Trachoma Control Program, Carter Center, Atlanta, GA 30307, USA.
Carter Center, Khartoum, Sudan.
Trans R Soc Trop Med Hyg. 2020 Aug 1;114(8):561-565. doi: 10.1093/trstmh/traa022.
Approximately 1.9 million people have become blind or visually impaired from trachoma, the leading cause of infectious blindness. Trachoma prevalence surveys conducted in Sudan have shown that thousands of Sudanese suffer from the advanced stages of the disease, trachomatous trichiasis (TT), and warrant sight-saving surgery. Sudan's National Trachoma Control Program (NTCP) provides free TT surgery; however, given that many TT patients live in remote areas with limited access to health services, identifying patients and providing eye care services has proved challenging. For this reason, the Sudan NTCP piloted a systematic TT case-finding approach to identify patients.
In Gedarif state, 11 villages in Baladyat el Gedarif locality and 21 villages in West Galabat locality were included in a TT case-searching activity from September to November 2018. TT case finders were selected from the villages where the activity took place and were trained by ophthalmic medical assistants to identify possible patients.
Of 66 626 villagers examined, 491 were identified as having TT by TT case finders. Of those, 369 were confirmed as true cases by the TT surgeons, a 75.2% (369/491) success rate.
The TT case-finding approach provides an example of an effective method for identifying TT patients and should be expanded to other parts of the country known to be endemic for trachoma.
约有 190 万人因沙眼而失明或视力受损，沙眼是导致传染性失明的主要原因。在苏丹进行的沙眼流行情况调查显示，数千名苏丹人患有该病的晚期，即沙眼性倒睫（TT），需要进行挽救视力的手术。苏丹国家沙眼控制规划（NTCP）提供免费的 TT 手术；然而，鉴于许多 TT 患者生活在偏远地区，获得医疗服务的机会有限，发现患者并提供眼保健服务具有挑战性。出于这个原因，苏丹 NTCP 试行一种系统的 TT 病例发现方法来识别患者。
在加达里夫州，巴拉迪亚特加达里夫地方的 11 个村庄和西加拉巴特地方的 21 个村庄于 2018 年 9 月至 11 月期间参加了 TT 病例搜索活动。TT 病例发现者从活动开展的村庄中选出，并由眼科助理医师进行培训以识别可能的患者。
在检查的 66626 名村民中，有 491 名 TT 病例发现者确定患有 TT。其中，369 名 TT 外科医生确诊为真病例，成功率为 75.2%（369/491）。
TT 病例发现方法提供了一种有效识别 TT 患者的方法的范例，应将其推广到已知流行沙眼的该国其他地区。
