Operational adaptations of the trachoma pre-validation surveillance strategy employed in Ghana:a qualitative assessment of successes and challenges  

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作  者:Laura Senyonjo Agatha Aboe Robin Bailey David Agyemang Benjamin Marfo Seth Wanye Elena Schmidt James Addy Karl Blanchet 

机构地区:[1]Research team,Sightsavers,Haywards Heath,UK [2]Clinical Research Department,London School of Hygiene&Tropical Medicine,London,UK [3]不详

出  处:《Infectious Diseases of Poverty》2019年第4期104-105,共2页贫困所致传染病(英文)

摘  要:Background:In 2009 Ghana began to design a trachoma pre-validation surveillance plan,based on then-current WHO recommendations.The plan aimed to identify active trachoma resurgence and identify and manage trichiasis cases,through both active and passive surveillance approaches.This paper outlines and reviews the adaptations made by Ghana between 2011 and 2016.The assessment will provide a learning opportunity for a number of countries as they progress towards elimination status.Methods:A mixed methods approach was taken,comprising in-depth interviews and documents review.Between January and April 2016,20 in-depth interviews were conducted with persons involved in the operationalisation of the trachoma surveillance system from across all levels of the health system.A three-tier thematic coding framework was developed using a primarily inductive approach but also allowed for a more iterative approach,which drew on aspects of grounded theory.Results:During the operationalisation of the Ghana surveillance plan there were a number of adaptations(as compared to the WHO recommendations),these included:(i)Inclusion of surveillance of active trachoma in the passive surveillance approach,as compared to trichiasis alone.Issues with case identification,challenges in implementation coverage and a non-specific reporting structure hampered effectiveness;(ii)Random selection and increase in number of sites selected for the active surveillance component.This likely lacked the spatiotemporal power to be able to identify recrudescence in a timely manner;(iii)Targeted trichiasis door-to-door case searches,led by ophthalmic nurses.An effective methodology to identify trichiasis cases but resource intensive;(iv)A buddy system between ophthalmic nurses to support technical skills in an elimination setting where it is difficult to attain diagnostic and surgical skills,due to a lack of cases.The strategy did not take into account the loss of proficiency within experienced personnel.Conclusions:Ghana developed a comprehensive surveillance

关 键 词:TRACHOMA Pre-validation SURVEILLANCE Elimination CASE-FINDING Surveillance strategy Adaptation 

分 类 号:R49[医药卫生—康复医学]

 

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