Community Health Workers for Prevention of Corneal Ulcers in South India: A Cluster-Randomized Trial.
Community Health Workers for Prevention of Corneal Ulcers in South India: A Cluster-Randomized Trial.
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DOI：
10.1016/j.ajo.2021.12.010
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发表时间：
2022-05
影响因子：
4.2
通讯作者：
Keenan, Jeremy D.
中科院分区：
文献类型：
--
作者：
Srinivasan, Muthiah;Ravilla, Thulasiraj;Vijayakumar, Valaguru;Yesunesan, Devanesam;Mani, Iswarya;Whitcher, John P.;Oldenburg, Catherine E.;O'brien, Kieran S.;Lietman, Thomas M.;Keenan, Jeremy D.
确定社区卫生工作者（CHW）计划是否增加了向当地眼科护理提供者的转诊，并最终降低了角膜溃疡的发病率。2014年至2017年在印度南部农村进行的随机试验。以社区为基础。42个南印度农村社区的所有居民。CHW接受了诊断角膜擦伤的培训，并协助参与者在当地视力中心寻求护理。鉴于干预的性质，试验未设盲。偶发性角膜溃疡，定义为活动性浸润或新发混浊证据，在年度挨家挨户普查期间通过笔式检查进行评估。21个研究群组被随机分配到CHW干预组，21个群组被随机分配到无干预组。在为期两年的研究中，视力中心诊断出195例角膜擦伤（发生率：223/100，000人-年，95%CI 28- 1，743），62例来自对照组（发生率：62/100，000人-年，95%CI 8-496）;发病率比[IRR]=3.57，95%CI 2.01-6.35; P<0.001。研究期间，干预组角膜溃疡的估计发病率为60/100，000人-年（95%CI 25 - 141），对照组为32/100，000人-年（95%CI 13 - 80）（IRR 1.86，95%CI 0.5 - 6.4; P=0.32）。CHW项目导致因角膜擦伤而转诊至当地眼科护理提供者的人数增加了3.5倍，但在角膜溃疡的发生率方面没有发现差异。CHW计划提供了一种机制，增加转诊到眼科医院。clinicaltrials.gov：NCT02284698。
To determine whether a community health worker (CHW) program increases referrals to local eye care providers and ultimately reduces the incidence of corneal ulcers. Cluster-randomized trial performed from 2014-2017 in rural South India. Community-based. All inhabitants of 42 rural South Indian communities. CHWs were trained to diagnose corneal abrasions and assist participants in seeking care at a local vision center. The trial was not masked given the nature of the intervention. Incident corneal ulcer, defined as an active infiltrate or evidence of a new opacity, assessed by penlight examination during an annual door-to-door census. 21 study clusters were randomized to the CHW intervention and 21 to no intervention. Vision centers diagnosed 195 corneal abrasions from the intervention clusters over the two-year study (rate: 223 per 100,000 person-years, 95%CI 28-1,743) and 62 from the control clusters (rate: 62 per 100,000 person-years, 95%CI 8-496); incidence rate ratio [IRR]=3.57, 95%CI 2.01-6.35; P<0.001. The estimated incidence of corneal ulceration over the study period was 60 per 100,000 person-years (95%CI 25 to 141) in the intervention group and 32 per 100,000 person-years (95%CI 13 to 80) in the control group (IRR 1.86, 95%CI 0.5 to 6.4; P=0.32). A CHW program resulted in 3.5 times more referrals to local eye care providers for corneal abrasions, but no difference could be detected in the incidence of corneal ulceration. CHW programs provide a mechanism for increasing referrals to eye hospitals. clinicaltrials.gov: NCT02284698.
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DOI：
10.1136/bjo.2009.169607
发表时间：
2011-06
期刊：
The British journal of ophthalmology
影响因子：
--
作者：
Shah A;Sachdev A;Coggon D;Hossain P
通讯作者：
Hossain P
影响因子：
3.3
作者：
Bhandari, Sadhan;Nesemann, John M.;Keenan, Jeremy D.
通讯作者：
Keenan, Jeremy D.
影响因子：
4.1
作者：
Maung, N.;Thant, C. C.;Whitcher, J. P.
通讯作者：
Whitcher, J. P.
影响因子：
13.7
作者：
Shekhawat NS;Niziol LM;Sharma SS;Joseph S;Robin AL;Gillespie BW;Musch DC;Woodward MA;Venkatesh R
通讯作者：
Venkatesh R
DOI：
10.2147/opth.s266218
发表时间：
2020
期刊：
Clinical ophthalmology (Auckland, N.Z.)
影响因子：
--
作者：
Bajracharya L;Bade AR;Gurung R;Dhakhwa K
通讯作者：
Dhakhwa K