PURPOSE: There are approximately 8 million people with trachomatous trichiasis globally; in the year 2009, less than 160,000 people had surgery. These numbers are too low in order to achieve the goal of elimination of blinding trachoma by the year 2020. Task shifting approaches have led to the training of general nurses in trichiasis surgery in eastern Africa. The overall aim of this study was to determine the attrition and productivity (and the factors associated with productivity) of trichiasis surgeons in Kenya, Tanzania, and Malawi. METHODS: A 3-year cohort study of trichiasis surgeons. RESULTS: The overall response rate was 86%. Defining high productivity as 50+ operations per year per surgeon, only 16.1% of the trichiasis surgeons were highly productive. Among the surgeons, 27.9% were no longer at their site and ceased providing surgery (attrition) over the 3 years of study. High productivity was associated with having been trained by an experienced trainer, supervised by a clinical officer, having more than three surgical sets, and having an outreach program. CONCLUSION: Attrition of general nurses trained in trichiasis surgery was high. Surgical productivity of trichiasis surgeons remained too low. It is likely that other approaches are needed to address the burden of trichiasis in the three countries. In terms of recommendations, training of trichiasis surgeons should be done in a "package," including a plan for provision of surgical equipment, continuous support and supervision, and outreach.
PURPOSE: There are approximately 8 million people with trachomatous trichiasis globally; in the year 2009, less than 160,000 people had surgery. These numbers are too low in order to achieve the goal of elimination of blinding trachoma by the year 2020. Task shifting approaches have led to the training of general nurses in trichiasis surgery in eastern Africa. The overall aim of this study was to determine the attrition and productivity (and the factors associated with productivity) of trichiasis surgeons in Kenya, Tanzania, and Malawi. METHODS: A 3-year cohort study of trichiasis surgeons. RESULTS: The overall response rate was 86%. Defining high productivity as 50+ operations per year per surgeon, only 16.1% of the trichiasis surgeons were highly productive. Among the surgeons, 27.9% were no longer at their site and ceased providing surgery (attrition) over the 3 years of study. High productivity was associated with having been trained by an experienced trainer, supervised by a clinical officer, having more than three surgical sets, and having an outreach program. CONCLUSION: Attrition of general nurses trained in trichiasis surgery was high. Surgical productivity of trichiasis surgeons remained too low. It is likely that other approaches are needed to address the burden of trichiasis in the three countries. In terms of recommendations, training of trichiasis surgeons should be done in a "package," including a plan for provision of surgical equipment, continuous support and supervision, and outreach.
Authors: Vladimir Pente; Stevens Bechange; Emma Jolley; Patrick Tobi; Anne Roca; Anna Ruddock; Nancy Smart; Kolawole Ogundimu; Matthew Vandy; Elena Schmidt Journal: J Glob Health Date: 2021-03-10 Impact factor: 4.413
Authors: Stephanie M Davis; Helen Baker; Jessica M Gross; Sharon L Leslie; Cynthia M Z Chasokela; Julia Samuelson; Carlos Toledo Journal: J Assoc Nurses AIDS Care Date: 2021 Jan-Feb 01 Impact factor: 1.809