Department of Epidemiology and Biostatistics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS One. 2024 May 28;19(5):e0304407. doi: 10.1371/journal.pone.0304407. eCollection 2024.
In Trachoma endemic countries, many people who underwent Trichiasis surgery faced a recurrence of the disease. Postoperative Trichiasis is a significant problem for patients and health care providers because it puts the eye at renewed risk of sight loss. Despite the low utilization of Trachomatous Trichiasis surgery and the high recurrence rate, evidence that elucidate why it recurs after surgery is limited. This study was aimed to assess the magnitude and associated factors of postoperative Trichiasis among 18 years and above individuals who underwent Trachomatous Trichiasis surgery between 2013 and 2019 in Ambassel District, Northeast Ethiopia, 2020.
The community-based cross-sectional study design was conducted from March 10 to March 23/2020 in selected kebeles of Ambassel District. The required sample size (506) was calculated using EPI-INFO Version 7. A multi-stage sampling technique was used to employ study participants. Data were collected through the interviewer-administered structured pre-tested questionnaire and entered into EpiData version 3.1 and then exported to SPSS version 23.0 for analysis. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of Postoperative Trachomatous Trichiasis.
Four hundred ninety two individuals participated in this study with a response rate of 97.2%. In Ambassel district, the prevalence of postoperative Trichiasis was 23.8% (95% CI = 19.9-27.8). Among associated factors of postoperative Trachomatous Trichiasis: age 50-59 (AOR = 3.34, CI = 1.38-8.1), 60-69 (AOR = 3.24, CI = 1.38-7.61), ≥70 years (AOR = 6.04, CI = 2.23-16.41), duration since surgery (AOR = 1.7, CI = 1.35-2.14), complication (AOR = 2.98, CI = 1.24-7.2), washing the face two times (AOR = 0.25, CI = 0.13-0.47), washing the face three and more times (AOR = 0.1, CI = 0.41-0.25), taking Azithromycin following surgery (AOR = 0.19, CI = 0.09-0.41), pre-operative epilation history (AOR = 2.11, CI = 1.14, 3.9) and having a knowledge about TrachomaTtrichiasis (AOR = 0.21, CI = 0.08-0.58) showed a statistical significant association.
The prevalence of postoperative Trichiasis in Ambassel District was higher than most Ethiopian studies. Age, frequency of face washing, medication following surgery, duration since the last surgery, knowledge about trachoma, pre-operative epilation history, and complication after surgery were identified to be independent factors. To minimize postoperative Trachomatous Trichiasis stakeholders need to consider health education for patients, provision of Azithromycin after surgery, and proper training for integrated eye care workers.
在沙眼流行国家，许多接受过倒睫手术的人都面临着疾病复发的问题。术后倒睫对患者和医疗保健提供者来说是一个重大问题，因为它使眼睛再次面临失明的风险。尽管沙眼倒睫手术的利用率较低，复发率较高，但阐明其术后复发原因的证据有限。本研究旨在评估 2013 年至 2019 年期间在埃塞俄比亚东北部阿姆巴塞尔区接受过沙眼倒睫手术的 18 岁及以上人群中术后倒睫的严重程度和相关因素，2020 年。
采用 2020 年 3 月 10 日至 3 月 23 日在阿姆巴塞尔区选定的 kebeles 进行基于社区的横断面研究设计。使用 EPI-INFO 版本 7 计算所需的样本量（506）。采用多阶段抽样技术招募研究参与者。通过访谈者管理的结构化预测试问卷收集数据，并输入 EpiData 版本 3.1，然后导出到 SPSS 版本 23.0 进行分析。采用双变量和多变量逻辑回归模型来确定术后沙眼性倒睫的相关因素。
492 人参加了这项研究，应答率为 97.2%。在阿姆巴塞尔区，术后倒睫的患病率为 23.8%（95%CI=19.9-27.8）。在与术后沙眼性倒睫相关的因素中：年龄 50-59 岁（AOR=3.34，CI=1.38-8.1）、60-69 岁（AOR=3.24，CI=1.38-7.61）、≥70 岁（AOR=6.04，CI=2.23-16.41）、手术时间（AOR=1.7，CI=1.35-2.14）、并发症（AOR=2.98，CI=1.24-7.2）、洗脸两次（AOR=0.25，CI=0.13-0.47）、洗脸三次及以上（AOR=0.1，CI=0.41-0.25）、术后服用阿奇霉素（AOR=0.19，CI=0.09-0.41）、术前拔毛史（AOR=2.11，CI=1.14-3.9）和对沙眼性倒睫的了解（AOR=0.21，CI=0.08-0.58）显示有统计学意义。
阿姆巴塞尔区术后倒睫的患病率高于大多数埃塞俄比亚研究。年龄、洗脸频率、术后用药、上次手术后的时间、对沙眼的了解、术前拔毛史和术后并发症是独立的危险因素。为了最大限度地减少术后沙眼性倒睫，利益相关者需要考虑为患者提供健康教育、术后提供阿奇霉素以及为综合眼保健工作者提供适当培训。
