Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
Int Health. 2023 Dec 4;15(Supplement_2):ii58-ii67. doi: 10.1093/inthealth/ihad067.
Trachomatous trichiasis (TT) is a painful, potentially blinding eye condition that can be managed through epilation or surgery. Women are affected by TT approximately twice as often as men and are believed to face gendered barriers to receiving surgical care to prevent vision loss.
We used data from 817 cross-sectional surveys conducted during 2015-2019 in 20 African countries to estimate the prevalence difference (PD) between female and male eyes for four outcomes potentially indicating gender-related differences in TT management: (1) received surgery and developed postoperative TT (PTT), (2) never offered surgery, (3) offered surgery but declined it, and (4) offered epilation but never offered surgery.
The prevalence was modestly elevated among female eyes compared with male eyes for having PTT (PD:1.8 [95% confidence limits (CL): 0.6, 3.0]) and having declined surgery for the eye (PD: 6.2 [95% CL: 1.8, 10.7]). The proportion offered epilation was similar by gender (PD:0.5 [95% CL: -0.4, 1.3]), while never having been offered surgery was somewhat more prevalent among male eyes (PD: -2.1 [95% CL: -3.5, -0.7]).
Our results suggest potential gender differences in TT management. More research is needed to determine the causes and implications of the observed differences.
沙眼性倒睫（TT）是一种痛苦且可能致盲的眼部疾病，可以通过拔睫毛或手术来治疗。女性受 TT 的影响大约是男性的两倍，据信女性在接受手术以防止视力丧失方面面临着性别障碍。
我们使用了 2015 年至 2019 年期间在 20 个非洲国家进行的 817 项横断面调查的数据，来估计四个可能表明 TT 管理方面存在性别差异的结果的男女眼部患病率差异（PD）：（1）接受手术并出现术后 TT（PTT），（2）从未接受过手术，（3）曾被提供手术但拒绝了，以及（4）曾被提供拔睫毛但从未被提供手术。
与男性眼睛相比，女性眼睛出现 PTT 的患病率略高（PD：1.8[95%置信区间（CL）：0.6，3.0]），并且该眼睛拒绝手术的比例也较高（PD：6.2[95%CL：1.8，10.7]）。提供拔睫毛的比例在性别之间相似（PD：0.5[95%CL：-0.4，1.3]），而从未被提供手术的比例在男性眼睛中则略高（PD：-2.1[95%CL：-3.5，-0.7]）。
我们的结果表明 TT 管理方面可能存在性别差异。需要进一步研究来确定观察到的差异的原因和影响。
