Assessing Access to and Utilization of the Advanced Diagnostic and Management Equipment for Early Keratoconus in Public and Private Healthcare Facilities Across Nyanza and Western Kenya.
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Abstract
Purpose: To evaluate the availability and utilization of the advanced equipment for the diagnosis and management of early keratoconus in the public and private healthcare facilities in Nyanza and Western Kenya.
Methods: A cross-sectional study design was applied. An online questionnaire was sent to the eyecare practitioners. Data on socio-demographics, equipment availability, and utilization for early keratoconus diagnosis and management were obtained and analyzed using SPSS V 29.
Results: A total of 134 eyecare practitioners (out of 143), with the majority 80 (59.7%) being males, responded to the questionnaire. The study found that advanced equipment were scarcely available, such as Tomographer 14 (10.4%), Topographer 17 (12.7%) and Pachymeter 21 (15.7%) as compared to basic equipment: distance VA chart 134 (100%), trial lens/phoropter 129 (96.3%), retinoscope 128 (95.5%) and slit-lamp 111 (82.8%), with level 6 having the highest availability. Additionally, the available advanced equipment had working conditions far below standards and below standards: topographer 6 (35.2%) and contact lens fitting set 12 (46.1%). The utilization rates of the advanced equipment were low as follows: contact lens fitting set 8 (31.0%), pachymeter 11 (52.4%) and topographer 9 (52.9%). A chi-square test found a significant association between equipment availability and their utilization, VA chart (p=0.03333), trial lens/phoropter (p=0.00292), slit-lamp (p=0.00283) and keratometer (p=0.00001).
Conclusion: The study revealed a lack of advanced diagnostic equipment, with some existing tools falling below standard and underutilized. It recommends that healthcare institutions prioritize the acquisition and maintenance of essential equipment. Additionally, the Ministry of Health should collaborate with stakeholders to incorporate early keratoconus detection into national eyecare guidelines.
期刊介绍：
Clinical Optometry is an international, peer-reviewed, open access journal focusing on clinical optometry. All aspects of patient care are addressed within the journal as well as the practice of optometry including economic and business analyses. Basic and clinical research papers are published that cover all aspects of optics, refraction and its application to the theory and practice of optometry. Specific topics covered in the journal include: Theoretical and applied optics, Delivery of patient care in optometry practice, Refraction and correction of errors, Screening and preventative aspects of eye disease, Extended clinical roles for optometrists including shared care and provision of medications, Teaching and training optometrists, International aspects of optometry, Business practice, Patient adherence, quality of life, satisfaction, Health economic evaluations.
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