@article{99243,
  keywords = {Public Health, Environmental and Occupational Health, General Medicine, Health (social science), mismatch, survey, Trachoma},
  author = {Mwangi G and Harding-Esch E and Kabona G and Watitu T and Mpyet C and Gemechu A and Abdeta A and Wamyil-Mshelia T and Ajege G and Kelly M and Abony M and Otinda P and Chege M and Courtright P and Geneau R},
  title = {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},
  abstract = {<p><strong>Background:</strong> 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.</p>

<p><strong>Methods:</strong> 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.</p>

<p><strong>Results:</strong> 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.</p>

<p><strong>Conclusions:</strong> 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.</p>
},
  year = {2023},
  journal = {International Health},
  volume = {15},
  pages = {ii44-ii52},
  publisher = {Oxford University Press (OUP)},
  issn = {1876-3413, 1876-3405},
  url = {https://academic.oup.com/inthealth/article-pdf/15/Supplement_2/ii44/53979147/ihad085.pdf},
  doi = {10.1093/inthealth/ihad085},
  language = {Eng},
}