EVALUATION OF COMMUNITY-BASED SURGERY IN NORTHWEST ETHIOPIA

Abstract

BACKGROUND: Surgery to correct trachomatous trichiasis (TT) is recommended to prevent blindnesscaused by trachoma. This study evaluated the outcomes of community-based trichiasis surgery withabsorbable sutures, conductd in Amhara Regional State, Ethiopia.METHODS: A simple random sample of 431 patients was selected from surgical campaign records ofwhich 363 (84.2%) were traced and enrolled into the study. Participants were interviewed and examinedfor trichiasis recurrence, complications of TT surgery and corneal opacity. Multilevel logistic regressionmodels were used to explore the associations between trichiasis recurrence, corneal opacity andexplanatory variables at the eye level.RESULTS: The prevalence of trichiasis recurrence was 9.4% (95% Confidence Interval [CI] 6.6-12.8)and corneal opacity was found in 14.3% (95% CI 10.9-18.3) of the study participants. The proportion ofparticipants with complications of TT surgery was: granuloma 0.6% (95% CI 0.1-2.0); lid closure defects5.5% (95% CI 3.4-8.4) and lid notching 16.8% (95% CI 13.1-21.1). No factors were identified fortrichiasis recurrence. Corneal opacity was associated with increased age (Ptrend=0.001), more than 12months post surgery (OR=2.7; 95%CI 1.3-5.6), trichiasis surgery complications (OR=2.9; 95%CI 1.4-5.9)and trichiasis recurrence (OR=2.5; 95%CI 1.0-6.3).CONCLUSION: Prevalence of recurrent trichiasis and granuloma were lower than expected but higherfor lid closure defects and lid notching. The majority of the participants reported satisfaction with thetrichiasis surgery they had undergone. The findings suggest that recurrence of trichiasis impacts on thepatients’ risk of developing corneal opacity but longitudinal studies are required to confirm this.