INTRODUCTION: Surgery for trachomatous trichiasis prevents blindness and is advocated by the WHO as part of the SAFE strategy for the global elimination of trachoma. We conducted a randomised community trial to investigate the effect of providing surgery in villages on surgical uptake in The Gambia. METHODS:56 villages from two divisions were assigned to eight pairs of clusters matched by geographical division and proximity. One cluster from each pair was randomly assigned to receive village-based surgery and the other cluster health centre-based surgery. Outcome measures were uptake rates and surgical results after 1 week and 3 months. The paired t-test was used to analyse the results. RESULTS:Overall uptake was 66% in the village-based clusters and 44% in the health centre-based clusters. Subjects in the village-based surgery arm had significantly shorter journey times (P = 0.01) and lower costs (P = 0.002). The mean difference in absolute acceptance rates of surgery was 20% better in village-based clusters (95% CI -9 to + 49%, P = 0.15), which would equate to an improvement of 45% (95% CI -20% to 120%) on the average acceptance rates of 44% in the health centre-based group. CONCLUSION: These results strongly suggest better surgical uptake when surgery is provided in patients' villages due to lower cost to the patient, time saved and less fear of the operation.
RCT Entities:
INTRODUCTION: Surgery for trachomatous trichiasis prevents blindness and is advocated by the WHO as part of the SAFE strategy for the global elimination of trachoma. We conducted a randomised community trial to investigate the effect of providing surgery in villages on surgical uptake in The Gambia. METHODS: 56 villages from two divisions were assigned to eight pairs of clusters matched by geographical division and proximity. One cluster from each pair was randomly assigned to receive village-based surgery and the other cluster health centre-based surgery. Outcome measures were uptake rates and surgical results after 1 week and 3 months. The paired t-test was used to analyse the results. RESULTS: Overall uptake was 66% in the village-based clusters and 44% in the health centre-based clusters. Subjects in the village-based surgery arm had significantly shorter journey times (P = 0.01) and lower costs (P = 0.002). The mean difference in absolute acceptance rates of surgery was 20% better in village-based clusters (95% CI -9 to + 49%, P = 0.15), which would equate to an improvement of 45% (95% CI -20% to 120%) on the average acceptance rates of 44% in the health centre-based group. CONCLUSION: These results strongly suggest better surgical uptake when surgery is provided in patients' villages due to lower cost to the patient, time saved and less fear of the operation.
Authors: Michael Mahande; Manisha Tharaney; Edward Kirumbi; Edith Ngirawamungu; Robert Geneau; Lisa Tapert; Paul Courtright Journal: Br J Ophthalmol Date: 2006-10-18 Impact factor: 4.638
Authors: Saul N Rajak; Esmael Habtamu; Helen A Weiss; Amir Bedri; Teshome Gebre; Robin L Bailey; David C W Mabey; Peng T Khaw; Clare E Gilbert; Paul M Emerson; Matthew J Burton Journal: Invest Ophthalmol Vis Sci Date: 2011-10-10 Impact factor: 4.799
Authors: M J Burton; R J C Bowman; H Faal; E A N Aryee; U N Ikumapayi; N D E Alexander; R A Adegbola; S K West; D C W Mabey; A Foster; G J Johnson; R L Bailey Journal: Br J Ophthalmol Date: 2005-05 Impact factor: 4.638