title: A Community-based Eye Care Intervention in Southern Egypt: Impact on Trachomatous Trichiasis Surgical Coverage.
abstract: OBJECTIVE
  The purpose of this study was to measure the impact of a community-based intervention on uptake of trichiasis surgery in Southern Egypt.
  
  
  METHODS
  Four villages where trachoma is endemic were randomly selected in the Samalout district, Egypt. Two villages were selected for intervention (intervention villages) and two matched villages for nonintervention (nonintervention villages). The intervention model provided community information sessions, door-to-door health education, screening, and improvements in the clinical capacity of eye care providers. The intervention was evaluated through two pre- and post-intervention community-based surveys that included the prevalence of trachoma and the utilization of eye care services at local hospitals. All patients with trichiasis answered a questionnaire regarding surgical utilization and barriers.
  
  
  RESULTS
  In the baseline survey, the trachomatous trichiasis (TT) surgical coverage was 22.7% (38.9% males, 16.7% females) in all villages. Following the intervention, the TT surgical coverage increased to 68% in villages that received the intervention (81.5% males, 60% females). Nonintervention villages had a TT surgical coverage of 26.1% (37.5% males, 20% females). In the intervention villages, the prevalence of TT significantly decreased from 9.4% (5.7% males, 11.8% females) to 3.8% (1.9% males, 5.1% females) (P = 0.013), in 2008. In nonintervention villages, there was a slight, but insignificant decrease in TT from 10.1% (3.1% males, 14.4% females) to 8.2% (3% males, 11.5% females) (P = 0.580). The major barriers to uptake of TT surgical services were: "Feeling no problem" (17.3%), "fear of surgery" (12.7%) and "cost" (12.7%).
  
  
  CONCLUSIONS
  A community-based eye health education program with door-to-door screening significantly increased the uptake of TT surgical services. Although improvements to the delivery of surgical service are essential, they did not lead to any significant improvements in the nonintervention villages.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia ; Department of Ophthalmology, Gluaocma Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mousa
authors.affiliation: Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa ; School of Population and Public Health, University of British Columbia, Vancouver, Canada ; British Columbia Centre for Epidemiologic and International Ophthalmology, University of British Columbia, Vancouver, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Courtright
authors.affiliation: School of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Arminee
authors.initials: A
authors.lastname: Kazanjian
authors.affiliation: British Columbia Centre for Epidemiologic and International Ophthalmology, University of British Columbia, Vancouver, Canada.
authors.forename: Ken
authors.initials: K
authors.lastname: Bassett
mesh_terms: D003318:Corneal Opacity / Q000453:epidemiology; D004534:Egypt / Q000453:epidemiology; D005143:Eyelids / Q000601:surgery; D005260:Female; D006266:Health Education; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000706:statistics & numerical data; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014141:Trachoma / Q000453:epidemiology / Q000601:surgery*; D058457:Trichiasis / Q000453:epidemiology / Q000601:surgery*
keywords: Health Education; Intervention Model; Surgical Uptake; Trachoma; Trichiasis