Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.
<h4>Background</h4>Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a no...
| প্রধান লেখক: | , , , , |
|---|---|
| বিন্যাস: | প্রবন্ধ |
| ভাষা: | English |
| প্রকাশিত: |
Public Library of Science (PLoS)
2015-12-01
|
| মালা: | PLoS Neglected Tropical Diseases |
| অনলাইন ব্যবহার করুন: | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0004270&type=printable |
| _version_ | 1826583999185682432 |
|---|---|
| author | Gregory S Greene Sheila K West Harran Mkocha Beatriz Munoz Shannath L Merbs |
| author_facet | Gregory S Greene Sheila K West Harran Mkocha Beatriz Munoz Shannath L Merbs |
| author_sort | Gregory S Greene |
| collection | DOAJ |
| description | <h4>Background</h4>Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs) to use during Mass Drug Administration (MDA) was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania.<h4>Methodology/principal findings</h4>A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50) as those assigned to usual care (n = 9, p < 0.05). While specificity was above 90% for both groups, the sensitivity for the novel screening tool was 31.2% compared to 5.6% for the usual care group (p < 0.05).<h4>Conclusions/significance</h4>CTAs appear to be viable resources for the identification of TT cases. Additional training and use of a TT screening card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases. |
| first_indexed | 2024-12-10T13:35:53Z |
| format | Article |
| id | doaj.art-696fdd7ab0e24f7fb363009b6fc50482 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2025-03-14T15:30:46Z |
| publishDate | 2015-12-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-696fdd7ab0e24f7fb363009b6fc504822025-02-25T05:36:44ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352015-12-01912e000427010.1371/journal.pntd.0004270Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.Gregory S GreeneSheila K WestHarran MkochaBeatriz MunozShannath L Merbs<h4>Background</h4>Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs) to use during Mass Drug Administration (MDA) was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania.<h4>Methodology/principal findings</h4>A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50) as those assigned to usual care (n = 9, p < 0.05). While specificity was above 90% for both groups, the sensitivity for the novel screening tool was 31.2% compared to 5.6% for the usual care group (p < 0.05).<h4>Conclusions/significance</h4>CTAs appear to be viable resources for the identification of TT cases. Additional training and use of a TT screening card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0004270&type=printable |
| spellingShingle | Gregory S Greene Sheila K West Harran Mkocha Beatriz Munoz Shannath L Merbs Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania. PLoS Neglected Tropical Diseases |
| title | Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania. |
| title_full | Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania. |
| title_fullStr | Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania. |
| title_full_unstemmed | Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania. |
| title_short | Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania. |
| title_sort | assessment of a novel approach to identify trichiasis cases using community treatment assistants in tanzania |
| url | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0004270&type=printable |
| work_keys_str_mv | AT gregorysgreene assessmentofanovelapproachtoidentifytrichiasiscasesusingcommunitytreatmentassistantsintanzania AT sheilakwest assessmentofanovelapproachtoidentifytrichiasiscasesusingcommunitytreatmentassistantsintanzania AT harranmkocha assessmentofanovelapproachtoidentifytrichiasiscasesusingcommunitytreatmentassistantsintanzania AT beatrizmunoz assessmentofanovelapproachtoidentifytrichiasiscasesusingcommunitytreatmentassistantsintanzania AT shannathlmerbs assessmentofanovelapproachtoidentifytrichiasiscasesusingcommunitytreatmentassistantsintanzania |