RESUMO
AIM: To review the prevalence and causes of blindness in sub-Saharan Africa, the existing services and limitations, and the Vision 2020 goals for the future. METHODS: Methodologically sound population based surveys published in the past 20 years are reviewed and results for prevalence and causes of blindness are tabulated. The current resources and needs according to recent publications and international working groups are described. CONCLUSIONS: Blindness prevalence rates vary widely but the evidence suggests that approximately 1% of Africans are blind. The major cause is cataract; trachoma and glaucoma are also important causes of blindness. The bulk of blindness in the region is preventable or curable. Efforts should focus on eye problems which are universally present and for which there are cost effective remedies, such as cataract and refractive problems and on those problems which occur focally and can be prevented by primary healthcare measures, such as trachoma, onchocerciasis, and vitamin A deficiency. Major development of staffing levels, infrastructure, and community programmes will be necessary to achieve Vision 2020 goals.
Assuntos
Cegueira/epidemiologia , Avaliação das Necessidades , Infecções Oportunistas Relacionadas com a AIDS/complicações , África Subsaariana/epidemiologia , Cegueira/etiologia , Catarata/complicações , Retinopatia Diabética/complicações , Traumatismos Oculares/complicações , Feminino , Previsões , Glaucoma/complicações , Acessibilidade aos Serviços de Saúde/tendências , Humanos , Hanseníase/complicações , Masculino , Avaliação das Necessidades/tendências , Oncocercose Ocular/complicações , Aceitação pelo Paciente de Cuidados de Saúde , Vigilância da População , Prevalência , Erros de Refração/complicações , Tracoma/complicações , Deficiência de Vitamina A/complicaçõesRESUMO
The importance of health education in the prevention of deformity and changing of attitudes has been emphasised. Education implies change. This is needed in three areas, and these are: 1- Change in the content of training for staff who are to plan and carry out health educational activities. 2- This will lead to a change in the concept of health education, an improvement in the skill of staff responsible for health education, and a greater emphasis on the denvelopment of comunication skills. 3- Improved health education may involve a change in clinic organisation and planning. The time allotted for health education activities is an important factor for the clinic worker and how much time is available for each patient will depend on the case load. Some health education activities are easy and take place unobtrusively and need little planning. More important changes are more difficult, and there is a danger of taking short cuts or rapid methods not based on sufficient thought and study. It has been shown that health education works if it is sufficiently adapted to the problem, to the people, and the circumstances in which they live(8). What we do not yet know is how to describe these crucial adaptations