埃及南部一项基于社区的眼保健干预措施：对沙眼性倒睫手术覆盖率的影响。
A Community-based Eye Care Intervention in Southern Egypt: Impact on Trachomatous Trichiasis Surgical Coverage.
作者信息
Mousa Ahmed, Courtright Paul, Kazanjian Arminee, Bassett Ken
机构信息
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.
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.
出版信息
Middle East Afr J Ophthalmol. 2015 Oct-Dec;22(4):478-83. doi: 10.4103/0974-9233.167808.
PURPOSE
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%).
CONCLUSION
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.
目的
本研究旨在衡量一项基于社区的干预措施对埃及南部倒睫手术接受率的影响。
方法
在埃及萨马卢特地区随机选取四个沙眼流行的村庄。两个村庄被选为干预对象（干预村庄），另外两个匹配的村庄作为非干预对象（非干预村庄）。干预模式包括举办社区信息发布会、挨家挨户进行健康教育、筛查以及提高眼科护理人员的临床能力。通过两次干预前后基于社区的调查对干预效果进行评估，调查内容包括沙眼患病率和当地医院眼科护理服务的利用率。所有倒睫患者都回答了一份关于手术利用情况和障碍的问卷。
结果
在基线调查中，所有村庄的沙眼性倒睫（TT）手术覆盖率为22.7%（男性为38.9%，女性为16.7%）。干预后，接受干预的村庄TT手术覆盖率增至68%（男性为81.5%，女性为60%）。非干预村庄的TT手术覆盖率为26.1%（男性为37.5%，女性为20%）。在干预村庄，2008年TT患病率从9.4%（男性为5.7%，女性为11.8%）显著降至3.8%（男性为1.9%，女性为5.1%）（P = 0.013）。在非干预村庄，TT患病率从10.1%（男性为3.1%，女性为14.4%）略有下降至8.2%（男性为3%，女性为11.5%），但差异不显著（P = 0.580）。接受TT手术服务的主要障碍包括：“感觉没问题”（17.3%）、“害怕手术”（12.7%）和“费用”（12.7%）。
结论
一项结合挨家挨户筛查的基于社区的眼部健康教育项目显著提高了TT手术服务的接受率。虽然手术服务提供方面的改进至关重要，但在非干预村庄并未带来任何显著改善。
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