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1.
Arq. bras. oftalmol ; 82(2): 91-97, Mar.-Apr. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-989394

RESUMO

ABSTRACT - Purpose: To estimate the prevalence of blindness and visual impairment in older adults living in Guatemala. Methods: Participants ³50 years of age were selected using random cluster sampling and evaluated using the Rapid Assessment of Avoidable Blindness method. Visual acuity was measured, and the lens was examined. If presenting visual acuity was <20/60, it was also tested with a pinhole and fundoscopy was performed. Blindness and visual impairment were classified as moderate visual impairment (presenting visual acuity <20/60 to 20/200), severe visual impairment (presenting visual acuity <20/200 to 20/400), or blindness (presenting visual acuity <20/400). The primary cause of blindness or visual impairment in each eye was determined, and if the cause was cataracts, the barriers to treatment were assessed. Results: The study included 3,850 people ³50 years of age, of whom 3,760 (97.7%) were examined. The age- and sex-adjusted prevalence of blindness was 2.9% (95% confidence interval, 2.0%-3.8%), while 5.2% (4.0%-6.4%) presented with severe visual impairment, and 27.6% (23.3%-32.0%) presented with moderate visual impairment. Cataracts were the leading cause of blindness (77.6%), followed by other posterior segment diseases (6.0%). Cataracts caused 79.4% of cases of severe visual impairment, while uncorrected refractive errors caused 67.9% of cases of moderate visual impairment. Following cataract surgery, 75% of participants had a presenting visual acuity of 20/200 or better, and in 19.0% of participants, visual acuity was not better than 20/200 with correction. Cost was the main barrier to cataract surgery (56.7%). Conclusions: The prevalence of blindness in older adults is higher in Guatemala than in most Central American countries. Most cases of blindness and visual impairment were either preventable or treatable. Increased availability of affordable, high-quality cataract treatment would have a substantial impact on blindness prevention.


RESUMO - Objetivo: Estimar a prevalência de cegueira e de­fi­ciência visual em idosos que vivem na Guatemala. Métodos: Indivíduos com idade ³50 anos foram selecionados por amos­tragem aleatória por conglomerados, e os participantes do estudo foram avaliados pelo método de Avaliação Rápida da Cegueira Evitável. A acuidade visual foi medida e o cristalino foi examinado. Se a acuidade visual apresentada fosse <20/60, então também foi testada com um buraco estenopeico e a fundoscopia realizada. A cegueira e a deficiência visual foram classificadas como deficiência visual moderada com acuidade visual <20/60-20/200; deficiência visual grave com acuidade visual <20/200-20/400; ou cegueira com acuidade visual <20/400. A principal causa de cegueira ou deficiência visual em cada olho foi determinada, e naqueles com catarata, as barreiras ao tratamento foram avaliadas. Resultados: O estudo incluiu 3.850 pessoas com ³50 anos de idade; 3.760 (97,7%) foram examinadas. A prevalência de cegueira ajustada à idade e ao sexo foi de 2,9% (intervalo de confiança de 95%, 2,0-3,8%), 5,2% (4,0-6,4%) deficiência visual grave e 27,6% (23,3-32,0%) deficiência visual moderada. A catarata foi a principal de cegueira (77,6%), seguida de outras doenças do segmento posterior (6,0%). Catarata causada por 79,4% de deficiência visual grave, enquanto erros refrativos não corrigidos causaram 67,9% de deficiência visual moderada. Após a cirurgia de catarata, 75% dos participantes tiveram uma acuidade de 20/200, ou melhor, e 19,0% a deficiência visual não foi melhor do que 20/200 com a correção. O custo foi a principal barreira à cirurgia de catarata (56.7%). Conclusões: A prevalência de cegueira em idosos é maior na Guatemala do que na maioria dos outros países da América Central. A maioria dos casos de cegueira e deficiência visual era evitável ou tratável. O aumento da disponibilidade de tratamento de catarata a preços acessíveis e de alta qualidade teria um impacto substancial na prevenção da cegueira.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transtornos da Visão/epidemiologia , Extração de Catarata/estatística & dados numéricos , Cegueira/epidemiologia , Transtornos da Visão/etiologia , Índice de Gravidade de Doença , Acuidade Visual , Cegueira/etiologia , Prevalência , Distribuição por Sexo , Guatemala/epidemiologia
2.
Arq Bras Oftalmol ; 82(2): 91-97, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30726408

RESUMO

PURPOSE: To estimate the prevalence of blindness and visual impairment in older adults living in Guatemala. METHODS: Participants ³50 years of age were selected using random cluster sampling and evaluated using the Rapid Assessment of Avoidable Blindness method. Visual acuity was measured, and the lens was examined. If presenting visual acuity was <20/60, it was also tested with a pinhole and fundoscopy was performed. Blindness and visual impairment were classified as moderate visual impairment (presenting visual acuity <20/60 to 20/200), severe visual impairment (presenting visual acuity <20/200 to 20/400), or blindness (presenting visual acuity <20/400). The primary cause of blindness or visual impairment in each eye was determined, and if the cause was cataracts, the barriers to treatment were assessed. RESULTS: The study included 3,850 people ³50 years of age, of whom 3,760 (97.7%) were examined. The age- and sex-adjusted prevalence of blindness was 2.9% (95% confidence interval, 2.0%-3.8%), while 5.2% (4.0%-6.4%) presented with severe visual impairment, and 27.6% (23.3%-32.0%) presented with moderate visual impairment. Cataracts were the leading cause of blindness (77.6%), followed by other posterior segment diseases (6.0%). Cataracts caused 79.4% of cases of severe visual impairment, while uncorrected refractive errors caused 67.9% of cases of moderate visual impairment. Following cataract surgery, 75% of participants had a presenting visual acuity of 20/200 or better, and in 19.0% of participants, visual acuity was not better than 20/200 with correction. Cost was the main barrier to cataract surgery (56.7%). CONCLUSIONS: The prevalence of blindness in older adults is higher in Guatemala than in most Central American countries. Most cases of blindness and visual impairment were either preventable or treatable. Increased availability of affordable, high-quality cataract treatment would have a substantial impact on blindness prevention.


Assuntos
Cegueira/epidemiologia , Extração de Catarata/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Cegueira/etiologia , Feminino , Guatemala/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença , Distribuição por Sexo , Transtornos da Visão/etiologia , Acuidade Visual
3.
Rev. Col. Méd. Cir. Guatem ; 156(2): 67-70, nov. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-986776

RESUMO

PROPÓSITO: Explorar los factores que influyen en la aplicación de la interculturalidad con respecto a la atención del parto y puerperio inmediato en personal médico y paramédico, comadronas y usuarias del Centro de Urgencias Médicas (CUM) de Tecpán, Chimaltenango, abril-mayo 2017. MATERIAL Y MÉTODOS: Estudio cualitativo con diseño etnográfico. Se realizaron entrevistas en profundidad al personal de salud y usuarias del CUM y grupos focales con comadronas. Se evaluó la infraestructura de las salas de parto y posparto. RESULTADOS: En el personal médico y paramédico se evidenciaron saberes limitados acerca de la pertinencia cultural, descrita en las Normas de Atención con Pertinencia Cultural. Se contó con el 65% de los elementos de infraestructura y equipo de la sala de partos culturalmente adecuada. Las comadronas percibieron una atención deficiente y refirieron poco interés y capacitación del personal del servicio de salud. Las usuarias opinaron que existe una buena relación con el personal de salud, sin embargo no se les brindó una atención con adecuación cultural. CONCLUSIONES: Los factores que influyen en la implementación de las prácticas interculturales son de índole económica principalmente, además de aspectos estructurales, organizaciones y socioculturales.


PURPOSE: To explore the factors that influence the implementation of interculturality in regards to care during childbirth and the immediate postpartum period, in medical and paramedical staff, traditional midwives and patients of the Center of Medical Urgencies (CUM), Tecpán, Chimaltenango, April-May 2017. MATERIALS AND METHODS: Qualitative study with an ethnographic design. In-depth interviews with medical staff and patients of the CUM were carried out in addition to focal groups with traditional midwives. The infrastructure of the birthing room and postpartum ward were evaluated. RESULTS: CONCLUSIONS: The medical and paramedical staff showed limited awareness of cultural pertinence, as described in the Norms of Attention with Cultural Pertinence. The birthing room satisfies 65% of the criteria of infrastructure and equipment of a culturally pertinent birthing room. The traditional midwives perceived deficient patient care and identified a lack of interest and training of the health staff. The patients experienced a good relationship with the health staff, but declared a lack of cultural adequacy in the attention. The factors that influence in the implementation of intercultural practices are principally of economic nature, in addition to structural, organizational and sociocultural aspects.


Assuntos
Humanos , Feminino , Parto/etnologia , Período Pós-Parto/etnologia , Atenção à Saúde , Competência Cultural/educação , Tocologia/educação , Estudos de Avaliação como Assunto/etnologia , Guatemala/etnologia
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