Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?

 

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dc.contributor.author Andriamanjato, Hery en_ZA
dc.contributor.author Mathenge, Wanjiku en_ZA
dc.contributor.author Kalua, Khumbo en_ZA
dc.contributor.author Courtright, Paul en_ZA
dc.contributor.author Lewallen, Susan en_ZA
dc.date.accessioned 2015-11-04T11:50:25Z
dc.date.available 2015-11-04T11:50:25Z
dc.date.issued 2014 en_ZA
dc.identifier.citation Andriamanjato, H. H., Mathenge, W., Kalua, K., Courtright, P., & Lewallen, S. (2014). Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel. Human resources for health, 12(Suppl 1), S3. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14671
dc.identifier.uri http://dx.doi.org/10.1186/1478-4491-12-S1-S3
dc.description.abstract BACKGROUND:The inclusion of primary eye care (PEC) in the scope of services provided by general primary health care (PHC) workers is a 'task shifting' strategy to help increase access to eye care in Africa. PEC training, in theory, teaches PHC workers to recognize specific symptoms and signs and to treat or refer according to these. We tested the sensitivity of these symptoms and signs at identifying significant eye pathology. METHODS: Specialized eye care personnel in three African countries evaluated specific symptoms and signs, using a torch alone, in patients who presented to eye clinics. Following this, they conducted a more thorough examination necessary to make a definite diagnosis and manage the patient. The sensitivities and specificities of the symptoms and signs for identifying eyes with conditions requiring referral or threatening sight were calculated. RESULTS: Sensitivities of individual symptoms and signs to detect sight threatening pathology ranged from 6.0% to 55.1%; specificities ranged from 8.6 to 98.9. Using a combination of symptoms or signs increased the sensitivity to 80.8 but specificity was 53.2. CONCLUSIONS: In this study, the sensitivity and specificity of commonly used symptoms and signs were too low to be useful in guiding PHC workers to accurately identify and refer patients with eye complaints. This raises the question of whether this task shifting strategy is likely to contribute to reducing visual loss or to providing an acceptable quality service. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source Human Resources for Health en_ZA
dc.source.uri http://www.human-resources-health.com/ en_ZA
dc.subject.other Ophthalmology en_ZA
dc.subject.other Primary Eye Care en_ZA
dc.title Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel? en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2014 Andriamanjato et al; licensee BioMed Central Ltd en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Ophthalmology en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Andriamanjato, H., Mathenge, W., Kalua, K., Courtright, P., & Lewallen, S. (2014). Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?. <i>Human Resources for Health</i>, http://hdl.handle.net/11427/14671 en_ZA
dc.identifier.chicagocitation Andriamanjato, Hery, Wanjiku Mathenge, Khumbo Kalua, Paul Courtright, and Susan Lewallen "Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?." <i>Human Resources for Health</i> (2014) http://hdl.handle.net/11427/14671 en_ZA
dc.identifier.vancouvercitation Andriamanjato H, Mathenge W, Kalua K, Courtright P, Lewallen S. Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel?. Human Resources for Health. 2014; http://hdl.handle.net/11427/14671. en_ZA
dc.identifier.ris TY - Journal Article AU - Andriamanjato, Hery AU - Mathenge, Wanjiku AU - Kalua, Khumbo AU - Courtright, Paul AU - Lewallen, Susan AB - BACKGROUND:The inclusion of primary eye care (PEC) in the scope of services provided by general primary health care (PHC) workers is a 'task shifting' strategy to help increase access to eye care in Africa. PEC training, in theory, teaches PHC workers to recognize specific symptoms and signs and to treat or refer according to these. We tested the sensitivity of these symptoms and signs at identifying significant eye pathology. METHODS: Specialized eye care personnel in three African countries evaluated specific symptoms and signs, using a torch alone, in patients who presented to eye clinics. Following this, they conducted a more thorough examination necessary to make a definite diagnosis and manage the patient. The sensitivities and specificities of the symptoms and signs for identifying eyes with conditions requiring referral or threatening sight were calculated. RESULTS: Sensitivities of individual symptoms and signs to detect sight threatening pathology ranged from 6.0% to 55.1%; specificities ranged from 8.6 to 98.9. Using a combination of symptoms or signs increased the sensitivity to 80.8 but specificity was 53.2. CONCLUSIONS: In this study, the sensitivity and specificity of commonly used symptoms and signs were too low to be useful in guiding PHC workers to accurately identify and refer patients with eye complaints. This raises the question of whether this task shifting strategy is likely to contribute to reducing visual loss or to providing an acceptable quality service. DA - 2014 DB - OpenUCT DO - 10.1186/1478-4491-12-S1-S3 DP - University of Cape Town J1 - Human Resources for Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel? TI - Task shifting in primary eye care: how sensitive and specific are common signs and symptoms to predict conditions requiring referral to specialist eye personnel? UR - http://hdl.handle.net/11427/14671 ER - en_ZA


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This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License