Gender differences in the surgical management of trachomatous trichiasis: an exploratory analysis of global trachoma survey data, 2015

Gender differences in the surgical management of trachomatous trichiasis: an exploratory analysis of global trachoma survey data, 2015–2019

Published:2023-12 Issue:Supplement_2 Volume:15 Page:ii58-ii67
ISSN:1876-3413
Container-title:International Health
language:en
Short-container-title:

Author:

Sullivan Kristin M¹²^ORCID,Harding-Esch Emma M³,Batcho Wilfrid E⁴,Issifou Amadou A Bio⁵,Lopes Maria de Fátima Costa⁶,Szwarcwald Celia Landmann⁷,Vaz Ferreira Gomez Daniela⁸,Bougouma Clarisse⁹,Christophe Nassa¹⁰,Kabore Martin¹¹,Bucumi Victor¹²,Bella Assumpta L¹³,Epee Emilienne¹⁴,Yaya Georges¹⁵,Trujillo-Trujillo Julian¹⁶,Dejene Michael¹⁷,Gebretsadik Fikre Seife¹⁸,Gebru Genet¹⁸,Kebede Fikreab¹⁸,Mathewos Tsedeke¹⁸,Cassama Eunice Texiera de Silva¹⁹,Sanha Salimato²⁰,Barasa Ernest²¹,Sultani Hadley Matendechero²²,Watitu Titus²¹,Tekeraoi Rabebe²³,Kalua Khumbo M²⁴,Masika Michael P²⁵,Traoré Lamine²⁶,Minnih Abdallahi O²⁷,Abdala Mariamo²⁸,Massangaie Marília E²⁸,Win Ye²⁹,Apadinuwe Sue-Chen³⁰,Mishra Sailesh Kumar³¹,Sharma Shekhar³²,Amza Abdou³³,Kadri Boubacar³³,Nassirou Beido³³,Mpyet Caleb D³⁴,Olobio Nicholas³⁵,Hussain Arif³⁶,Khan Asad Aslam³⁷,Jambi Garap³⁸,Ko Robert³⁹,Kello Amir B⁴⁰,Badiane Mouctar D⁴¹,Sarr Boubacar⁴²,Dalmar Abdi⁴³,Elshafie Balgesa E⁴⁴,Kabona George E⁴⁵,Kaitaba Oscar⁴⁵,Mwingira Upendo⁴⁵,Simon Alistidia⁴⁵,Kanyi Sarjo⁴⁶,Awoussi Marcel S⁴⁷,Togbey Kwamy⁴⁸,Baayenda Gilbert⁴⁹,Francis Mugume⁴⁹,Tukahebwa Edridah M⁵⁰,Bakhtiari Ana⁵¹,Keil Alexander P¹²,Maselko Joanna¹²,Westreich Daniel¹²,Garae Mackline⁵²,Taleo Fasiah⁵²,Al-Khateeb Tawfik Q⁵³,Mwale Consity⁵⁴,Solomon Anthony W⁵⁵,Gower Emily W¹²

Affiliation:

1. Department of Epidemiology , , Chapel Hill, North Carolina , USA

2. University of North Carolina at Chapel Hill , , Chapel Hill, North Carolina , USA

3. Clinical Research Department, London School of Hygiene & Tropical Medicine , London , UK

4. Programme National De Lutte Contre Les Maladies Transmissibles, Ministère De La Santé , Cotonou , Benin

5. Département D'ophthalmologie, Université De Parakou , Borgou , Benin

6. Secretaria de Vigilância em Saúde e Ambiente , Ministério da Saúde, Brazil

7. Institute of Scientific and Technological Communication and Information in Health , Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

8. Ministério da Saúde , Brazil

9. Direction de la Protection de la Santé de la Population , Ministère de la Santé, Burkina Faso

10. Attaché de Santé en Épidémiologie , Programme National de Lutte Contre Les MTN, Burkina Faso

11. L'unité d'élimination du trachome , PNMTN, Ouagadougou , Burkina Faso

12. Département En Charge des Maladies Tropicales , Négligées Ministère De La Santé Publique Et De La Lutte Contre Le Sida, Bujumbura , Burundi

13. Programme National de Lutte Contre La Cecite , Ministère de la Santé Publique, Yaoundé, Cameroun

14. Department Of Ophthalmology, University of Yaoundé Yaounde Centre/Ministère de la Santé Publique , Yaoundé, Cameroun

15. Ministère de la Santé Publique , Bangui , Central African Republic

16. Subdirectorate of Communicable Diseases, Ministry of Health and Social Protection , Bogotá, Colombia

17. Sightsavers , Addis Ababa, Ethiopia

18. Neglected Tropical Disease Prevention and Control Program, Ministry of Health , Addis Ababa, Ethiopia

19. Region Sanitaria Bolama-Bijagós , Bubaque , Guinea Bissau

20. Programa Nacional De Sau´de De Visão , Minsap, Bissau , Guinea -Bissau

21. Ministry of Health , Nairobi , Kenya

22. State Department for Public Health and Professional Standards, Ministry of Health , Nairobi , Kenya

23. Tungaru Central Hospital , MHMS Tarawa , Kiribati

24. Blantyre Institute for Community Outreach , Blantyre, Malawi

25. Department of Clinical and Medical Rehabilitation Services, Ministry of Health , Lilongwe, Malawi

26. National Eye Health Program, Ministry of Health and Social Development , Mali

27. Département Des Maladies Transmissibles , Ministère De La Santé Nouakchott, Nouakchott, Mauritania

28. Direção Nacional de Saúde Pública , Ministerio Da Saude, Maputo , Mozambique

29. Department of Public Health, Ministry of Health and Sports , Nay Pyi Taw, Myanmar

30. Department of Health , Denigomodu District Nauru, Nauru

31. National Society for Comprehensive Eye Care , Nepal Netra Jyoti Sangh, Kathmandu , Nepal

32. Ministry of Health , Kathmandu , Nepal

33. Programme National De Santé Oculaire , Ministère De La Santé Publique, Niamey , Niger

34. Department of Ophthalmology, University of Jos , Jos, Plateau , Nigeria

35. Neglected Tropical Diseases Division, Department of Public Health, Federal Ministry of Health , Abuja, Nigeria

36. Community Ophthalmology, College of Ophthalmology & Allied Vision Sciences (COAVS), Mayo Hospital Lahore , Lahore , Pakistan

37. College of Ophthalmology and Allied Vision Sciences, Mayo Hospital , Lahore , Pakistan

38. Prevention of Blindness Committee, PNG Eye Care, Boroko , Papua New Guinea

39. National Department of Health , Waigani, Papua New Guinea

40. AF/UCU UHC/Communicable and Noncommunicable Diseases Unit, ESPEN, World Health Organization , Brazzaville , Republic of Congo

41. Programme National de Promotion de La Santé Oculaire, Ministère de la Santé et de L'Action Sociale , Dakar , Senegal

42. Ministère de la Santé et de l'Action Sociale , Senegal

43. Ministry of Health , Mogadishu, Somalia

44. National Program for Prevention of Blindness, Federal Ministry of Health , Khartoum, Sudan

45. Neglected Tropical Diseases Control Program, Ministry of Health , Dodoma , Tanzania

46. National Eye Health Programme, Ministry of Health and Social Welfare , Banjul , The Gambia

47. Ministère de la Santé et de L'Hygiène Publique , Lomé, Togo

48. Programme National des Maladies Tropicales Negligées, Ministry of Health , Public Hygiene and Universal Access to Care, Lomé, Togo

49. Neglected Tropical Diseases Control, Ministry of Health , Kampala , Uganda

50. Vector-Borne and Neglected Tropical Diseases, Ministry of Health , Kampala , Uganda

51. International Trachoma Initiative, Task Force for Global Health , Decatur, Georgia , USA

52. Department of Neglected Tropical Diseases, Vanuatu Ministry of Health , Port Vila, Vanuatu

53. Department Of Ophthalmology, Sana'a University , Sana'a, Yemen

54. Kitwe Teaching Eye Hospital, Ministry of Health , Kitwe , Zambia

55. Global Neglected Tropical Diseases Programme, World Health Organization , Geneva , Switzerland

Abstract

Abstract Background 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. Methods 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. Results 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]). Conclusions Our results suggest potential gender differences in TT management. More research is needed to determine the causes and implications of the observed differences.

Funder

University of North Carolina at Chapel Hill

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine,Health (social science)

Link

https://academic.oup.com/inthealth/article-pdf/15/Supplement_2/ii58/53979170/ihad067.pdf

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