03096nas a2200313   4500000000100000008004100001260001200042653002800054653002300082653001500105653001600120653001100136100001200147700001300159700001700172700001400189700001300203700001200216700001800228700001400246700001500260700001400275245012100289856006700410300000900477490000600486520227600492022001402768       2024                            d  bMDPI AG10aTrachomatous trichiasis10aFree surgical care10achallenges10arural areas10aGuinea1 aLamah L1 aKolié D1 aZoumanigui A1 aDiallo NK1 aCamara M1 aManet H1 aMillimouno TM1 aCamara BS1 aTounkara A1 aDelamou A00aDeterminants of Low Coverage of the Free Surgical Care Programme for Trachomatous Trichiasis in Rural Guinea in 2022  uhttps://www.mdpi.com/2414-6366/9/10/239/pdf?version=1728643182  a1-140 v93 a<jats:p>This study aimed to describe the experiences of healthcare personnel and patients in the organization of free surgical campaigns and care for trachomatous trichiasis in the health district of Siguiri in Guinea, including challenges experienced in providing surgical care. This was an explanatory qualitative study conducted in 2022 in the health district of Siguiri. A total of 20 participants were interviewed including patients (n = 7; 35%), community health workers (n = 4; 20%), health services managers, and healthcare providers (n = 8; 40%). Two main data collection technics were used: documentary review and in-depth individual interviews. All interviews were transcribed and manually coded using an Excel extraction spreadsheet. Data were analysed using inductive and deductive approaches. The results showed several organizational, structural, and community challenges that underlined the low surgical coverage of trachomatous trichiasis in the health district of Siguiri. Organizational challenges included the low involvement of local actors in planning activities, the limited timeframe of the campaigns, and the lack of logistics for activities supervision and patients’ transportation to surgery sites. Structural challenges included the inadequacy of health centres to provide surgical services, poor health infrastructures, and sanitation conditions in some areas. Individual challenges included remoteness of surgical sites and costs associated with services provision including medicines. Community challenges included fear of surgery and the coincidence of the campaigns with agricultural and mining activities. The results of the study call on the national neglected tropical disease program and its partners to adopt and promote micro-planning of trachomatous trichiasis surgical activities, with the effective participation of local stakeholders in endemic health districts. They should also envision integrating the management of surgical treatment including costs associated with care (transportation, food, rehabilitation support for patients who have undergone surgery) and complications of surgical procedures for an expansion of the trachomatous trichiasis free surgical care coverage in endemic health districts in Guinea.</jats:p>  a2414-6366