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. 2023 Dec 4;15(15 Suppl 2):ii58-ii67.
doi: 10.1093/inthealth/ihad067.

Gender differences in the surgical management of trachomatous trichiasis: an exploratory analysis of global trachoma survey data, 2015-2019

Kristin M Sullivan  1 , Emma M Harding-Esch  2 , Wilfrid E Batcho  3 , Amadou A Bio Issifou  4 , Maria de Fátima Costa Lopes  5 , Celia Landmann Szwarcwald  6 , Daniela Vaz Ferreira Gomez  7 , Clarisse Bougouma  8 , Nassa Christophe  9 , Martin Kabore  10 , Victor Bucumi  11 , Assumpta L Bella  12 , Emilienne Epee  13 , Georges Yaya  14 , Julian Trujillo-Trujillo  15 , Michael Dejene  16 , Fikre Seife Gebretsadik  17 , Genet Gebru  17 , Fikreab Kebede  17 , Tsedeke Mathewos  17 , Eunice Texiera de Silva Cassama  18 , Salimato Sanha  19 , Ernest Barasa  20 , Hadley Matendechero Sultani  21 , Titus Watitu  20 , Rabebe Tekeraoi  22 , Khumbo M Kalua  23 , Michael P Masika  24 , Lamine Traoré  25 , Abdallahi O Minnih  26 , Mariamo Abdala  27 , Marília E Massangaie  27 , Ye Win  28 , Sue-Chen Apadinuwe  29 , Sailesh Kumar Mishra  30 , Shekhar Sharma  31 , Abdou Amza  32 , Boubacar Kadri  32 , Beido Nassirou  32 , Caleb D Mpyet  33 , Nicholas Olobio  34 , Arif Hussain  35 , Asad Aslam Khan  36 , Garap Jambi  37 , Robert Ko  38 , Amir B Kello  39 , Mouctar D Badiane  40 , Boubacar Sarr  41 , Abdi Dalmar  42 , Balgesa E Elshafie  43 , George E Kabona  44 , Oscar Kaitaba  44 , Upendo Mwingira  44 , Alistidia Simon  44 , Sarjo Kanyi  45 , Marcel S Awoussi  46 , Kwamy Togbey  47 , Gilbert Baayenda  48 , Mugume Francis  48 , Edridah M Tukahebwa  49 , Ana Bakhtiari  50 , Alexander P Keil  1 , Joanna Maselko  1 , Daniel Westreich  1 , Mackline Garae  51 , Fasiah Taleo  51 , Tawfik Q Al-Khateeb  52 , Consity Mwale  53 , Anthony W Solomon  54 , Emily W Gower  1
Affiliations

Gender differences in the surgical management of trachomatous trichiasis: an exploratory analysis of global trachoma survey data, 2015-2019

Kristin M Sullivan et al. Int Health. .

Abstract

Background: Trachomatous trichiasis (TT) is a painful, potentially blinding eye condition that can be managed through epilation or surgery. Women are affected by TT approximately twice as often as men and are believed to face gendered barriers to receiving surgical care to prevent vision loss.

Methods: We used data from 817 cross-sectional surveys conducted during 2015-2019 in 20 African countries to estimate the prevalence difference (PD) between female and male eyes for four outcomes potentially indicating gender-related differences in TT management: (1) received surgery and developed postoperative TT (PTT), (2) never offered surgery, (3) offered surgery but declined it, and (4) offered epilation but never offered surgery.

Results: The prevalence was modestly elevated among female eyes compared with male eyes for having PTT (PD:1.8 [95% confidence limits (CL): 0.6, 3.0]) and having declined surgery for the eye (PD: 6.2 [95% CL: 1.8, 10.7]). The proportion offered epilation was similar by gender (PD:0.5 [95% CL: -0.4, 1.3]), while never having been offered surgery was somewhat more prevalent among male eyes (PD: -2.1 [95% CL: -3.5, -0.7]).

Conclusions: Our results suggest potential gender differences in TT management. More research is needed to determine the causes and implications of the observed differences.

Keywords: Chlamydia trachomatis; elimination; gender; surgery; trachoma; trichiasis.

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Conflict of interest statement

CM and MD are Guest Editors of this supplement but had no role in the review of this manuscript. AB is employed by the International Trachoma Initiative at The Task Force for Global Health, which receives an operating budget and research funds from Pfizer Inc., the manufacturers of Zithromax (azithromycin); EMHE is funded by the International Trachoma Initiative, a program of The Task Force for Global Health, which receives funding from Pfizer Inc., the manufacturers of Zithromax (azithromycin). All other authors have no completing interests to declare. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated, USAID or the United States Government.

Figures

Figure 1.
Figure 1.
Conceptual framework describing categorization of study eyes regarding surgical management of trachomatous trichiasis*.
Figure 2.
Figure 2.
Prevalence difference comparing female with male eyes on four outcomes of trachomatous trichiasis management*.
See this image and copyright information in PMC

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