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.authorAndriamanjato, Heryen_ZA
dc.contributor.authorMathenge, Wanjikuen_ZA
dc.contributor.authorKalua, Khumboen_ZA
dc.contributor.authorCourtright, Paulen_ZA
dc.contributor.authorLewallen, Susanen_ZA
dc.date.accessioned2015-11-04T11:50:25Z
dc.date.available2015-11-04T11:50:25Z
dc.date.issued2014en_ZA
dc.description.abstractBACKGROUND: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.identifier.apacitationAndriamanjato, 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/11427/14671en_ZA
dc.identifier.chicagocitationAndriamanjato, 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/11427/14671en_ZA
dc.identifier.citationAndriamanjato, 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.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
dc.identifier.urihttp://hdl.handle.net/11427/14671
dc.identifier.urihttp://dx.doi.org/10.1186/1478-4491-12-S1-S3
dc.identifier.vancouvercitationAndriamanjato 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.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDivision of Ophthalmologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2014 Andriamanjato et al; licensee BioMed Central Ltden_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourceHuman Resources for Healthen_ZA
dc.source.urihttp://www.human-resources-health.com/en_ZA
dc.subject.otherOphthalmologyen_ZA
dc.subject.otherPrimary Eye Careen_ZA
dc.titleTask 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.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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