Acceptability and perceived utility of different diagnostic tests and sample types for trachoma surveillance in the Bijagos Islands, Guinea Bissau

Abstract

Background Trachoma is the leading infectious cause of blindness worldwide and is nearing elimination as a public health problem in Guinea Bissau. It is imperative that elimination is followed by a successful postvalidation surveillance programme. The aim of this study was to determine the acceptability and perceived utility of different diagnostic tests and sample types that could be used for postvalidation trachoma surveillance in the Bijagos Islands, Guinea Bissau. Methods Semistructured interviews with community members and stakeholders involved in trachoma elimination were followed by focus group discussions with community members, covering experiences with trachoma and views on trachoma diagnostic methods and sample types. Results In this setting, all diagnostic tests and sample types used for trachoma surveillance were generally considered acceptable by communities. A preference for laboratory-based testing and finger-prick blood samples was expressed as these results were considered more accurate and applicable to a range of diseases beyond trachoma. Conclusions Appropriate community and stakeholder engagement and communication regarding the purpose and processes around diagnostic practice prior to trachoma programme implementation are crucial for long-term successful disease-elimination efforts.

Soil-transmitted helminth surveillance in Benin: A mixed-methods analysis of factors influencing non-participation in longitudinal surveillance activities

“…In contrast, refusal to provide a sample was largely driven by mistrust of the sample's purpose and fear about misuse or physical harm to the individual. These results parallel findings from other settings that tie decisions to participate in STH programs, willingness to provide a stool sample for diagnostic purposes, and consent to NTD surveillance activities to an understanding of the importance of the research, fears of how the samples might be misused, and perceived benefits [15][16][17]19]. Similarly, studies examining participation in MDA have found that trust in the program, rumors about harmful consequences, and perceptions of benefits drive acceptability of treatment [29][30][31][32].…”

“…Evidence from clinical settings in higher income countries indicate that providing stool samples is driven by perceived benefits, clear information about the process, and protocols that assuage fears around hygiene and discretion [ 17 ]. Studies of other NTD surveillance activities, including those for onchocerciasis and trachoma, indicate that less invasive sampling procedures are preferable and decisions are similarly driven by perceived benefits, and trust and understanding of the program [ 18 , 19 ]. However the specific factors influencing participation in STH stool-based surveillance activities are not fully understood.…”

Accuracy, acceptability and feasibility of photography for use in trachoma surveys: a mixed methods study in Tanzania

“…The community FGD participants highlighted the importance of pre-visit sensitisation, as well as feedback immediately post-examination, in order to improve participation in trachoma grading activities. The importance of good communication with communities has been noted by others 30 —if interventions are being implemented with and by communities, rather than to them, they are much more likely to be successful.…”

Acceptability and feasibility of tests for infection, serological testing, and photography to define need for interventions against trachoma

“…A study in the Bijagós Islands, Guinea Bissau on different diagnostic tests and sample types for trachoma surveillance (including clinical exams, eye swabs, and finger-prick blood samples) reported that although all the studied test types were generally acceptable, there was a preference among community members for laboratory-based testing; these results were considered more accurate than clinical examination. [ 26 ] Additionally, sample types that did not require close proximity to the eye (i.e., finger-prick blood samples) were preferred. [ 26 ] Our study had similar results, with participants noting a perception of improved accuracy from laboratory-based methods, although expressing some unease with the eye swab and blood spot procedures, especially with regards to children.…”

“…[ 26 ] Additionally, sample types that did not require close proximity to the eye (i.e., finger-prick blood samples) were preferred. [ 26 ] Our study had similar results, with participants noting a perception of improved accuracy from laboratory-based methods, although expressing some unease with the eye swab and blood spot procedures, especially with regards to children. This similarity in findings is reassuring given the different locations and population types, indicating some generalizability of the results.…”