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1.
PLoS One ; 15(2): e0229008, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053650

RESUMO

PURPOSE: This study has two main objectives: 1) to assess the value of combining the rapid assessment of avoidable blindness (RAAB) and the recently developed rapid assessment of hearing loss (RAHL) based on existing population-based data from Cameroon andIndia; 2) to test the feasibility of a combined RAAB-RAHL protocol. METHODS: A secondary data analysis of population-based disability surveys in India and Cameroon (in 2013-2014) was conducted, focussing on people aged 50+. Hearing impairment (HI) was defined as pure tone average of ≥41dB (better ear).Visual impairment (VI) was defined as presenting visual acuity of <6/18 (better eye). The relationship between HI and VI was examined. The feasibility of a combined RAAB-RAHL survey was assessed within a RAHL conducted among adults aged 50+ in Malawi in 2018. Outcomes included: time taken, costs, number of people examined in a day, and qualitative feedback from participants and field teams. RESULTS: The prevalence of combined VI and HI among people aged 50+ was 4.4% (95% confidence interval (CI) 3.0, 6.4) in India and 4.8% (95%CI 3.0, 8.0) in Cameroon. Among participants with VI, approximately a third in India (29.3%) and Cameroon (35.1%) also had HI. A quarter of participants in India (25.4%) and Cameroon (26.9%) who had HI also had VI. In Malawi, the total time taken to complete both RAAB and RAHL assessments was approximately 27 minutes per participant. It was feasible to complete 30 participants per day for a team of four people. The estimated cost of a combined RAAB-RAHL approach in comparison to two separate impairment surveys is up to 37% less depending on the method of combination. CONCLUSION: The substantial overlap between VI and HI supports a combined rapid survey of the two impairments. The pilot study of a combined RAAB-RAHL survey demonstrates feasibility and lower cost compared to conducting two standalone impairment surveys. A combined RAAB-RAHL approach could maximize limited resources to increase prevalence data for both vision and hearing impairment.


Assuntos
Cegueira/epidemiologia , Perda Auditiva/epidemiologia , Camarões/epidemiologia , Estudos de Viabilidade , Humanos , Índia/epidemiologia , Malaui/epidemiologia , Projetos Piloto , Prevalência , Inquéritos e Questionários
2.
Curr Opin Ophthalmol ; 31(2): 81-84, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31904597

RESUMO

PURPOSE OF REVIEW: To describe the VISION 2020: The Right to Sight, global initiative for the elimination of avoidable blindness, the contribution of glaucoma to the magnitude of global blindness and priorities going forward. RECENT FINDINGS: Although the target of the World Health Organization's Global Action Plan (2014-2019) has not been met in terms of 25% reduction in avoidable blindness, there is evidence that the contribution of glaucoma to blindness and vision impairment is reducing. Yet this focus on a threshold of visual acuity by which to measure prevalence underestimates the true burden of glaucoma. Recent population-based studies demonstrate the scale of the unmet need. SUMMARY: Scaling up of integrated people-centered eye care, by embedding glaucoma detection and care pathways in health systems with a strong focus on primary healthcare, is necessary. Solutions include reinforcing existing pathways while emphasizing high-quality glaucoma care, in addition to novel solutions such as self-testing, digital portable technology, artificial intelligence, and multilevel care pathways that extend to the most underserved parts of the global community.


Assuntos
Cegueira/prevenção & controle , Oftalmopatias/prevenção & controle , Visão Ocular/fisiologia , Cegueira/epidemiologia , Oftalmopatias/epidemiologia , Saúde Global , Humanos , Agências Internacionais , Prevalência , Acuidade Visual
3.
Artigo em Inglês | MEDLINE | ID: mdl-31842249

RESUMO

Type 2 diabetes mellitus (T2DM) poses significant challenges to individuals and broader society, much of which is borne by disadvantaged and marginalised population groups including Indigenous people. The increasing prevalence of T2DM among Indigenous people has meant that rates of diabetes-related complications such as blindness from end-stage diabetic retinopathy (DR) continue to be important health concerns. Australia, a high-income and resource-rich country, continues to struggle to adequately respond to the health needs of its Indigenous people living with T2DM. Trends among Indigenous Australians highlight that the prevalence of DR has almost doubled over two decades, and the prevalence of diabetes-related vision impairment is consistently reported to be higher among Indigenous Australians (5.2%-26.5%) compared to non-Indigenous Australians (1.7%). While Australia has collated reliable estimates of the eye health burden owing to T2DM in its Indigenous population, there is fragmentation of existing data and limited knowledge on the underlying risk factors. Taking a systems approach that investigates the social, environmental, clinical, biological and genetic risk factors, and-importantly-integrates these data, may give valuable insights into the most important determinants contributing to the development of diabetes-related blindness. This knowledge is a crucial initial step to reducing the human and societal impacts of blindness on Indigenous Australians, other priority populations and society at large.


Assuntos
Cegueira/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Retinopatia Diabética/epidemiologia , Grupo com Ancestrais Oceânicos , Austrália/epidemiologia , Cegueira/etnologia , Diabetes Mellitus Tipo 2/etnologia , Retinopatia Diabética/etnologia , Equidade em Saúde , Humanos , Prevalência , Fatores de Risco
4.
Rom J Ophthalmol ; 63(3): 245-248, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687626

RESUMO

Objective. The objective of this study was to determine the prevalence of visual impairment and blindness among students in 13 schools in coastal Karnataka and to determine the most common causes for the same. Materials and Methods. This was a prospective cross-sectional study. A total of 833 students from 13 different schools were screened as a part of the school screening programme. The examiners were an ophthalmologist and an ophthalmic assistant. For all the students, visual acuity (VA) was measured with a Snellen chart, color vision was done using an Ishiaras chart, fundus examination was done using a direct ophthalmoscope, while students with subnormal vision (VA ≤ 6/ 9) were examined using pinhole, and referred for detailed eye examination and clinical refraction. Results. The age range was from 6 to 16 years comprising 390 males and 443 females. Refractive error in either eye was present in 69 of these students of which myopic astigmatism was the commonest type. This was followed by allergic conjunctivitis 15 cases, amblyopia 3, squint 2, lids and adnexal disorders in 2 students; defective color vision was seen in 8 students, all of whom were males. Spectacle usage was found to be present only in 11 students, who showed lack of awareness concerning eye care and possibly the lack of access to health care. There were no students with retinal or posterior segment disorders. Conclusions. Uncorrected refractive error is the most common visual impairment found in schools students in coastal Karnataka and there is a need for the establishment of a regular school vision-screening program to detect such problems in order to prevent the burden on society due to the long life span ahead.


Assuntos
Cegueira/epidemiologia , População Rural , Instituições Acadêmicas , População Urbana , Seleção Visual/métodos , Baixa Visão/epidemiologia , Acuidade Visual , Adolescente , Cegueira/diagnóstico , Criança , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Prevalência , Estudos Prospectivos , Baixa Visão/diagnóstico
5.
Saudi Med J ; 40(10): 1063-1066, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31588488

RESUMO

OBJECTIVES: To describe causes of blindness and visual impairment (VI) in children in Eastern province, Saudi Arabia. Methods: A record-based descriptive cross-sectional study was conducted. Medical records of patients aged 2 to 16 years who were following up in the Pediatric Ophthalmology Clinics, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia between September and December 2018 were reviewed. Causes of vision loss according to visual acuity (VA) with best correction were recorded. Blindness was defined as VA less than 20/400, VI as VA from 20/400 to 20/60, and visual loss as VA of ≤20/60. RESULTS: Of 818 patients, 39% had visual loss, 22.9% were blind, and 71.2% had VI. Common etiologies of bilateral blindness were retinal dystrophy disease and Leber's congenital amaurosis, whereas unilateral blindness was most common due to trauma and refractive error (RE). Common etiologies of bilateral VI were RE, esotropia, and retinal dystrophy. Unilateral VI was mainly due to RE, cataract, congenital esotropia, and trauma. Of all patients, 58.8% had treatable causes, 22.6% had preventable causes, and 19.5% had non-preventable and non-treatable causes; mostly genetic or congenital (59.7%) rather than acquired (40.2%). CONCLUSION: Genetic or congenital causes are major factors causing blindness. Most causes are treatable and preventable, emphasizing on early detection and treatment of those causes.


Assuntos
Cegueira/etiologia , Adolescente , Fatores Etários , Cegueira/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Traumatismos Oculares/complicações , Traumatismos Oculares/epidemiologia , Feminino , Humanos , Masculino , Distrofias Retinianas/epidemiologia , Distrofias Retinianas/etiologia , Arábia Saudita/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia
6.
Middle East Afr J Ophthalmol ; 26(2): 101-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31543668

RESUMO

BACKGROUND: This study was undertaken to ascertain the current magnitude and causes of blindness and visual impairment in persons aged 50 years and over and to assess the impact of a 10-year eye care program in Sokoto State, Nigeria. METHODS: A rapid assessment of avoidable blindness (RAAB) survey (in persons 50 years and over) was conducted in 2016. Participants were selected in Wurno health zone using a two-stage cluster randomized sampling with probability proportional to size. Operational definitions were based on RAAB and World Health Organization eye examination record definitions. Eye care program documents were reviewed and data from a baseline survey undertaken in 2005 were reanalyzed. RESULTS: A response of 89.1% (2405 of 2700 participants) was obtained in the 2016 survey. With available correction, the unadjusted prevalence of blindness was 7.7% (95% confidence interval [CI]: 6.4, 8.9). The odds of blindness were 1.8 times higher in females than males (95% CI: 1.3, 2.4; P < 0.001). Major causes of blindness were cataract (48.9%) corneal disease (20.1%), glaucoma (10.3%), and uncorrected refractive error/aphakia (8.7%). The age- and sex-adjusted prevalence of blindness has declined from 11.6% (95% CI: 7.4, 17.0) in 2005 to 6.8% (95% CI: 5.6, 8.0%) in 2016. CONCLUSION: The blindness prevalence is high, and the major causes are avoidable in the health zone. The findings suggest that investments in the program over the last 10 years might have led to almost a halving in the prevalence of blindness in th e population. However, the small sample size of persons 50+ years from Wurno zone in the 2005 survey necessitate caution when comparing the 2005 and the 2016 surveys.


Assuntos
Cegueira/epidemiologia , Assistência à Saúde/estatística & dados numéricos , Baixa Visão/epidemiologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Cegueira/etiologia , Catarata/complicações , Doenças da Córnea/complicações , Assistência à Saúde/organização & administração , Feminino , Glaucoma/complicações , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Exame Físico , Prevalência , Erros de Refração/complicações , Baixa Visão/etiologia
7.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31558576

RESUMO

OBJECTIVES: To study the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using the National Health Interview Survey. METHODS: Data come from the 2009 to 2017 National Health Interview Survey, a nationally representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder; autism spectrum disorder; blindness; cerebral palsy; moderate to profound hearing loss; learning disability; intellectual disability; seizures; stuttering or stammering; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated and stratified by demographic and socioeconomic characteristics. RESULTS: From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%-17.8%, P < .001), attention-deficit/hyperactivity disorder (8.5%-9.5%, P < .01), autism spectrum disorder (1.1%-2.5%, P < .001), and intellectual disability (0.9%-1.2%, P < .05), but a significant decrease for any other developmental delay (4.7%-4.1%, P < .05). The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight ≥2500 g, and children living in urban areas and with less-educated mothers. CONCLUSIONS: The prevalence of developmental disability among US children aged 3 to 17 years increased between 2009 and 2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care.


Assuntos
Deficiências do Desenvolvimento/epidemiologia , Adolescente , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Cegueira/epidemiologia , Paralisia Cerebral/epidemiologia , Criança , Pré-Escolar , Escolaridade , Feminino , Perda Auditiva/epidemiologia , Humanos , Cobertura do Seguro/estatística & dados numéricos , Deficiência Intelectual/epidemiologia , Masculino , Dinâmica Populacional , Prevalência , Convulsões/epidemiologia , Fatores Sexuais , Fatores Socioeconômicos , Gagueira/epidemiologia , Estados Unidos/epidemiologia
8.
Zhonghua Yan Ke Za Zhi ; 55(8): 625-628, 2019 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-31422641

RESUMO

With the growth of the global population and the acceleration of the aging process, the situation of blindness all over the world is increasingly severe. According to the latest data published by the Vision Loss Expert Group in 2017, there were an estimated 36 million blind people worldwide in 2015. The 66(th) World Health Assembly has endorsed the "Universal eye health: a global action plan 2014-2019" , which aims to reduce the prevalence of avoidable visual impairment by 25% by 2019 from the baseline of 2010. As a country with the largest number of blind people in the world, China has an arduous task of preventing and treating eye diseases.This review article summarizes and analyzes the relevant literature on the prevalence of blindness, the main blinding diseases and prevention measures in China, so as to provide reference materials for ophthalmologists to better carry out eye health work and reduce the number of blind people in China. (Chin J Ophthalmol, 2019, 55:625-628).


Assuntos
Cegueira , Transtornos da Visão , Baixa Visão , Cegueira/epidemiologia , China/epidemiologia , Humanos , Prevalência , Transtornos da Visão/epidemiologia , Baixa Visão/epidemiologia
10.
J Environ Public Health ; 2019: 3813298, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428165

RESUMO

Purpose: The aim of this study was to analyse eye health delivery in Ghana and examine the progress towards achieving VISION 2020 indicator targets. Methods: This descriptive cross-sectional study was conducted between October 2017 and May 2018. It used a mixed method approach including desk-based reviews, a questionnaire-based survey of eye facilities in Ghana, and interviews with eye health system stakeholders to collect information on eye health delivery in facilities owned by the Ghana Health Service (GHS), quasigovernmental bodies (security agencies), and Christian Association of Ghana (CHAG). The information was benchmarked against the World Health Organization (WHO) targets for achieving the goals of VISION 2020. Results: The magnitude of blindness and moderate to severe visual impairment (without pinhole) was 0.9% and 3.0%, respectively. The number of ophthalmologists available at the country level was 80.6% of the VISION 2020 target with optometrists and ophthalmic nurses exceeding targets for VISION 2020. The distribution of human resources was heavily skewed towards two out of the 10 regions in Ghana. Cataract surgical rate was low and met 25% of the WHO target. Basic equipment for refraction was available in the majority of facilities; however, there was a general lack of specialised eye care equipment across the country. Comparatively, CHAG facilities were better equipped than GHS facilities at the same level. Conclusion: The Government of Ghana should revitalize the goals of VISION 2020 beyond the year 2020 and spearhead a concerted effort to ensure equitable distribution of human and infrastructural resources across the country.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Visão Ocular , Cegueira/epidemiologia , Extração de Catarata/estatística & dados numéricos , Estudos Transversais , Assistência à Saúde/organização & administração , Gana/epidemiologia , Pesquisas sobre Serviços de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Oftalmologia/estatística & dados numéricos , Optometria/estatística & dados numéricos
11.
Niger J Clin Pract ; 22(7): 988-996, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293266

RESUMO

Background: Health-seeking behavior is important as it reveals the preventive, curative, and rehabilitative actions taken by individuals to rectify perceived ill-health. Aim and Objectives: To identify existing eye health-seeking behavior, factors influencing such behavior, and suggest ways in which the system can respond to the needs of the target population in order to reduce visual impairment and blindness. Methods: This was a descriptive cross-sectional study; 600 respondents were interviewed using a semistructured pretested questionnaire administered to every fifth new patient attending the eye clinic of University of Calabar Teaching Hospital (UCTH) for a period of 5 months by a single interviewer. People unable to respond appropriately were interviewed alongside their caregivers. Results: Poor distant vision was the most frequent ocular complaint in this study. The mean duration of complaint before presentation to any health facility was 370.65 ± 889.48 days with a range of 0-9,125 days. Nature of eye complaint was the most significant factor that determined how early respondents sought help (P < 0.001). Place of residence, nature of eye complaint, and employment status were significant determinants of the choice of place of first presentation for ocular complaints. Conclusion: There is need for improved eye health education and awareness for prompt presentation to an appropriate eye care professional at the onset of symptoms and even case finding for potentially blinding eye conditions.


Assuntos
Oftalmopatias/diagnóstico , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Adolescente , Adulto , Idoso , Cegueira/epidemiologia , Cegueira/etiologia , Criança , Pré-Escolar , Estudos Transversais , Oftalmopatias/epidemiologia , Feminino , Acesso aos Serviços de Saúde , Hospitais de Ensino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Atenção Primária à Saúde , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e Questionários , Baixa Visão/epidemiologia , Baixa Visão/etiologia , Adulto Jovem
12.
Ophthalmic Epidemiol ; 26(6): 416-419, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31272275

RESUMO

Purpose: This study was conducted to evaluate the causes of blindness in Syrian refugees living in southeastern Turkey. Another aim was to help the authorities determine strategies for dealing with blindness.Methods: A detailed ophthalmologic examination, including visual acuity and intraocular pressure, of 253 Syrian refugee patients complaining of visual impairment was conducted between January 2016 and January 2018 at our hospital's outpatient clinic.Results: Of the 253 Syrian refugee patients who visited our outpatient clinic, 176 (69.6%) were female and 77 (30.4%) male. The mean age of the patients was 46.4 ± 20.8 years. 27.3% of the patients were blind (N = 69) and 5.9% of the patients had severe visual impairment (N = 15). The most common causes of blindness were cataract (N = 42, 60.8%), refractive error (N = 8, 11.6%), phthisis (N = 5, 7.3%) and corneal opacity (N = 5, 7.3%). The highest rate of blindness (21.3%) was observed in the subgroup of patients over 40 years of age.Conclusions: Our study showed that Syrian refugees living in southeastern Turkey have been affected by several causes of preventable blindness, although they had free access to public health services in the country. The possible reasons of this situation are difficulties associated with lack of knowledge regarding eye health services and challenges arising from organisational problems related to the delivery of health services. Providing regular eye disease screening programmes and rehabilitation services may be beneficial in preventing blindness in the refugee population.


Assuntos
Cegueira/epidemiologia , Refugiados/estatística & dados numéricos , Baixa Visão/epidemiologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Adulto , Idoso , Cegueira/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Síria/etnologia , Turquia/epidemiologia , Baixa Visão/etiologia
13.
PLoS One ; 14(6): e0211991, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31173584

RESUMO

This study aimed to investigate the prevalence and causes of childhood blindness in a rural area of Bangladesh. We adopted a cross-sectional quantitative study design for this study, which was performed in three unions (sub-districts) located in Raiganj Upazila of the Sirajganj district in Bangladesh. Using a validated tool, a screening program was conducted at the household level. After initial screening, a team of ophthalmologists confirmed the diagnoses by clinical examinations. The prevalence of childhood blindness was observed to be 6.3 per 10,000 children, whereas the rate of uniocular blindness was 4.8 per 10,000 children. Congenital problems were the major causes of both uniocular and binocular blindness (uniocular blindness: 84% and binocular blindness: 92%). The whole globe was the site responsible for binocular blindness (28.0%, 95% confidence interval [CI]: 13.1, 47.7), whereas the cornea was responsible for uniocular blindness (57.8%, 95% CI: 35.3, 78.1). Childhood blindness is a public health problem in Bangladesh and is highly prevalent, regardless of sex. The major causes of childhood blindness are congenital.


Assuntos
Cegueira/epidemiologia , Bangladesh/epidemiologia , Cegueira/congênito , Cegueira/etiologia , Criança , Pré-Escolar , Doenças da Córnea , Status Econômico , Oftalmopatias , Feminino , Humanos , Lactente , Masculino , Prevalência
14.
JAMA Netw Open ; 2(6): e196354, 2019 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-31251374

RESUMO

Importance: Half of all the cases of blindness worldwide are associated with cataract. Cataract disproportionately affects people living in low- and middle-income countries and persons of African descent. Objective: To estimate the 6-year cumulative incidence of visually impairing cataract in adult participants in the Nakuru Eye Disease Cohort Study in Kenya. Design, Setting, and Participants: This secondary analysis of the Nakuru Eye Disease Cohort Study was conducted from February 2016 to April 2016. This cohort comprised citizens of Nakuru, Kenya, aged 50 years or older who consented to participate in the initial or baseline survey from January 2007 to November 2008, as well as the follow-up conducted from January 2013 to March 2014. All participants at baseline (n = 4364) and follow-up (n = 2159) underwent ophthalmic examination. Main Outcomes and Measures: Six-year cumulative incidence of visually impairing cataract, risk factors of incidence, population estimates, and required cataract surgical rates to manage incident visually impairing cataract. Results: In total, 4364 individuals (with a mean [SD] age of 63.4 [10.5] years and with 2275 women [52.1%]) had complete eye examinations at baseline, and 2159 participants (with a mean [SD] age of 62.5 [9.3] years and with 1140 men [52.8%]) were followed up 6 years later. The 6-year cumulative incidence of visually significant cataract in either eye was 251.9 per 1000 (95% CI, 228.5-276.8), with an increase with age from 128.9 (95% CI, 107.9-153.2) per 1000 for the group aged 50 to 59 years to 624.5 (95% CI, 493.1-739.9) per 1000 for the group aged 80 years or older. This equated to an annual incidence of visually significant cataract of 45.0 per 1000 people aged 50 years or older. Multivariable analysis showed alcohol consumption (risk ratio [RR], 1.4; 95% CI, 1.1-1.8), diabetes (RR, 1.7; 95% CI, 1.3-2.3), educational level, and increasing age (RR, 3.8; 95% CI, 2.6-5.5 for those aged ≥80 years) were associated with incident visually impairing cataract. Extrapolations to all people aged 50 years or older in Kenya indicated that 148 280 (95% CI, 134 510-162 950) individuals might develop new visually impairing cataract in either eye (visual acuity <6/18 in the worse-seeing eye) and that 9540 (95% CI, 6610-13 750) might become cataract blind in both eyes (visual acuity <3/60 in better-seeing eye). Conclusions and Relevance: Adults in Kenya appeared to have a high incidence of visually impairing cataract, making cataract a priority for blindness prevention programs in the region; surgical interventions and awareness of these services are also required.


Assuntos
Catarata/epidemiologia , Transtornos da Visão/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cegueira/epidemiologia , Cegueira/etiologia , Catarata/complicações , Extração de Catarata/estatística & dados numéricos , Feminino , Humanos , Incidência , Quênia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Transtornos da Visão/etiologia , Pessoas com Deficiência Visual/estatística & dados numéricos
15.
Indian J Ophthalmol ; 67(7): 1012-1015, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31238398

RESUMO

Purpose: To compare the prevalence and causes of blindness and visual impairment in tribal school students in the rural day-care and in a residential urban school. Methods: This was a cross-sectional comparative study. The 4-Stage screening in the native habitat of the tribal students performed in the school and hospital involved the trained school teachers, optometrists, comprehensive ophthalmologist, and pediatric ophthalmologist. The 2-Stage screening in the urban school involved only the optometrists and pediatric ophthalmologist. In both instances, vision (presenting and best corrected) was recorded and refraction performed. In addition, fundus photo was taken in all students in the urban school using a non-mydriatic fundus camera. Results: The comparison of blindness, visual impairment, and ocular anomalies were between tribal children (153,107 children; mean age 9.3 ± 2.7 years) examined in the native school and tribal children (10,038 children; mean age 8.8 + 1.64 years) in an urban residential school. Mild and moderate visual impairment was higher in the urban settings (P < 0.05), but severe visual impairment and blindness were similar in both settings. Refractive error, amblyopia, and posterior segment anomaly were detected more often in an urban settings (P < 0.05). Vitamin A deficiency (Bitot's spot) was detected only in children studying in the native schools (P < 0.05). Conclusion: The location, urban or rural, did not influence the visual impairment profile of tribal children. The food habit and environment seem to impact nutritional status.


Assuntos
População Rural , Instituições Acadêmicas , Estudantes , População Urbana , Seleção Visual/métodos , Baixa Visão/epidemiologia , Acuidade Visual , Adolescente , Cegueira/diagnóstico , Cegueira/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Humanos , Índia/epidemiologia , Masculino , Prevalência , Estudos Retrospectivos , Baixa Visão/diagnóstico , Baixa Visão/fisiopatologia
16.
Indian J Ophthalmol ; 67(6): 726-731, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124480

RESUMO

Many of the causes of childhood blindness are avoidable, being either preventable or treatable. Retinopathy of prematurity (ROP) remains one of the most preventable causes of childhood blindness worldwide. Currently, India is facing the third epidemic of ROP. In India, the health system involving the mother and child health services needs to be strengthened with a policy to cover the existing inadequacies in neonatal care and implementation of program covering newborn, especially premature. The access, availability, and affordability of services related to the care of premature babies need strengthening in India. ROP-trained ophthalmologists and neonatal care pediatricians and a professional togetherness is a big issue. Inadequacies in awareness of ROP among the parents, health care workers, counsellors add up to the problem. Community-based health workers such as Accredited Social Health Activist are a good dependable force in India and are needed to be trained in awareness and establishing a proper identification for prompt referral. ROP prevention needs a multidisciplinary team approach. ROP management stands as a good example of all the strategies for prevention, which includes primary prevention (improving obstetric and neonatal care), secondary prevention (screening and treatment programs), and tertiary prevention (treating complications and rehabilitation to reduce disability). Given its demographic and cultural diversity, India faces numerous challenges, with significant rural-urban, poor-rich, gender, socioeconomic, and regional differences. So, we need to gear up to face the present challenge of the third epidemic of ROP and prevent ROP-related childhood blindness as it is the need of the hour.


Assuntos
Cegueira , Triagem Neonatal/métodos , Retinopatia da Prematuridade/epidemiologia , Cegueira/epidemiologia , Cegueira/etiologia , Cegueira/prevenção & controle , Humanos , Incidência , Índia/epidemiologia , Recém-Nascido , Prevalência , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico
17.
Indian J Ophthalmol ; 67(6): 816-818, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124493

RESUMO

Purpose: Retinopathy of prematurity (ROP) is now emerging as one of the major causes of preventable childhood blindness. The proportion of preterm babies has increased dramatically over the past decade. Our study aims to emphasize the need for ROP screening and management services in these preterm infants. Methods: ICD-coded medical records of children less than 10 years of age presenting to a subspecialty eye hospital from 2000 to 2017 were reviewed. ROP, congenital cataract, congenital glaucoma, and vitamin A deficiency were the most common diagnoses. We evaluated the trend of these diseases from 2000 to 2017. Results: Our data suggested a 20-fold increase in the attendance of children with a diagnosis of ROP who now make over 2% of outpatient children. Vitamin A deficiency has declined over time whereas cataract and glaucoma have remained stable. Conclusion: Our data indicate a need to scale up ROP screening integrated with neonatal care, as well as to build capacity for the treatment of acute and late-stage ROP in India.


Assuntos
Cegueira/epidemiologia , Triagem Neonatal/métodos , Retinopatia da Prematuridade/epidemiologia , Medição de Risco/métodos , Centros de Atenção Terciária/estatística & dados numéricos , Acuidade Visual , Cegueira/etiologia , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Prevalência , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Fatores de Risco
18.
Indian J Ophthalmol ; 67(6): 819-823, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124494

RESUMO

Purpose: To describe the prevalence, characteristics including risk factors, and pattern of severe ROP from eastern Madhya Pradesh region of India. Methods: In this 5-year retrospective study, Baseline characteristics, systemic risk factors, and findings of ROP screening were noted. Factors associated with severe ROP including aggressive posterior ROP (APROP), stage IV and V ROP were analyzed. Statistical analysis was done using SPSS version 20. Results: Of 763 babies screened, 30% were diagnosed to have ROP. Prevalence of severe ROP was 14.2% (109) of which 60 (55.5%) were classic and 30 (27.7%) were APROP. Eighteen (16.6%) were diagnosed as advanced ROP (stage IV and V). Mean gestational age (GA) and birth weight (BW) for severe ROP were 31.05 weeks and 1.34 kg, respectively which were inversely associated with severe ROP. But a significant 10% of severe ROP were seen in late preterm babies, >34 weeks. Low GA and respiratory distress syndrome (RDS) were significant risk factors for APROP. Most important factor for stage IV and V ROP was late presentation for screening. Conclusion: The study found a high prevalence of severe ROP including APROP. Almost 7% severe ROP cases were outside screening guidelines of NNF. Late presentation for screening is the most important factor associated with ROP related blindness.


Assuntos
Triagem Neonatal/métodos , Retinopatia da Prematuridade/epidemiologia , Medição de Risco/métodos , Cegueira/epidemiologia , Cegueira/etiologia , Progressão da Doença , Feminino , Seguimentos , Idade Gestacional , Humanos , Índia , Lactente , Recém-Nascido , Masculino , Prevalência , Prognóstico , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo
19.
Indian J Ophthalmol ; 67(6): 928-931, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124517

RESUMO

Purpose: To explore the knowledge of retinopathy of prematurity (ROP) and habilitation services for children with visual loss from ROP, among health care professionals (HCPs) involved in care of preterm children and to explore their attitudes and practices in relation to referral for habilitation. Methods: A modified knowledge, attitude and practice questionnaire were administered to ophthalmologists and paediatricians associated with ROP care. Data were collected about their knowledge, beliefs and practices of ROP and referral to rehabilitation facilities. Data were analysed to establish level of knowledge, type of attitude and practices and its association with speciality. Results: Response rate was 78% (25/32). Most (14/25, 56%) were ophthalmologists. All (100%) participants knew that ROP can cause blindness. Knowledge about Indian ROP screening criteria was poor among a third (8/25, 32%), more so in paediatricians (5/11, 45.5%). Most (21/25, 84%) did not have knowledge of what a habilitation service entails and where such facilities are located. More than two-thirds (18/25, 72%) believed that special education should be preferred over inclusive education. Overall, 10/25 (40%) of the HCPs had never referred a child for rehabilitation. More than a half (13/25, 52%) were not confident of counselling parents of blind children. All agreed that rehabilitation services are not part of but should be included in medical curriculum. Conclusion: Indian guidelines for ROP screening are not universally known among HCPs. Educating medical undergraduates, providing counselling training to professionals and integration of rehabilitation into the health system will ensure continuity of care for children with visual loss and their families.


Assuntos
Cegueira/reabilitação , Conhecimentos, Atitudes e Prática em Saúde , Triagem Neonatal/métodos , Pediatras/normas , Retinopatia da Prematuridade/reabilitação , Acuidade Visual , Adolescente , Adulto , Distribuição por Idade , Cegueira/epidemiologia , Cegueira/etiologia , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Retinopatia da Prematuridade/complicações , Retinopatia da Prematuridade/fisiopatologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
20.
Ophthalmic Epidemiol ; 26(4): 279-285, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31062638

RESUMO

Purpose: Vision loss has been associated with negative health outcomes, but population-level data on vision loss are lacking, and there are limited data on low vision-associated outcomes among women, minorities, and older age groups. The objective of this study was to determine the prevalence of vision loss in a nationally representative sample of older US adults and examine its association with hip fracture, depression, anxiety, and dementia. Methods: Cross-sectional analysis of Medicare claims data from 2014. Blindness and low vision, hip fracture, depression, anxiety, and dementia were identified using Chronic Condition Warehouse indicator variables based on ICD-9 and CPT codes. Multivariable logistic regression models were built to examine whether sociodemographic factors were associated with vision loss and to determine the relationships between vision loss and hip fracture and neuropsychiatric outcomes. Results: The prevalence of low vision in the Medicare population was 994/100,000 and increased significantly with age, Black (1,854/100,000) or Hispanic (2,862/100,000) race/ethnicity, female gender (1,181/100,000), and Medicaid eligibility (2,975/100,000). After adjusting for relevant comorbidities, low vision was significantly associated with hip fracture (adjusted odds ratio [AOR] 2.54, 95% CI: 2.52-2.57), depression (AOR 3.99, 95% CI: 3.97-4.01), anxiety (AOR 2.93, 95% CI: 2.91-2.95), and dementia (AOR 3.91, 95% CI: 3.88-3.93). Conclusion: Blindness and low vision are common in older Americans, especially among racial and ethnic minorities and lower income individuals, and associated with hip fracture, depression, anxiety, and dementia. The prevention and treatment of vision loss may reduce health disparities and negative health outcomes in the aging population.


Assuntos
Cegueira/epidemiologia , Disparidades em Assistência à Saúde , Fraturas do Quadril/etiologia , Medicare/estatística & dados numéricos , Transtornos Psicóticos/etiologia , Transtornos da Visão/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Cegueira/complicações , Estudos Transversais , Feminino , Fraturas do Quadril/epidemiologia , Humanos , Masculino , Morbidade/tendências , Transtornos Psicóticos/epidemiologia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Transtornos da Visão/complicações
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