Impact of trichiasis surgery on daily living: A longitudinal study in Ethiopia

Wellcome Open Research

article

Esmael Habtamu¹  Tariku Wondie¹  Sintayehu Aweke¹  Zerihun Tadesse¹  Mulat Zerihun¹  Berhanu Melak¹  Bizuayehu Gashaw³  Kelly Callahan¹  Paul M. Emerson⁴  Robin L. Bailey⁵  David C.W. Mabey⁵  Saul N. Rajak²  Hannah Kuper⁶  Sarah Polack⁶  David Macleod⁷  Helen A. Weiss⁷  Matthew J. Burton² 

[1] The Carter Center;International Centre for Eye Health, London School of Hygiene & Tropical Medicine;Amhara Regional Health Bureau;International Trachoma Initiative;Clinical Research Department, London School of Hygiene & Tropical Medicine;International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine;MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine

关键词: Trachoma;    Trachomatous Trichiasis;    Surgery;    Impact;    Activity;    Participation;    Difficulty;    Productivity;   

DOI  :  10.12688/wellcomeopenres.11891.2

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: Trachomatous trichiasis (TT) may lead to disability, impeding productive activities, resulting in loss of income. This study was conducted to determine if trichiasis surgery improves participation in productive and leisure activities, and ability to perform activities without difficulty or assistance.Methods: We recruited 1000 adults with trichiasis (cases) and 200 comparison participants, matched to every fifth trichiasis case on age (+/- two years), sex and location. The ‘Stylised Activity List’ tool, developed for the World Bank Living Standard Measurement Survey, was adapted to collect data on activity in the last week (participation in activity, difficulty with activity, requirement of assistance for activity), at baseline and 12 months later. All trichiasis cases received trichiasis surgery at baseline. Random effect logistic regression was used to compare cases and comparison participants.Results: There was strong evidence that trichiasis surgery substantially improves the ability of trichiasis cases to perform all the productive and leisure activities investigated without difficulty, with large increases in processing agricultural products, 21.1% to 87.0% (p<0.0001), farming, 19.1% to 82.4% (p<0.0001), and fetching wood, 25.3% to 86.0% (p<0.0001). Similarly, there was a significant increase in the proportion of cases who could perform activities without assistance, with the largest increases in animal rearing 54.2% to 92.0% (p<0.0001) and farming 73.2% to 96.4% (p<0.0001). There was no change in the proportion of comparison participants performing activities without difficulty or assistance. The change in most of the activities in cases was independent of visual acuity improvement and recurrent TT at 12 months. One year after trichiasis surgery, the proportion of cases reporting ocular pain reduced from 98.9% to 33.7% (p<0.0001).Conclusions: Eyelid surgery for TT improves functional capabilities regardless of vision gains. These data lend strong support to the view that TT surgery improves function and contributes to improved household income and wealth.

【 授权许可】

CC BY