Determinants of uptake of surgical treatment for trachomatous trichiasis in North Ethiopia.
BACKGROUND
Surgery for trachomatous trichiasis prevents blindness. However people still decline surgery despite the availability of services in nearby health facilities.


OBJECTIVE
To assess what proportion of cases of trichiasis had surgical treatment and to investigate the determinants of uptake of surgery.


METHODS
Eight villages in Enebse Sarmidir district of Amhara Region-Ethiopia were randomly selected and all self-reported cases of trichiasis were approached. Both operated and un-operated trichiasis cases were interviewed using structured questionnaires.


RESULTS
The study employed a case control study design with patients with untreated trichiasis being cases (135) and those operated, controls (141). The main reasons given for not having surgery were burden of household tasks, indirect cost of surgery, lack of companion and fear of surgery. Uptake of surgery was found to rise with duration of illness (Chi Square for trend = 26.62, P < 0.05). Longer walking distance (more than one hour) to the nearby health facility was a negative predictor of uptake of surgical treatment (adjusted odd ratio 0.31, 95% confidence interval 0.15-0.67).


CONCLUSIONS
Behavior change communication interventions targeted on early uptake of surgery are very important. Village-based surgical service provision may be worthwhile in settings of high blinding trachoma burden.
Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. derejehabte@yahoo.com
Dereje
D
Habte
Teshome
T
Gebre
Mulat
M
Zerihun
Yared
Y
Assefa
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005002:Ethiopia / Q000453:epidemiology; D005140:Eyelashes; D005260:Female; D006201:Hair Diseases / Q000517:prevention & control / Q000601:surgery*; D006204:Hair Removal / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014141:Trachoma / Q000517:prevention & control / Q000601:surgery*