Shu'aibu Joy, Ajege Grace, Mpyet Caleb, Dejene Michael, Isiyaku Sunday, Tafida Abubakar, Kelly Michaela, Emereuwa Innocent, Courtright Paul
Sightsavers, Abuja 900231, Nigeria.
Department of Family Medicine, Bingham University, Karu 961105, Nigeria.
Trop Med Infect Dis. 2024 Jul 11;9(7):157. doi: 10.3390/tropicalmed9070157.
As national trachoma programmes increase efforts to reduce the burden of trachomatous trichiasis (TT), TT case finding and referral are critical public health programme components. Our research aimed to explore the most effective and efficient approaches to finding, referring, and managing TT cases.
This was a prospective descriptive study, utilizing both routine programme data and primary data collection. This study compared four different approaches to finding TT cases across three different local government areas (LGAs) in Kano State, Nigeria. Each of the study LGAs was divided into four sub-units to accommodate the four different approaches.
The number of outreach attendees was 4795 across the four case finding approaches, and this varied hugely, with the smallest number and proportion (403, 0.26%) in settings only employing house-to-house case finding and the largest number and proportion (1901, 0.99%) when town criers were used. That said, the proportion of TT cases among people presenting at outreach was highest (32.5%) when house-to-house case finding was used and lowest (10.3%) when town criers were used. More female TT patients were found (53-70%) and had surgery (79-85%) compared to male cases, across all approaches. The average project expenditure for finding one TT case was similar for approaches that included house-to-house case finding (USD 5.4-6.3), while it was 3.5 times higher (USD 21.5 per TT case found) when town criers were used.
This study found that the house-to-house TT case finding approaches were the most efficient method with the highest yield of TT cases. Including other eye condition and/or vision testing yielded similar results but required more personnel and cost.
随着国家沙眼防治项目加大力度减轻沙眼性倒睫（TT）的负担，TT病例的发现和转诊成为公共卫生项目的关键组成部分。我们的研究旨在探索发现、转诊和管理TT病例的最有效且高效的方法。
这是一项前瞻性描述性研究，利用常规项目数据和原始数据收集。本研究在尼日利亚卡诺州的三个不同地方政府区域（LGA）比较了四种不同的发现TT病例的方法。每个研究LGA被划分为四个子单元以适应四种不同方法。
在四种病例发现方法中，外展活动的参与人数为4795人，差异极大，仅采用挨家挨户病例发现方法的场所参与人数和比例最小（403人，0.26%），而使用公告员时参与人数和比例最大（1901人，0.99%）。也就是说，采用挨家挨户病例发现方法时，外展活动中出现的TT病例比例最高（32.5%），而使用公告员时最低（10.3%）。在所有方法中，发现的女性TT患者更多（53 - 70%），接受手术的比例也更高（79 - 85%）。对于包括挨家挨户病例发现的方法，发现一例TT病例的平均项目支出相似（5.4 - 6.3美元），而使用公告员时则高出3.5倍（每发现一例TT病例21.5美元）。
本研究发现，挨家挨户发现TT病例的方法是最有效的，TT病例检出率最高。纳入其他眼部疾病和/或视力检测产生了类似结果，但需要更多人员和成本。
