Outcome of trachoma lid surgeries in Jigawa state, Nigeria

Alice Ramyil,Catey Bunce,Joel Alada,Patricia Wade,Covadonga Bascaran,Caleb Mpyet,Udo Schumacher

doi:10.1080/2331205x.2016.1233683

Abstract

AbstractBackground: Following the implementation of the SAFE strategy in Jigawa state, ophthalmic nurses trained as lid surgeons perform trichiasis surgery in the state. This study aimed to determine the early outcome of these surgeries with the specific objectives to determine the recurrence rate of trichiasis; the incidence of eyelid contour abnormality and incidence of eyelid closure defects 3–6 months postoperatively. Methods: A retrospective cohort study of patients operated for the first time between December 2012 and April 2013 in four zones in Jigawa state. Zones were selected based on the location of the most active surgeons. Patients were examined with torchlight for presence of recurrent trichiasis (TT recurrence), eyelid contour abnormality (ECA) and eyelid closure defects (ECD). Results: 133 eyes of 77 patients were examined; incidences recorded were TT recurrence 17.29% (95% CI 11.29–24.80%), ECA 18.93% (95% CI 12.64–26.67%) and ECD 5.3% (95% CI 2.15–10.62%). Incidence of poor outcome varied...

Highlights

Trachoma is the leading cause of blindness due to an infectious agent worldwide (Resnikoff et al, 2004)
This study evaluates the outcome of trichiasis surgery and factors relating to poor surgical outcomes in Jigawa state, with a view to improving quality and acceptability
Over 40 million people are estimated to suffer from active trachoma, and about 8.2 million have trichiasis; 2.2 million have visual impairment and 1.2 million of these are irreversibly blind from trachoma (Mariotti, Pascolini, & Rose-Nussbaumer, 2009; Pascolini & Mariotti, 2012)

Summary

Introduction

Trachoma is the leading cause of blindness due to an infectious agent worldwide (Resnikoff et al, 2004). It is a disease of poverty found in the poorest communities of developing countries and is endemic in 53 countries most of which are in sub-Saharan Africa and Asia (Pascolini & Mariotti, 2012). The magnitude of trichiasis has risen by about 10% from 7.6 million in 2003 with resultant marked increase in the number of people at risk of blindness from the disease. Incidence of poor outcome varied with zone and was associated with female sex, duration of symptoms >1 year preoperatively, bilaterally operated eyes, and paid surgery. The risk factors associated with poorer outcome include late presentation, female sex, Bilateral surgery, and paid surgery

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