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Han X, Zou M, Liu Z, Sun Y, Young CA, Zheng D, Jin G. Time trends and heterogeneity in the disease burden of visual impairment due to cataract, 1990–2019: A global analysis. Front Public Health 2023; 11:1140533. [PMID: 37077196 PMCID: PMC10106776 DOI: 10.3389/fpubh.2023.1140533] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/07/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectivesThis study aimed to estimate the disease burden of cataract and evaluate the contributions of risk factors to cataract-associated disability-adjusted life years (DALYs).Materials and methodsPrevalence and DALYs of visual impairment due to cataract were extracted from the Global Burden of Disease (GBD) study 2019 to explore time trends and annual changes. Regional and country-level socioeconomic indexes were obtained from open databases. The time trend of prevalence and DALYs was demonstrated. Stepwise multiple linear regression was used to evaluate associations between the age-standardized rate of DALYs of cataract and potential predictors.ResultsGlobal Prevalence rate of visual impairment due to cataract rose by 58.45% to 1,253.9 per 100,000 population (95% CI: 1,103.3 to 1,417.7 per 100,000 population) in 2019 and the DALYs rate rose by 32.18% from 65.3 per 100,000 population (95% CI: 46.4 to 88.2 per 100,000 population) in 1990 to 86.3 per 100,000 population (95% CI: 61.5 to 116.4 per 100,000 population) in 2019. Stepwise multiple linear regression model showed that higher refractive error prevalence (β = 0.036, 95% CI: 0.022, 0.050, P < 0.001), lower number of physicians per 10,000 population (β = −0.959, 95% CI: −1.685, −0.233, P = 0.010), and lower level of HDI (β = −134.93, 95% CI: −209.84, −60.02, P = 0.001) were associated with a higher disease burden of cataract.ConclusionSubstantial increases in the prevalence of visual impairment and DALYs of cataract were observed from 1990 to 2019. Successful global initiatives targeting improving cataract surgical rate and quality, especially in regions with lower socioeconomic status, is a prerequisite to combating this growing burden of cataract in the aging society.
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Affiliation(s)
- Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | | | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
- Danying Zheng
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Guangming Jin
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Bechange S, Jolley E, Tobi P, Mailu E, Sentongo J, Chulu T, Abony M, Chege M, Mulenga G, Ngorok J, Adera T, Schmidt E. Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study. Int Health 2021; 14:i57-i63. [PMID: 34581785 PMCID: PMC8986356 DOI: 10.1093/inthealth/ihab061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme. METHODS Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018-2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach. RESULTS Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system. CONCLUSIONS Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients' expectations and needs, as strategies for increasing cataract surgery uptake.
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Affiliation(s)
- Stevens Bechange
- Sightsavers Zambia Country Office, 10247 Great East Road, Cresta Golf View, Villa 6, PO Box 37535, Lusaka 10101, Zambia
| | - Emma Jolley
- Sightsavers United Kingdom, 35 Perrymount Road, Haywards Heath, West Sussex, RH16 3BW, UK
| | - Patrick Tobi
- Sightsavers United Kingdom, 35 Perrymount Road, Haywards Heath, West Sussex, RH16 3BW, UK.,Department of Natural Sciences, Middlesex University, The Burroughs, London, NW4 4BT, UK
| | - Eunice Mailu
- Sightsavers Kenya Country Office, Studio House, Ground Floor, Argwings Kodhek Road Hurlingham, PO Box 34690 00100 GPO, Nairobi, Kenya
| | - Juliet Sentongo
- Sightsavers Uganda Country Office, Second Floor, EADB Building, 4 Nile Avenue, PO Box 21249, Kampala, Uganda
| | - Titamenji Chulu
- Sightsavers Zambia Country Office, 10247 Great East Road, Cresta Golf View, Villa 6, PO Box 37535, Lusaka 10101, Zambia
| | - Maurice Abony
- Sightsavers Kenya Country Office, Studio House, Ground Floor, Argwings Kodhek Road Hurlingham, PO Box 34690 00100 GPO, Nairobi, Kenya
| | - Moses Chege
- Sightsavers Kenya Country Office, Studio House, Ground Floor, Argwings Kodhek Road Hurlingham, PO Box 34690 00100 GPO, Nairobi, Kenya
| | - Glenda Mulenga
- Sightsavers Zambia Country Office, 10247 Great East Road, Cresta Golf View, Villa 6, PO Box 37535, Lusaka 10101, Zambia
| | - Johnson Ngorok
- Sightsavers Uganda Country Office, Second Floor, EADB Building, 4 Nile Avenue, PO Box 21249, Kampala, Uganda
| | - Tesfaye Adera
- Sightsavers United Kingdom, 35 Perrymount Road, Haywards Heath, West Sussex, RH16 3BW, UK
| | - Elena Schmidt
- Sightsavers United Kingdom, 35 Perrymount Road, Haywards Heath, West Sussex, RH16 3BW, UK
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Ko KK, Pumpaibool T, Wynn MMM, Win Y, Kyi TM, Aung PL. Door-to-Door Eye Health Education to Improve Knowledge, Attitude, and Uptake of Eyecare Services Among Elderly with Cataracts: A Quasi-Experimental Study in the Central Tropical Region, Myanmar. Clin Ophthalmol 2021; 15:815-824. [PMID: 33658757 PMCID: PMC7920616 DOI: 10.2147/opth.s287257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/15/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Cataract-related blindness is routinely reported globally. This study aimed to measure the effect of door-to-door eye health education in improving knowledge and attitude toward cataracts and the use of eyecare services among the elderly residing in a rural area of Naypyitaw Union Territory, Myanmar. Methods A quasi-experimental study design that used intervention and control groups was employed in Lewe Township from November 2018 to April 2019. Stratified sampling method was used to select lists of patients diagnosed with cataracts via a township-wide prevalence survey of eye diseases. A total of 56 elderly people with cataracts were involved in each group. The intervention group received door-to-door eye health education for 3 consecutive months. The data were collected using pre- and post-intervention surveys. Descriptive statistics for general characteristics as well as Chi-squared tests and multivariate analysis of variance for significant differences between knowledge and attitude scores of the two groups were analyzed. Results Both groups represented similarities in socio-economic characteristics, pre-existing knowledge and attitude levels, and eyecare services use. During the baseline study, the mean knowledge score in the intervention group was 7.8 and after the intervention, it increased to 10.67. Attitude score increased from 4.51 to 7.55. Among the control group, the scores remained unchanged. For use of eyecare services in the intervention group, 35.7% of patients sought eyecare services before the intervention, but after, 85.7% accessed eyecare services. Among them, 78.6% were satisfied with the treatment outcome. Further, there was a significant difference in knowledge and attitude between the control group and the intervention group (p-value <0.05), representing a medium effect of the intervention on improving knowledge and attitude level. Conclusion Door-to-door eyecare education significantly increased knowledge and attitude toward cataracts and the use of eyecare services among the elderly with cataracts. Intervention might be effective in improving the use of eyecare services and reduction of avoidable blindness due to cataracts.
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Affiliation(s)
- Kyaw Ko Ko
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Tepanata Pumpaibool
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Maung Maung Myo Wynn
- Department of Public Health, Ministry of Health and Sports, Naypyitaw, 15032, Myanmar
| | - Ye Win
- Department of Public Health, Ministry of Health and Sports, Naypyitaw, 15032, Myanmar
| | - Tin Moe Kyi
- Ophthalmology Ward, General Hospital, Hinthada, 10061, Myanmar
| | - Pyae Linn Aung
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
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Pain Perception and Acceptance of Illness in Patients Undergoing Phacoemulsification Cataract Surgery under Drip Anesthesia. J Clin Med 2019; 8:jcm8101575. [PMID: 31581551 PMCID: PMC6832406 DOI: 10.3390/jcm8101575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/17/2019] [Accepted: 09/26/2019] [Indexed: 02/06/2023] Open
Abstract
For many years, cataracts have been the main cause of vision loss and vision impairments in the world (43% and 33%, respectively). Currently, the most common surgical method for treating cataracts is phacoemulsification. The aim of this study was to assess the pain perception and acceptance of illness connected with awaiting phacoemulsification cataract surgery under intravenous drip anesthesia, as well as to determine the effect of selected sociodemographic factors on the above. Methods: The study was conducted in a group of patients of the Department of Ophthalmology, University Clinical Hospital in Białystok, Poland suffering from cataracts, who underwent phacoemulsification surgery under intravenous drip anesthesia. The study group consisted of 151 people. The study used an original short questionnaire and three standardized psychometric scales: The acceptance of illness scale (AIS), the Beliefs about Pain Control Questionnaire (BPCQ), and the Coping Strategies Questionnaire (CSQ). Results: The median overall AIS point value was 24 points, which is considered an average score in terms of disease acceptance. Respondents assessed the influence of individual factors on the level of perceived pain and the impact of individual strategies for coping with pain similarly. The level of perceived pain decreased with the patient’s age. People with a higher education level experienced a greater level of pain; however, this relationship was not statistically significant. The place of residence did not affect the level of pain experienced during the procedure. Women had a greater level of acceptance of illness. The respondents’ education level negligibly differentiated the approach to the disease. The place of residence also did not affect the assessment of illness acceptance as measured by the AIS. Whether the surgery pertained to the first or second eye did not significantly affect the approach to the disease. Conclusions: The level of acceptance of illness and pain perception were at a moderate level among the patients. The acceptance of illness was significantly influenced by the age of patients and the waiting period for phacoemulsification, and this level of acceptance decreased significantly with the increasing age of patients. The longer the waiting period for surgery, the lower the acceptance of illness. Sex significantly differentiated the level of pain experienced during the procedure. Education and place of residence did not significantly affect the acceptance of illness and the feeling of pain.
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