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

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.

More information

Type
Journal Article
Author
Sullivan KM
Harding-Esch EM
Batcho WE
Issifou AAB
Lopes MDFC
Szwarcwald CL
Vaz Ferreira Gomez D
Bougouma C
Christophe N
Kabore M
Bucumi V
Bella AL
Epee E
Yaya G
Trujillo-Trujillo J
Dejene M
Gebretsadik FS
Gebru G
Kebede F
Mathewos T
Cassama ETDS
Sanha S
Barasa E
Sultani HM
Watitu T
Tekeraoi R
Kalua KM
Masika MP
Traoré L
Minnih AO
Abdala M
Massangaie ME
Win Y
Apadinuwe S
Mishra SK
Sharma S
Amza A
Kadri B
Nassirou B
Mpyet CD
Olobio N
Hussain A
Khan AA
Jambi G
Ko R
Kello AB
Badiane MD
Sarr B
Dalmar A
Elshafie BE
Kabona GE
Kaitaba O
Mwingira U
Simon A
Kanyi S
Awoussi MS
Togbey K
Baayenda G
Francis M
Tukahebwa EM
Bakhtiari A
Keil AP
Maselko J
Westreich D
Garae M
Taleo F
Al-Khateeb TQ
Mwale C
Solomon AW
Gower EW