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. 2023 Dec 4;15(15 Suppl 2):ii44-ii52.
doi: 10.1093/inthealth/ihad085.

Explaining the continuing high prevalence of trachomatous trichiasis unknown to the health system in evaluation units: a mixed methods explanatory study in four trachoma-endemic countries

Grace Mwangi  1 , Emma Harding-Esch  2 , George Kabona  3 , Titus Watitu  4 , Caleb Mpyet  5   6 , Alemu Gemechu  7 , Alemayehu Abdeta  7 , Teyil Wamyil-Mshelia  5 , Grace Ajege  5 , Michaela Kelly  8 , Maurice Abony  9 , Peter Otinda  9 , Moses Chege  9 , Paul Courtright  1   8   10 , Robert Geneau  1   10
Affiliations

Explaining the continuing high prevalence of trachomatous trichiasis unknown to the health system in evaluation units: a mixed methods explanatory study in four trachoma-endemic countries

Grace Mwangi et al. Int Health. .

Abstract

Background: We explored reasons for continuing higher-than-anticipated prevalence of trachomatous trichiasis (TT) unknown to the health system in population-based prevalence surveys in evaluation units where full geographical coverage of TT case finding was reported.

Methods: A mixed-methods study in Ethiopia, Kenya, Nigeria and Tanzania was conducted. We compared data from clinical examination, campaign documentation and interviews with original trachoma impact survey (TIS) results.

Results: Of 169 TT cases identified by TIS teams, 130 (77%) were examined in this study. Of those, 90 (69%) were a match (both TIS and study teams agreed on TT classification) and 40 (31%) were a mismatch. Of the 40 mismatches, 22 (55%) were identified as unknown to the health system by the study team but as known to the health system by the TIS team; 12 (30%) were identified as not having TT by the study team but as having TT by the TIS team; and six (15%) were identified as unknown to the health system in the TIS team but as known to the health system by the study team based on documentation reviewed.

Conclusions: Incorrectly reported geographical coverage of case-finding activities, and discrepancies in TT status between TIS results and more detailed assessments, are the key reasons identified for continuing high TT prevalence.

Keywords: mismatch; survey; trachoma; trachomatous trichiasis.

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Conflict of interest statement

PC, CM, GM and MK are Guest Editors of this supplement but had no role in the review of this manuscript. This submission has not been published anywhere previously and it is not simultaneously being considered for any other publication.

Figures

Figure 1.
Figure 1.
Summary of the data collection procedure.
Figure 2.
Figure 2.
Number and proportion of matched and mismatched trachomatous trichiasis cases by country.
See this image and copyright information in PMC

References

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