Gender differences in the surgical management of trachomatous trichiasis: an exploratory analysis of global trachoma survey data, 2015–2019
Kristin M Sullivan, Emma M Harding-Esch, Wilfrid E Batcho, Amadou A Bio Issifou, Maria de Fátima Costa Lopes, Celia Landmann Szwarcwald, Daniela Vaz Ferreira Gomez, Clarisse Bougouma, Nassa Christophe, Martin Kabore, Victor Bucumi, Assumpta L Bella, Emilienne Epee, Georges Yaya, Julian Trujillo-Trujillo, Michael Dejene, Fikre Seife Gebretsadik, Genet Gebru, Fikreab Kebede, Tsedeke Mathewos, Eunice Texiera de Silva Cassama, Salimato Sanha, Ernest Barasa, Hadley Matendechero Sultani, Titus Watitu, Rabebe Tekeraoi, Khumbo M Kalua, Michael P Masika, Lamine Traoré, Abdallahi O Minnih, Mariamo Abdala, Marília E Massangaie, Ye Win, Sue-Chen Apadinuwe, Sailesh Kumar Mishra, Shekhar Sharma, Abdou Amza, Boubacar Kadri, Beido Nassirou, Caleb D Mpyet, Nicholas Olobio, Arif Hussain, Asad Aslam Khan, Garap Jambi, Robert Ko, Amir B Kello, Mouctar D Badiane, Boubacar Sarr, Abdi Dalmar, Balgesa E Elshafie, George E Kabona, Oscar Kaitaba, Upendo Mwingira, Alistidia Simon, Sarjo Kanyi, Marcel S Awoussi, Kwamy Togbey, Gilbert Baayenda, Mugume Francis, Edridah M Tukahebwa, Ana Bakhtiari, Alexander P Keil, Joanna Maselko, Daniel Westreich, Mackline Garae, Fasiah Taleo, Tawfik Q Al-Khateeb, Consity Mwale, Anthony W Solomon, Emily W Gower- Public Health, Environmental and Occupational Health
- General Medicine
- Health (social science)
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.