Evaluation of community-based trichiasis surgery in Northwest Ethiopia.
BACKGROUND
Surgery to correct trachomatous trichiasis (TT) is recommended to prevent blindness caused by trachoma. This study evaluated the outcomes of community-based trichiasis surgery with absorbable sutures, conducted in Amhara Regional State, Ethiopia.


METHODS
A simple random sample of 431 patients was selected from surgical campaign records of which 363 (84.2%) were traced and enrolled into the study. Participants were interviewed and examined for trichiasis recurrence, complications of TT surgery and corneal opacity. Multilevel logistic regression models were used to explore the associations between trichiasis recurrence, corneal opacity and explanatory variables at the eye level.


RESULTS
The prevalence of trichiasis recurrence was 9.4% (95% Confidence Interval [CI] 6.6-12.8) and corneal opacity was found in 14.3% (95% CI 10.9-18.3) of the study participants. The proportion of participants with complications of TT surgery was: granuloma 0.6% (95% CI 0.1-2.0); lid closure defects 5.5% (95% CI 3.4-8.4) and lid notching 16.8% (95% CI 13.1-21.1). No factors were identified for trichiasis recurrence. Corneal opacity was associated with increased age (Ptrend=0.001), more than 12 months post surgery (OR=2.7; 95%CI 1.3-5.6), trichiasis surgery complications (OR=2.9; 95%CI 1.4-5.9) and trichiasis recurrence (OR=2.5; 95%CI 1.0-6.3).


CONCLUSIONS
Prevalence of recurrent trichiasis and granuloma were lower than expected but higher for lid closure defects and lid notching. The majority of the participants reported satisfaction with the trichiasis surgery they had undergone. The findings suggest that recurrence of trichiasis impacts on the patients' risk of developing corneal opacity but longitudinal studies are required to confirm this.
Department of Public Health and Pharmacy Care, University of Cambridge, Cambridge, UK.
Katherine
K
Pearson
Dereje
D
Habte
Mulat
M
Zerihun
Jonathan D
JD
King
Teshome
T
Gebre
Paul M
PM
Emerson
Mark H
MH
Reacher
Jeremiah M
JM
Ngondi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D003318:Corneal Opacity / Q000453:epidemiology / Q000209:etiology*; D005002:Ethiopia / Q000453:epidemiology; D005140:Eyelashes; D005141:Eyelid Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006099:Granuloma / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012008:Recurrence; D058457:Trichiasis / Q000601:surgery*; D014792:Visual Acuity; D055815:Young Adult
Corneal opacity; Ethiopia; Trichiasis; Trichiasis recurrence