Pediatric Case Finding in Madagascar: A Controlled, Prospective Population-based Assessment of Key Informant Productivity and Cost

摘要

Purpose: The Key Informant (Kl) case finding method, which trains community members to screen children for eye problems and refer them to eye services, is a common strategy to identify and refer children with blindness and visual impairment. However, studies to date have not determined the benefit and cost of adding KIs to routine outreach activities. Methods: Four eye programs in Madagascar with established outreach camps added KIs to a portion of their camps distributed equally throughout their service region over a one year period. KIs recorded children screened and their attendance at an outreach camp. Outreach personnel used standardized registration forms to gather age, sex, visual acuity, diagnosis and treatment data. Costs were gathered for the Kl program and outreach camps. Results: In one year, the 4 eye programs held 138 outreach camps, 43 with KIs. The Kl camps were more productive than regular camps seeing an average of 61 and 24 children and 50 and 19 children with an eye problem, for Kl and regular camps, respectively. The Kl camps also saw more children with moderate or severe visual impairment or blindness with 21 and 8 children (per 10 camps) for Kl and regular camps, respectively. A Kl camp cost $463 ($642 vs. $179) more than a regular camp and $3 ($8 vs. $11) more per child seen. Conclusion: The Kl method significantly increased the number of children attending outreach camps, at all levels of visual impairment and blindness, at a modest increase in costs.