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Padhy D, Pyda G, Marmamula S, Khanna RC. Barriers to uptake of referral services from secondary eye care to tertiary eye care and its associated determinants in L V Prasad Eye Institute network in Southern India: A cross-sectional study-Report II. PLoS One 2024; 19:e0303401. [PMID: 38743737 PMCID: PMC11093387 DOI: 10.1371/journal.pone.0303401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/07/2024] [Indexed: 05/16/2024] Open
Abstract
AIM To investigate the barriers to the uptake of referral services from secondary care centers (SC) to a higher-level tertiary care center (TC) in Southern India. METHODS A cross-sectional study was conducted in the Mahabubnagar district of Telangana, India, between February 1, 2018 to January 31, 2019 and all those referred from SC to TC between January 1, 2013 to December 30, 2016 were identified for interview. Based on inclusion criteria, of the 960 participants identified, 681 (70.9%) participated in the study. A validated study questionnaire was administered to all participants. Information collected were the demographic details, details related to their referral and barriers to referral. The participants that presented at TC were considered compliant and who did not, were non-compliant. Reasons for non-compliance was also collected. RESULTS The mean age those interviewed was 46.1 years (SD: 17.3 years) and 429 (63%) were males and 252 (37%) were females. Overall, 516 (75.8%) were compliant, and 165 (24.2%) were non-compliant. The major factors for non-compliance were economic (16.4%) and attitudinal (44.2%) barriers. Within the attitudinal barrier category, the most prevalent individual attitudinal barriers were 'too busy to go to the eye center for treatment (16.4%)'and 'able to manage routine daily activities with current vision (12.1%)'. The multivariable analysis showed that the non-compliant participants had only visited the SC once prior to the referral (odds ratio: 2.82; 95% CI: 1.43-5.57) (p = 0.003). CONCLUSIONS Participants with only one SC visit, were less likely to comply with referrals and the major barriers to compliance were economical and attitudinal. It is important to address these specific barriers to provide proper counseling to participants during referrals.
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Affiliation(s)
- Debananda Padhy
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Giridhar Pyda
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Rohit C. Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Kalisya LM, Yap A, Mitume B, Salmon C, Karafuli K, Poenaru D, Onyango R. Determinants of Access to Essential Surgery in the Democratic Republic of Congo. J Surg Res 2023; 291:480-487. [PMID: 37536189 DOI: 10.1016/j.jss.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION In the Democratic Republic of Congo (DRC), the determinants and barriers of essential surgical care are not well described, hindering efforts to improve national surgical programs and access. METHODS A cross-sectional study evaluated access to essential surgery in the Butembo and Katwa health zones in the North Kivu province of DRC. A double-clustered random sample of community members was surveyed using questions derived from the Surgeons OverSeas Surgical Needs Assessment Survey, a validated tool to determine the reasons for not seeking, reaching, or receiving a Bellwether surgery (i.e., caesarean delivery, laparotomy, and external fixation of a fracture) when needed. RESULTS Overall, 887 households comprising 5944 community members were surveyed from April to August 2022. Six percent (n = 363/5944) of the study population involving 35% (n = 309/887) households needed a Bellwether surgery in the previous year, 30% (n = 108/363) of whom died. Of those who needed surgery, 25% (n = 78) did not go to the hospital to seek care and were more likely to find transportation unaffordable (P = 0.042). The most common reasons for not seeking care were lack of funds for hospitalization, prior poor hospital experience, and fear of hospital care. CONCLUSIONS Access and delivery of essential surgery are drastically limited in the North Kivu province of the DRC, such that a quarter of households needing surgery fails to seek surgical care. Poor access was predominantly driven by households' inability to pay for surgery and community distrust of the hospital system.
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Affiliation(s)
- Luc Malemo Kalisya
- Department of Community Health and Development, Great Lakes University of Kisumu, Kisumu, Kenya
| | - Ava Yap
- Center of Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, California.
| | - Boniface Mitume
- Department of Computer Engineering, Université Officielle de Ruwenzori, Butembo, DRC
| | - Christian Salmon
- Center for Global Health Engineering, Department of Engineering Management and Industrial Engineering, Western New England University, Springfield, Massachusetts
| | | | - Dan Poenaru
- Department of Pediatric Surgery, McGill University, Montreal, Quebec, Canada
| | - Rosebella Onyango
- Department of Community Health and Development, Great Lakes University of Kisumu, Kisumu, Kenya
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Marbaniang SP, Patel R, Kumar P, Chauhan S, Srivastava S. Hearing and vision difficulty and sequential treatment among older adults in India. Sci Rep 2022; 12:19056. [PMID: 36351946 PMCID: PMC9646738 DOI: 10.1038/s41598-022-21467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Aging not only affect biomarker-related processes, but it also affects the physiological processes of the human body. Of all the physiological processes, hearing and vision are of utmost importance to a human. Therefore, this study examines the prevalence and factors associated with hearing and vision difficulty and their sequential treatment among older adults in India. Utilizing data from Building a Knowledge Base on Population Aging in India, study used two sets of outcome variables; firstly, self-reported hearing and vision difficulty and secondly, treatment-seeking for hearing and vision difficulty. A total of 9541 older adults aged 60+ years from seven major regionally representative states were selected. Descriptive statistics were used to perform preliminary analysis. Additionally, the study employed the Heckprobit selection model. It is a two-equation model. This model is used in order to accommodate the heterogeneity (i.e., shared unobserved factors) among older adults and then address the endogeneity (between hearing and vision loss problems and their treatment-seeking behaviour) for older adults in India, the model offers a two-step analysis and deals with the zero-sample issue. Around 59% and 21% of older adults reported vision and hearing difficulty, respectively. Only 5% of older adults suffering from hearing difficulty reported utilizing hearing aids. Lifestyle factors (smoking tobacco and chewing tobacco) significantly affect hearing and vision difficulty; various chronic diseases were also found to be associated with high levels of hearing and vision difficulty among older adults. Results from Heckprobit model shows that older adults with 11+ years of education had higher probability to use visual [β = 0.54, 95% confidence interval (CI): 0.37, 0.70] and hearing aids [β = 0.6, 95% CI: 0.18, 1.02]. The use of hearing and vision aids was lower among poor older adults, older adults from Scheduled Caste, and older adults in rural areas. The study indicates that more than half of older adults face vision difficulty and almost one-fourth face hearing difficulty in rural India, education and lifestyle appear to be the main driver of health-seeking behaviour. Additional attention shall be given to understand the strategies that may advocate a higher use for hearing aids among older adults.
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Affiliation(s)
| | - Ratna Patel
- grid.419349.20000 0001 0613 2600Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- grid.419349.20000 0001 0613 2600Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
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Rangavittal S, Narayanan A. Eye care seeking behavior among rural adults in South India: Tamil Nadu Rural Eye Examination (TREE) Study Report 1. Indian J Ophthalmol 2022; 70:3255-3259. [PMID: 36018098 DOI: 10.4103/ijo.ijo_516_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To present the eye care seeking behavior among rural adults in South India. Methods This cross-sectional study was conducted between 2019 and 2020 covering three blocks of the Thiruvannamalai district, Tamil Nadu, India. Door-to-door survey was performed to collect demographic information, status of literacy, occupation, and details of previous eye examination. Distance visual acuity was tested for individuals available in the house using a log MAR (logarithm of minimum angle of resonance) chart. Association between demographic details, details of previous eye examination, and status of vision was analyzed using logistic regression. Results A data of 12,913 individuals were included for the analysis, of which 6460 (50.03%) were females. Of the total individuals, 2007 (15.54%) had undergone an eye examination previously. There were 1639 (28.50%) people who had a vision less than 0.2 log MAR in at least one eye. The odds of reported 'previous eye examination' were more among females [odds ratio (OR) 1.48, 95% confidence interval (CI): 1.32-1.66, P < 0.001]; individuals aged above 60 years [OR: 11.46, 95% CI: 9.44-13.91, P < 0.001], between 40 and 60 years [OR: 10.43, 95% CI: 8.85-12.30, P < 0.001], and between 18 and 40 years [OR: 2.48, 95% CI: 2.16-2.84, P < 0.001]; illiterates (OR: 1.76, 95% CI: 1.45-2.15, P < 0.001); and farmers (OR: 1.32 95% CI: 1.12-1.55, P = 0.001). Conclusion The study presents the utilization of eye care among rural South Indian adults. Almost 84.46% of individuals had not undergone any eye examination. Robust measures to promote eye care management would help in effective utilization of eye care services among rural adults.
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Affiliation(s)
- Subhiksha Rangavittal
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Anuradha Narayanan
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
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Shetti S, Pradeep TG, Devappa N. Barriers for the uptake of cataract surgery: A rural community-based study. AFRICAN VISION AND EYE HEALTH 2022. [DOI: 10.4102/aveh.v81i1.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Shambhu R, Akshaya KM, Bappal A, Jain R, Hegde V, Pavithra H. Factors Associated with Out-of-Pocket Expenditure among Patients Admitted for Cataract Surgery under District Blindness Control Society Scheme: A Cross-Sectional Study from a Private Medical College Hospital of South India. Indian J Community Med 2022; 47:116-119. [PMID: 35368486 PMCID: PMC8971877 DOI: 10.4103/ijcm.ijcm_783_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The National Programme for Control of Blindness and Visual Impairment in India supports the management of various conditions of the eye including cataracts. Objective: The objective of this study is to estimate out-of-pocket expenditure (OOPE) and factors associated with it among patients admitted for cataract surgery under District Blindness Control Society (DBCS) scheme. Materials and Methods: A cross-sectional study was conducted in a Medical College Hospital of Coastal Karnataka, South India. Data were collected using a predesigned semi-structured interview schedule from 100 patients admitted for cataract surgery under DBCS scheme. Costs were reported as median values with interquartile range (IQR) and compared using the Kruskal-Wallis test. Results: Median total cost incurred by the patient was INR 1700 (IQR 1052–2575). Median direct costs (1425, IQR 762.5–2200 INR) included medical expenditure (600, IQR 0–1475 INR), mainly contributed by the treatment of systemic comorbid conditions and nonmedical expenditure toward travel. Median indirect costs (400, IQR 200–600 INR) included loss of wages for the patient and the bystander. Conclusions: OOPE for cataract surgery among DBCS patients was associated with the presence of comorbidity, postponement of surgery, duration of hospital stay, and distance traveled by the patient.
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Affiliation(s)
- Rashmi Shambhu
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Kibballi Madhukeshwar Akshaya
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Anupama Bappal
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Rashmi Jain
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Vidya Hegde
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - H Pavithra
- Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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TU Y, DENG J, FANG L, ZHANG Y, YING H, SUN Q. Effect of evidence-based nursing on the application of ultrasonic emulsification operation for cataract and the postoperative rehabilitation indicators. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.17921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yanqin TU
- The Second Affiliated Hospital of Nanchang University, China
| | - Jianmin DENG
- The Second Affiliated Hospital of Nanchang University, China
| | - Liang FANG
- The Second Affiliated Hospital of Nanchang University, China
| | - Yongmei ZHANG
- The Second Affiliated Hospital of Nanchang University, China
| | - Hongmei YING
- The Second Affiliated Hospital of Nanchang University, China
| | - Qiuzhen SUN
- The Second Affiliated Hospital of Nanchang University, China
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Mirza E, Mirza GD, Oltulu R, Okka M, Ozkagnici A. The Frequency and Causes of Blindness in a Rural Region of Central Anatolia of Turkey. Eurasian J Med 2019; 51:242-246. [PMID: 31692621 DOI: 10.5152/eurasianjmed.2019.18312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objective This study aimed to evaluate the frequency and primary causes of blindness in adults aged 18 years and more in Sarıkaya rural region of Yozgat, Turkey, to contribute to the epidemiologic information about blindness in our country. Materials and Methods Patients who were examined between October 2016 and March 2017 in Sarıkaya State Hospital, Clinic of Ophthalmology, were prospectively investigated. Demographic and ophthalmic examination data, presented visual acuities (VA), primary causes of blindness, and monocular blindness were recorded. Blindness was defined as presented visual acuities (VA) definition of World Health Organization criteria. Results A total of 3423 participants, aged 18-96 years, were examined. Among them, 1887 participants (55%) were female and 1536 (45%) were male. The frequency of blindness was 1.5% (95% CI: 1.1%-2.0%); and cataract was the primary cause of blindness (42%). Age-related macular degeneration (21%) and uncorrected refractive error (13%) were the next main causes of blindness. The frequency of monocular blindness was 4% (95% CI: 3.8%-5.2%), and cataract (27%) followed by phthisis bulbi/evisceration (13%) and glaucoma (12%) were the leading causes of monocular blindness. Conclusion In this rural region of Central Anatolia, the primary cause of blindness and monocular blindness was an unoperated cataract. The patterns of age-specific causes of blindness are variable, but most of them are avoidable or treatable. Thus, awareness should be increased in societies, and people should be prevented from blindness with health-care programs in rural regions of developing countries.
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Affiliation(s)
- Enver Mirza
- Department of Ophthalmology, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
| | - Gunsu Deniz Mirza
- Department of Ophthalmology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Refik Oltulu
- Department of Ophthalmology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Mehmet Okka
- Department of Ophthalmology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Ahmet Ozkagnici
- Department of Ophthalmology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
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