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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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Year : 2020  |  Volume : 27  |  Issue : 1  |  Page : 14-21

Pilot audit of trichiasis surgery outcomes using a mobile app in the Republic of Chad

1 National Program to Prevent Blindness, N'Djamena, Chad
2 Faculty of Medicine of N'Djamena; Department of Ophtalmology, National Referral Hospital, N'Djamena, Chad
3 Faculty of Medicine of Abéché, Abéché, Chad
4 Organization for the Prevention of Blindness, Paris, France
5 Organization for the Prevention of Blindness, N'Djamena, Chad

Correspondence Address:
Mr. Doniphan Hiron
17, Villa d'Alesia 75014, Organization for the Prevention of Blindness, Paris
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/meajo.MEAJO_75_19

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PURPOSE: The purpose of the study was to assess the feasibility of a mobile data collection app for use in trichiasis surgical audits in the Melfi and Mangalme districts of the Guera region of the Republic of Chad and to perform a cost analysis to determine if the auditing mechanism could be implemented nationally. MATERIALS AND METHODS: Patients who underwent trichiasis surgery 6 months prior and who had follow-up 7–14 days after surgery were included in the study. Each surgeon had a sample of 20% of operated eyelids; nine surgeons with data for ≥20 eyelids were included. A trichiasis recurrence rate of ≥25% suggested that the surgeon needed retraining. Smartphones captured data using the data collection app, which transmitted data to an online server. Direct costs and supervision costs were collated and summed. RESULTS: There were 916 eyelids operated on; 170 patients (269 eyelids, 29% follow-up rate) participated in the audit. Twenty participants (11.8%) had recurrence. The mean recurrence rate among surgeons was 8.3% (standard deviation: 0.07%; range: 0%–17.9%). None had a recurrence rate of ≥25%; thus, no retraining was necessary. The total cost of the audit was US$15,111.25 ($12,882.28 in direct costs and $2,228.97 in supervision costs). CONCLUSIONS: The simple, easy-to-use, and low-cost mobile auditing mechanism is a practical solution for conducting surgical audits in remote and resource-limited settings and is undergoing national scale-up by the Chadian trachoma elimination program.

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