Proportion and Associated Factors of Low Vision among Adult Patients Attending at University of Gondar Tertiary Eye Care and Training Center, Gondar Town, Ethiopia

Magnitude of Maladaptive Coping Strategy and Its Associated Factors Among Adult Glaucoma Patients Attending Tertiary Eye Care Center in Ethiopia

Introduction

Coping strategy is the mechanism by which patients adjust to the condition they face. It can be adaptive or maladaptive. A maladaptive coping strategy is a harmful and ineffective way of dealing with stress or anxiety. It is common among patients with chronic illnesses. Despite Ethiopia having a greater glaucoma prevalence, there was no evidence of patients with glaucoma using maladaptive coping mechanisms.

Objective

The main goal of this study was to evaluate the magnitude of maladaptive coping strategy use and the factors that associate with it among adult glaucoma patients enrolled in the Tertiary Eye Care and Training Center at the University of Gondar in Northwest Ethiopia in 2022.

Methods and Materials

At the University of Gondar, Tertiary Eye Care and Training Center, a facility-based cross-sectional study was carried out on a sample of 423 glaucoma patients chosen by a systematic random sampling technique from May 15 to June 30, 2022. Optometrists conducted an interview with the study subject and reviewed the medical record, and administered a pretested, structured questionnaire of the brief cope inventory assessment. In the multivariable logistic regression, binary logistic regression was performed to identify the related factors, and significance was taken into account when the p-value was less than 0.05 at the 95% confidence interval.

Results

The study found that among study participants 50.1% (95% CI: 45.1-54.5%) had a maladaptive coping strategy. Female sex (AOR=2.031, 95% CI:1.185-3.480), chronic medical illness (AOR=1.760, 95% CI:1.036-2.989), bilateral glaucoma (AOR=2.321, 95% CI: 1.328-4.055), receiving both drug and surgery treatment (AOR=1.895, 95% CI: 1.002-3.585), severe visual impairment (AOR=2.758, 95% CI:1.110-6.852), absolute glaucoma (AOR=2.543, 95% CI:1.048-6.169), duration of diagnosis >12 months (AOR=3.886, 95% CI: 2.295-6.580) were significantly associated with a maladaptive coping strategy.

Conclusion and Recommendation

Half of the participants had a maladaptive coping strategy. It is better to set and plan strategies that enable the integration of coping strategy care into the current treatment of patients with glaucoma to encourage positive coping strategies instead of maladaptive ones.

Visual impairment in Ethiopia: Systematic review and meta-analysis

WHO Prevention of Blindness Program launched ‘‘VISION 2020” in 1999 to reduce visual impairment and eradicate avoidable blindness by the year 2020. Ethiopia launched the “VISION 2020” initiative in 2002. This systematic review and meta-analysis aimed to present the national prevalence of visual impairment at the end of “VISION 2020”. Electronic search was conducted on the PubMed, SCOPUS, EMBASE, Web of Science, CINAHL, Google scholar databases for including articles. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Endnote reference manager was used for downloading, organizing, and citing articles. Methodological quality was assessed using the Joanna Briggs Institute (JBI) quality appraisal tool for prevalence studies. Statistical analysis was done using the STATA™ software version 14. In this systematic review and meta-analysis, 18 studies involving 14,953 participants were included. The pooled prevalence of visual impairment in Ethiopia after correction for publication bias by Duval and Tweedie’s trim and fill analysis was estimated to be 6.24% (95% confidence interval [CI] = [2.66, 9.82]). The pooled prevalence of visual impairment among school children and adults in Ethiopia was 6.13% (95% CI = [4.27, 7.98]) and 19.89% (95% CI = [10.85, 28.93]), respectively. The most common causes of visual impairment in decreasing order of prevalence were refractive error, cataract, trachoma, glaucoma, and corneal opacity. Amblyopia was the cause of visual impairment among school-age child. The prevalence of visual impairment in Ethiopia was still significant at the end of “VISION 2020” program. Therefore, the program of “VISION 2020” should be extended and other large-scale programs were needed to reduce the prevalence of vision impairment in Ethiopia.

Association of Glaucoma with Poor Quality of Sleep in an Ethiopian Glaucoma Population – A Comparative Cross-Sectional Study

Background

Glaucoma is a group of ocular disorders characterized by progressive optic nerve damage resulting in irreversible visual field defects. Poor quality of sleep in glaucoma patients could be explained by the reduction of the light input to the circadian system as a result of damage to photosensitive retinal ganglion cells in the retina. Information is limited on the association of poor quality of sleep with glaucoma in general and the Ethiopian glaucoma population in particular.

Objective

The study aimed to explore the association between poor quality of sleep and glaucoma at a Tertiary Eye Care Center in Ethiopia.

Methods

An institutional-based comparative cross-sectional study was conducted among 200 glaucoma and 201 non-glaucoma participants recruited by systematic random sampling. Each group was administered with a Pittsburgh Sleep Quality Index (PSQI) questionnaire. Stata-14 was employed for data analysis; an independent t-test was used to show the statistical difference in the global mean PSQI score for the two groups. A binary logistic regression model was applied to identify factors associated with poor quality of sleep. Statistical significance was declared at a 95% confidence interval and a p-value of <0.05.

Results

The prevalence of poor quality of sleep was 82.5% among the glaucoma population, which statistically differed (p<0.001) from the non-glaucomatous population (55.7%). Poor quality of sleep in glaucoma was associated with older age (adjusted odds ratio (AOR)=4.4, 95% confidence interval (CI): 1.5–5.4), depression (AOR=2.9, 95% CI: 1.1–7.3), visual impairment (AOR=3.9, 95% CI: 1.3–12.3) and severe glaucoma (AOR=2.5, 95% CI: 1.1–5.9).

Conclusion and Recommendation

Poor quality of sleep was significantly higher in the glaucoma population compared to their non-glaucoma control. It was associated with older age, depression, visual impairment and advanced glaucoma. Incorporating psychiatric counseling into the existing glaucoma follow-up was recommended.

Vision-related quality of life amongst patients with low vision and blindness in a resource-limited country

PURPOSE

To evaluate the significance of sociodemographic and clinical variables on the quality of life of low-vision patients in a tertiary hospital in Enugu, Nigeria, and also determine the causative ocular pathologies and their vision-related quality of life.

METHODS

A cross-sectional study of adults 18 years and above with low vision/blindness. They were consecutively enrolled and clinically evaluated. The WHO-NEI-VFQ-25 questionnaire for quality of life was administered. Descriptive statistics were used to summarize variables. Kruskal-Wallis test, analysis of variance, and post hoc tests were done where appropriate.

RESULTS

Of the 400 participants, 81% were above 40 years. Mean age was 57.27 ± 16.34 years. Males (52.0%) and females (48.0%). 225 (56.25%) had Moderately Severe Visual Impairment. Low vision/blindness negatively affected the different domains of quality of life significantly, except ocular pain and dependency. Glaucoma and Cataract were the major disease conditions that affected most of the domains significantly. These conditions when poorly managed, due to poor and limited health resources, progress to low vision/blindness. Of all the socio-demographic factors and clinical variables studied, only age and severity of low vision were significant predictors of quality of life.

CONCLUSION

There is the need for prompt and proper treatment of low-vision patients and advocacy for the establishment of adequate and functional rehabilitation services. Quality of life which measures the overall impact of a disease on an individual was low in people with low vision and blindness. Low-vision services, which include rehabilitation, will provide comprehensive eye-care services and thus improve their quality of life.

Pooled prevalence of blindness in Ethiopia: a systematic review and meta-analysis

Blindness is defined as presenting visual acuity worse than 3/60 in the better eye. Its highest proportion has been conforming to the developing countries such as Ethiopia. So, timely information is crucial to design strategies. However, the study on the magnitude of blindness in Ethiopia was outdated which means it was conducted in 2005–2006. Therefore, this study was proposed to estimate the pooled prevalence of blindness in Ethiopia.

Databases like PubMed, Cochrane library, Google Scholar and references of retrieved articles were used to search for articles. A standard data extraction approach was employed and presented using Preferred Reporting of Items for Systematic Reviews and Meta-Analyses. The Newcastle-Ottawa Scale quality assessment tool was used to evaluate the quality of studies. Analysis held using STATA V.11. The funnel plot and Egger’s regression test were applied to check for the potential sources of bias. Heterogeneity among the studies was tested using I² statistics that have been calculated and compared with the standard. Meta-regression and subgroup analysis were done to identify the potential sources of heterogeneity. Estimation of blindness was carried out using Duval and Twee die’s trim and fill analysis. The pooled prevalence of blindness in Ethiopia is found to be 1.18% (95% CI 0.650% to 1.706%). Blindness is among the main public health difficulties in Ethiopia. So, it demands up-to-date strategies and its implementation, preventive and curative eye care service with affordable and accessible interventions, and evidence-based advocacy. The trial Registration Number is CRD42021268448.

Glaucoma and its predictors among adult patients attending ophthalmic outpatient department: a hospital-based study, North West Ethiopia

BACKGROUND

Nearly 1.9% of global blindness is caused by glaucoma and this is sadly high in Africa which is around 15% and In Ethiopia, glaucoma is responsible for 5.2% of blindness. It is also the fifth cause of blindness in Ethiopia. Scarce information is available regarding glaucoma in Ethiopia; hence we determined the proportion of glaucoma and its associated factors in North West Ethiopia which will be utilized for future related researches and different stakeholders.

METHODS

Institution based cross-sectional study was conducted from September 1/2020 to February 30/21 among 258 adults aged 40 and above years old. The participants were selected using the systematic random sampling technique. The data was collected using an interview-administered questionnaire. Binary and Multi-variable logistic regressions were fitted to identify independent predictors of glaucoma. P-value less than 0.05 were used as a cutoff point for declaring statistical significance.

RESULTS

The prevalence of glaucoma was 66(26%) with a 95% CI of 17.7, 35.4%). Individuals with Positive family history of glaucoma (AOR: 3.72, 95% CI: 1.03-3.53), age (AOR: 3.21, 95% CI: 1.92-5.99) and elevated intraocular pressure (AOR: 3.09, 95% CI: 1.45-6.59) were statistically significant contributing factors for the development of glaucoma.

CONCLUSION

The study found a relatively high proportion of glaucoma in the study area, which is primarily a disease of the elderly. Age, elevated intraocular pressure, and positive family history of glaucoma was contributing factors for the emergence of glaucoma. Therefore, establishing public awareness programs about the identified risk factors for the prevention and early detection of cases is essential.