Prevalence of Post-Operative Trichiasis in Southern Ethiopia, 2021: A Community Based Cross Sectional Study

Abstract

Background

Post-operative trichiasis (PTT) is a major challenge following corrective eyelid surgery for trachomatous trichiasis. There is a scarcity of research on post-operative trichiasis in Southern Ethiopia, particularly in the study area. This study aimed to assess the prevalence of post-operative trichiasis in patients who underwent corrective surgery.

Objective

To assess the prevalence of post-operative trichiasis in the Gamo Zone in Southern Ethiopia in 2021.

Methods

A descriptive community-based cross-sectional study was conducted in the Dita district, Southern Ethiopia. The data were collected between 2014 and 2020. Three Qualified trachoma trichiasis (TT) graders working on a trachoma impact survey were recruited for this study. Eye examinations were performed by graders on all study subjects using a loupe to identify post-operative trichiasis. All patients underwent upper eyelid surgery only. A systematic sampling technique was used to select 459 participants from the TT Surgery Logbook.

Results

Of the 459 study participants, more than three quarter 353 (76.9%) were female. The mean age of the study subjects was 48.38 years with a standard deviation of +-10.4. A total of 10 upper eyelids (7 bilateral and 3 left upper eyelids) underwent PTT. The prevalence of post-operative trichiasis in the study area was 2.2% (95% CI: 0.9–3.5%. Fourteen (4.7%) unoperated upper eyelids developed trichiasis infection. A few patients had left and right lower eyelid trichiasis (6/459 [1.3%] and 3/459 [0.7%], respectively).

Conclusion and Recommendation

The prevalence of post-operative trichiasis in the study area was similar to that recommended by the World Health Organization (WHO) recommendation range. Trachoma trichiasis was observed on the lower and upper unoperated eyelids of the study participants. Therefore, sustainable interventions should be considered in the study area for all the components of the SAFE strategy, particularly on S component.

Keywords:

• post-operative trichiasis
• trachoma
• Dita district

Abbreviations

BLTR, bilamellar tarsal rotation; CSA, Central Statistics Agency; E.C, Ethiopian Calendar; IECWs, Integrated Eye Care Workers; IRB, Institutional Research Review Board; PLTR, Posterior Lamellar Tarsal rotation; PTT, Post-Operative Trachoma trichiasis; PPS, proportional to size; SAFE, Surgery, Antibiotic, Facial Cleanliness, Environmental hygiene; SPSS, Statistical Package for Social Sciences; TEO, Tetracycline Eye Ointment; TF, Trachomatous Follicular; TT, Trachomatous Trichiasis; WHO, World Health Organization.

Data Sharing Statement

The datasets during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethical Approval

This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was secured from the Arba Minch University Institutional Research Ethics Review Board (IRB) with reference number (IRB/1149/2021). A support letter was written to the district health office after permission was obtained. Voluntary informed oral consent was obtained from each participant because the survey did not include invasive procedures that harmed the study subjects. This study was approved by the Institutional Research Ethics Review Board. The purpose of the study and the right to stop responding at any time were explained to all the participants. All personal information was kept confidential. All participants diagnosed with post-operative trachoma trichiasis were linked to nearby health facilities.

Acknowledgments

We thank the Arba Minch University Collaborative Research Training Centre for Neglected Tropical Diseases for funding this study. We are also thankful to all the data collectors and supervisors who tried their best and devoted themselves to the data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas, took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; agreed on the journal to which the article has been submitted; and agreed to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was funded by the Arba Minch University College of Medicine and Health Sciences Collaborative Research and Training Centre with the grant code of GOV/AMU/TH-NTD/CRTC/05/14.