Brenda Heaton, Sarah R Baker
Methods to madness: The utility of complex systems science in a mad, mad world
Community dentistry and oral epidemiology
glaucoma significant cause blindness worldwide common presents earlier aggressive african descent nonadherence poor knowledge glaucoma significant barrier treatment associated low health literacy aim establish factors contributing late presentation treatment nonadherence disease progression glaucoma patients sierra leone help better understand challenges eye services face highlight fields requiring development patientclinician interaction identify areas specific vulnerable patient groups resources focused prospective consecutive recruitment 120 patients poag attending lowell ruth gess eye hospital connaught government teaching hospital freetown sierra leone february april 2020 data collected 3 sources 1 review clinical notes since first attendance 2 semistructured interviews 3 assessment study participants drop instillation technique using structured checklist descriptive statistics performed demographic data relevant data points logistic regression used analysis target variables average age 62 years males 526 agricultural workers informal street traders represented 132 participants occupation 258 participants formal school 474 either degree diploma proportion general population may represent hidden demographic glaucoma patients drop instillation technique successful 52 study participants notable responses questionnaire 30 patients know name eye condition 22 knowledge glaucoma investment wideranging robust screening programme public health campaigns targeting vulnerable groups highrisk individuals example positive family history alongside improved patient education staff training required improve glaucoma care support government international organisations private sector required reduce economic burden blindness sierra leone