背景:沙眼衣原体(Ct)反复结膜感染导致眼盲。传输强度估计,对于方案决策,1-9岁儿童的沙眼性炎症-滤泡(TF)的临床体征患病率。对现场分级TF的补充指标的研究包括结膜摄影方面的工作,眼部Ct感染测试,和血清学。这些指标在各种利益相关者中的可接受性和可行性尚不清楚。
方法:与社区成员进行了焦点小组讨论(FGD),并与坦桑尼亚的公共卫生从业人员进行了深入访谈(IDI)。FGD探讨了主题,包括参与者的经验,和思考,不同的诊断方法。使用了内容分析的框架方法。IDI产生了感知的优势列表,和障碍,每个指标的方案使用的实施。这些用于形成通过会议分发给全球利益攸关方的补充指标的在线定量调查,邮件列表,和社交媒体帖子。
结果:2022年10月至11月进行了16个FGD和11个IDI。总的来说,所有提出的样本方法均被社区成员认为是可接受的.常见的主题包括不想过度的不适和对被认为是准确的测试的偏好。卫生工作者指出了社区教育对某些样本类型的重要性。在线调查于2023年4月至5月进行,其中98人开始问卷,81人完成问卷。关于实施诊断的障碍,与可行性相关的最高协议项目,而不是可接受性。根据参与者的特征,在与社区可接受性有关的响应中没有发现显着差异的证据。
结论:所包括的所有指标通常被坦桑尼亚的所有利益相关者所接受,虽然社区教育围绕不同样本类型的利益和风险,以及解决可行性问题,将是成功的关键,将这些指标可持续地整合到沙眼计划中。
BACKGROUND: Trachoma causes blindness due to repeated conjunctival infection by Chlamydia trachomatis (Ct). Transmission intensity is estimated, for programmatic decision-making, by prevalence of the clinical sign trachomatous inflammation-follicular (TF) in children aged 1-9 years. Research into complementary indicators to field-graded TF includes work on conjunctival photography, tests for ocular Ct infection, and serology. The perceived acceptability and feasibility of these indicators among a variety of stakeholders is unknown.
METHODS: Focus group discussions (FGDs) with community members and in-depth interviews (IDIs) with public health practitioners in Tanzania were conducted. FGDs explored themes including participants\' experience with, and thoughts about, different diagnostic approaches. The framework method for content analysis was used. IDIs yielded lists of perceived strengths of, and barriers to, implementation for programmatic use of each indicator. These were used to form an online quantitative survey on complementary indicators distributed to global stakeholders via meetings, mailing lists, and social media posts.
RESULTS: Sixteen FGDs and 11 IDIs were conducted in October-November 2022. In general, all proposed sample methods were deemed acceptable by community members. Common themes included not wanting undue discomfort and a preference for tests perceived as accurate. Health workers noted the importance of community education for some sample types. The online survey was conducted in April-May 2023 with 98 starting the questionnaire and 81 completing it. Regarding barriers to implementing diagnostics, the highest agreement items related to feasibility, rather than acceptability. No evidence of significant differences was found in responses pertaining to community acceptability based on participant characteristics.
CONCLUSIONS: All of the indicators included were generally deemed acceptable by all stakeholders in Tanzania, although community education around the benefits and risks of different sample types, as well as addressing issues around feasibility, will be key to successful, sustainable integration of these indicators into trachoma programs.