Accessibility - statistics & numerical data Humans Interviews Logistics Male Management Medicine Medicine and Health Sciences Middle Aged Multivariate Analysis Patient Acceptance of Health Care - statistics & numerical data Patient care Patients People and Places Perceptions Prevention Self Care Sexually transmitted diseases Social Sciences STD Studies Surgery Surgical outcomes Surveys and Questionnaires Tanzania Trachoma - complications Trichiasis Trichiasis - etiology Trichiasis - surgery Tropical diseases |
| title | Identifying Patient Perceived Barriers to Trichiasis Surgery in Kongwa District, Tanzania |
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