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Chan VF, Yard E, Mashayo E, Mulewa D, Drake L, Price-Sanchez C, Omar F. Does an integrated school eye health delivery model perform better than a vertical model in a real-world setting? A non-randomised interventional comparative implementation study in Zanzibar. Br J Ophthalmol 2023; 108:152-158. [PMID: 36376063 PMCID: PMC10804016 DOI: 10.1136/bjo-2022-321752] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies on school eye health programmes have shown they were cost-effective. We compared the performance (Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM)) between an integrated model (IM) and a vertical model (VM) of school eye health delivery in Zanzibar. METHODS The set of RE-AIM performance indicators of the IM (n=9) and VM (n=10) cohorts was compared. The VM implemented only the eye health interventions, while the IM had the eye health interventions conducted within the school feeding programme. Semistructured interviews were conducted with 36 stakeholders to understand the challenges and outcomes experienced when implementing both models. RESULTS The IM achieved higher screening coverage, voluntary follow-up rate, screening validity and spectacle compliance than VM. This was due to effective coordination between implementers, motivated teachers to prevent vision problems and related negative impacts in children, and activities implemented timeously post-training. Both models recorded low wearing compliance. All schools in the IM cohort completed screening activities, but two schools in the VM cohort did not. Both models ceased activities after the funding stopped. Local stakeholders emphasised that evidence from this study can be used to advocate for more resources for children's eye health. CONCLUSIONS The IM cohort achieved better reach, effectiveness, adoption rate and implementation performance than the VM cohort. The poor maintenance performance indicators in both arms postfunding call for improvement to the implementation strategy to ensure the sustainability of school eye health. In the optics of scaling up, an integrated approach is recommended.
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Affiliation(s)
- Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Brien Holden Vision Institute Foundation (Africa) Trust, Durban, South Africa
| | - Elodie Yard
- Partnership for Child Development, Imperial College London, London, UK
| | - Eden Mashayo
- Brien Holden Vision Institute Foundation (Africa) Trust, Durban, South Africa
| | - Damaris Mulewa
- Partnership for Child Development, Imperial College London, London, UK
| | - Lesley Drake
- Partnership for Child Development, Imperial College London, London, UK
| | | | - Fatma Omar
- Ministry of Health, Zanzibar, United Republic of Tanzania
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Pratap T, Kokil P. Efficient network selection for computer-aided cataract diagnosis under noisy environment. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105927. [PMID: 33485073 DOI: 10.1016/j.cmpb.2021.105927] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/31/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Computer-aided cataract diagnosis (CACD) methods play a crucial role in early detection of cataract. The existing CACD methods are suffering from performance diminution due to the presence of noise in digital fundus retinal images. The lack of robustness in CACD methods against noise is a serious concern since even the presence of small noise levels may degrade the performance of cataract detection. However, noise in fundus retinal images is unavoidable due to various processes involved in the acquisition or transmission. Hence, a robust CACD method against noisy conditions is required to diagnose the cataract accurately. METHODS In this paper, an efficient network selection based robust CACD method under additive white Gaussian noise (AWGN) is proposed. The presented method consists a set of locally- and globally-trained independent support vector networks with features extracted at various noise levels. A suitable network is then selected based on the noise level present in the input image. The automatic feature extraction technique using pre-trained convolutional neural network (CNN) is adopted to extract features from input fundus retinal images. RESULTS A good-quality fundus retinal image dataset is obtained from EyePACS dataset with the use of natural image quality evaluator (NIQE) score. The synthetic noisy fundus retinal images are then generated artificially from good-quality fundus retinal images using AWGN model for effective analysis. The analysis is carried out with existing CNN based CACD methods at different noise levels. From results it is obvious that the proposed CACD method is superior in exhibiting robust performance against AWGN than existing CNN based CACD methods. CONCLUSIONS From the experimental results, it is clear that the proposed method show superior performance against noise when compared with existing methods in literature. The proposed method can be useful as a starting point to continue further research on CNN based robust CACD methods.
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Affiliation(s)
- Turimerla Pratap
- Department of Electronics and Communication Engineering, Indian Institute of Information Technology Design and Manufacturing, Kancheepuram, Chennai 600127, India
| | - Priyanka Kokil
- Department of Electronics and Communication Engineering, Indian Institute of Information Technology Design and Manufacturing, Kancheepuram, Chennai 600127, India.
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Sharma IP, Chaudhry M, Sharma D, Kaiti R. Mobile health intervention for promotion of eye health literacy. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000025. [PMID: 36962088 PMCID: PMC10021255 DOI: 10.1371/journal.pgph.0000025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Improving eye health awareness in the underserved population is a universal eye health priority. The ubiquity of cell phones and internet usage provides new and innovative opportunities for health promotion. This study evaluated the effect of mobile health intervention (text message link) to promote eye health literacy (EHL) of priority ocular morbidities. METHODS This study was an intervention evaluation and employed a two-armed pre-test post-test approach. Baseline assessment on EHL was performed on 424 university students. Participants were categorised into intervention and control groups, using the 1:1 allocation ratio. The intervention and control group received a text message alone and text message with a link, respectively. EHL was assessed via a self-administered questionnaire. The primary outcome measures were changes in EHL scores between baseline and one month post-intervention. Descriptive analysis was performed to assess the cost-effectiveness of the intervention. RESULTS With low attrition and a response rate of 95.6%, 409 responses were eligible for analysis. The mean age of the participants (49.4% males and 50.6% of females) was 19.9±1.68 years. Baseline EHL scores were low, and there was no correlation with a demographic profile (all p<0.05, CI 95%). The demographic characteristics were similar between the two groups (for all, P <0.05, CI 95%) at baseline. The EHL scores improved in both groups between the pre-and post-test assessment; however, improvements were statistically significant only in the control group. The one-month post-intervention EHL scores were also higher in the intervention group compared to the control (p≤0.001, CI 95% for all). The total cost incurred for the intervention used was 11.5 USD. CONCLUSION Text message link demonstrated effectiveness for improving the EHL scores; the low baseline EHL scores substantially improved with intervention. The text message link intervention is a cost-effective method and could be considered in advocating for eye health in developing countries, particularly during global emergencies.
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Affiliation(s)
- Indra Prasad Sharma
- GKCW National Eye Center, JDW National Referral Hospital, Thimphu, Bhutan
- Department of Optometry and Vision Science, Amity University Haryana, Gurugram, India
| | - Monica Chaudhry
- Department of Optometry and Vision Science, Amity University Haryana, Gurugram, India
| | - Dhanapati Sharma
- Department of English, Gedu College of Business Studies, Chukha, Bhutan
| | - Raju Kaiti
- Department of Optometry, Nepal Eye Hospital, Tripureshwor, Nepal
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Addo EK, Akuffo KO, Sewpaul R, Dukhi N, Agyei-Manu E, Asare AK, Kumah DB, Awuni M, Reddy P. Prevalence and associated factors of vision loss in the South African National Health and Nutrition Examination Survey (SANHANES-1). BMC Ophthalmol 2021; 21:1. [PMID: 33386075 PMCID: PMC7775629 DOI: 10.1186/s12886-020-01714-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/02/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Vision loss is a major public health concern that significantly affects developing countries, including South Africa. Although existing literature have reported on the prevalence, causes, and impact of vision loss on the quality of life of affected individuals (children and adults) in parts of South Africa, there is no evidence of the prevalence and associated factors of vision loss in the general population. Hence, this study aimed to determine the prevalence of vision loss and its associated factors in South Africa using a population-based survey. METHODS Secondary analyses were conducted using data from the South African National Health and Nutrition Examination Survey (SANHANES-1), a population-based national health survey conducted from 2011 to 2012. Vision loss was defined as presenting visual acuity (PVA) worse than Snellen 6/12 in the better eye. Visual acuity was assessed by clinicians and participants' subjective response to vision-related questions. Univariate and multiple logistic regression models were used to examine the association of the independent variables with vision loss. RESULTS The analytic sample comprised 4346 individuals with a mean age of 39.1 years. Female sex accounted for 55.6% of the participants. The prevalence of vision loss among participants was 9.2% (95% CI: 7.7-10.9). Older age (45-54 years, OR = 2.99, p < 0.001; 55-64 years, OR = 5.78, p < 0.001 and ≥ 65 years, OR = 5.12, p < 0.001), female sex (OR = 1.50, p = 0.016), and previous diabetes diagnosis (OR = 2.28, p = 0.001) were significantly associated with increased odds of vision loss. Further, secondary school education (OR = 0.71, p = 0.031), white ethnicity (OR = 0.11, p = 0.007), residing in Mpumalanga province (OR = 0.12, p < 0.001) and having never had an eye examination (OR = 0.56, p = 0.003) were significantly associated with reduced odds of vision loss. CONCLUSION Almost one in ten participants had vision loss. Adopting strategies targeted at reducing barriers to the utilization of eye care services will promote early detection and management of blinding conditions, and thereby, decrease the burden of vision loss in South Africa.
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Affiliation(s)
- Emmanuel Kofi Addo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Ophthalmology and Visual Sciences, John A. Moran Eye Centre, University of Utah, Salt Lake City, Utah, USA.,Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah, USA
| | - Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Ronel Sewpaul
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Natisha Dukhi
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Eldad Agyei-Manu
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Usher Institute for Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Akosua Kesewah Asare
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Moses Awuni
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Priscilla Reddy
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa.,Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
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Mbeboh SN, Christie SA, Carvalho M, Dickson D, Nana T, Embolo F, Dicker R, Juillard C, Chichom Mefire A. Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study. BMJ Open 2020; 10:e041367. [PMID: 33243810 PMCID: PMC7692974 DOI: 10.1136/bmjopen-2020-041367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To establish the prevalence of self-reported vision impairment (VI) in Southwest Cameroon and describe associated care-seeking practices, functional limitations and economic hardships. DESIGN A three-stage clustered sampling household community-based survey. SETTING The Southwest region of Cameroon. PARTICIPANTS 8046 individuals of all ages residing in the Southwest region of Cameroon. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of self-reported VI, onset of vision loss, care-seeking practices, diagnosis and treatment, functional limitations, economic hardships on household, beliefs about surgical treatability of blindness and barriers to surgical care. RESULTS The estimated prevalence of self-reported VI in Southwest Cameroon was 0.87% (95% CI 0.62 to 1.21). Among participants aged ≥40 years, the prevalence increased to 2.61% (95% CI 1.74 to 3.90). Less than a quarter of affected participants reported difficulty working (20.5%) or trouble going to school (12.0%) as a result of their VI. Yet, over half (52%, n=43) of affected households experienced significant economic hardships due to the VI. Residing in an urban setting (aOR 1.16, 95% CI 1.04 to 1.30) and belonging to a higher socioeconomic status (aOR 1.13, 95% CI 1.02 to 1.26) were factors associated with the belief that certain types of blindness were surgically reversible. Formal care was not sought by 16.3% (n=8) of affected participants. Cataracts was the leading diagnosis among participants who did seek formal care (43.2%, n=16), although 93.8% of these cases were not surgically treated, primarily due to a lack of perceived need. CONCLUSION The prevalence of individuals who report vision impairment in Southwest Cameroon is considerably lower than prior published estimates based on visual physical examinations. Routine community-level screening and cost financing schemes could improve detection of pre-clinical eye disease and the utilisation of surgical care. It could also pre-empt disability and economic hardships associated with advanced VI in the region.
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Affiliation(s)
- Susan N Mbeboh
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | | | - Melissa Carvalho
- Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Drusia Dickson
- Department of Surgery, University of California San Francisco, San Francisco, California, USA
| | - Theophile Nana
- Department of Surgery, Limbe Regional Hospital, Limbe, Cameroon
| | - Frida Embolo
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Rochelle Dicker
- Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Catherine Juillard
- Department of Surgery, University of California Los Angeles, Los Angeles, California, USA
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Abstract
People living with visual disabilities/impairment are more likely vulnerable to get contracted from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2) than people without visual impairment. This means more than 253 million people globally will be at higher risk of affecting by the COVID-19. The current pandemic, followed by a nationwide emergency lockdown to slow the unprecedented spread of the virus, will have a serious impact on people living with visual disabilities and even endangers their lives in the long run. Many restrictive and control measures, including the adoption of new behavioural changes (for example, social distance during outdoor movement, limiting touch or tactile contact) recommended by the government will pose immense challenges to individuals with a visual loss. This serious impact, including challenges in healthcare access, can be minimized through inclusive service approaches, involving persons with visual disabilities, caregivers, family members, and healthcare providers, along with the community to a large extent, and finally, support to improve the overall outcomes. The government, along with profit or non-profit private sectors, should consider initiating such inclusive approaches while planning responses to the pandemic. Indeed, the present COVID-19 pandemic provides an opportunity for health care planners and decision-makers of various organizations across India for a reformation of disabilities care. Impacts due to the pandemic and lockdown can be reduced substantially if planning and policy are in place before any emergency happened in the future.
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Affiliation(s)
- Suraj S Senjam
- Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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França ISXD, Coura AS, Sousa FSD, Aragão JDS, Silva AFR, Santos SRD. Acquiring of knowledge about sexual health by blind people: an action research. Rev Lat Am Enfermagem 2019; 27:e3163. [PMID: 31340347 PMCID: PMC6687357 DOI: 10.1590/1518-8345.3006.3163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/08/2019] [Indexed: 11/22/2022] Open
Abstract
Objective: to evaluate knowledge about sexual health, with blind people, before and
after educational intervention. Method: action research conducted with 58 blind people enrolled in a philanthropic
educational institution. A form with sociodemographic and knowledge
variables about Sexually Transmitted Infections was used. The Chi-square and
Fisher tests were performed. Results: men presented higher frequency of alcoholism (p <0.001) and illicit drugs
(p = 0.006). It was found that they used a male condom more frequently than
women using a female condom (p = 0.003), although they had more knowledge
about the prevention of Sexually Transmitted Infections (p = 0.006). Among
these infections, Trichomonas vaginalis (52.4%) was more frequent. Knowledge
gaps on risk factors and safe sex were identified. After the intervention,
an increase in the knowledge about sexual health was detected. Conclusion: the educational intervention, in the light of problematizing pedagogy, (re)
constructed the knowledge on sexual health, empowering the participants
regarding the prevention of Sexually Transmitted Infections. Therefore, it
is necessary that nurses carry out educational interventions with this
clientele, aiming to soften deficits of knowledge about the thematic in
screen.
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Affiliation(s)
| | | | | | - Jamilly da Silva Aragão
- Universidade Estadual da Paraíba, Campina Grande, PB, Brasil.,Universidade de Pernambuco, Recife, PE, Brasil.,Bolsista da Fundação de Amparo a Ciência e Tecnologia do Estado de Pernambuco (FACEPE), Brasil
| | - Arthur Felipe Rodrigues Silva
- Universidade Estadual da Paraíba, Campina Grande, PB, Brasil.,Universidade de Pernambuco, Recife, PE, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Alimaw YA, Hussen MS, Tefera TK, Yibekal BT. Knowledge about cataract and associated factors among adults in Gondar town, northwest Ethiopia. PLoS One 2019; 14:e0215809. [PMID: 31013319 PMCID: PMC6478322 DOI: 10.1371/journal.pone.0215809] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 04/09/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to assess knowledge regarding cataract and associated factors among adults in Gondar town Northwest Ethiopia. Methods A community-based cross-sectional study was conducted on 836 adults age ≥18years, using multi-stage systematic random sampling technique, in Gondar town Northwest Ethiopia from April 15-May 7, 2017. Data were collected using pre-tested structured questionnaires through face to face interview. The collected data was entered to Epi info version 7 and analyzed using SPSS version 20. Binary logistic regression was used to identify associated factors. Those variables with p-value <0.05 and confidence interval ≠ 1 in multivariable logistic regression were considered as statistically significant factors for knowledge regarding cataract. Result Among 845 eligible adults, 98.9% (836) of them were fully participated. The median age of participants was 28 years with an interquartile range of 17 years. Of the total participants, 67.2% (562) of them had awareness about cataract [95% CI, 63.8–70.2]. Among 562 participants, 61.7% of them had good knowledge about cataract [95% CI, 57.5–66.00]. It was also found that higher level of education [AOR = 2.86, 95%CI: 1.37–5.96], higher family monthly income [AOR = 1.92, 95%CI: 1.03–3.57], having previous eye examination [AOR = 1.53, 95% CI: 1.02–2.31] and positive family history of cataract [AOR = 1.76, 95%CI: 1.03–3.01] were positively associated with good knowledge. Conclusion Significant portion of the participants had good knowledge about cataract, which was positively associated with higher level of education, higher family monthly income, presence of previous eye examination and positive family history of cataract. However, significant knowledge gap regarding the risk factors and prevention strategies was recognized. Hence, it might be logical to pay special attention in prospering knowledge on how to prevent the occurrence of the disease.
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Affiliation(s)
- Yezinsh Addis Alimaw
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
| | - Mohammed Seid Hussen
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
| | - Tsehay Kassa Tefera
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
| | - Betelhem Temesgen Yibekal
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
- * E-mail:
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Alrasheed SH, Naidoo KS, Clarke-Farr PC, Binnawi KH. Building consensus for the development of child eye care services in South Darfur State of Sudan using the Delphi technique. Afr J Prim Health Care Fam Med 2018; 10:e1-e9. [PMID: 30456975 PMCID: PMC6244194 DOI: 10.4102/phcfm.v10i1.1767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 07/16/2018] [Accepted: 07/25/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Global estimates suggest there are almost 19 million visually impaired children worldwide, most of whom reside in poor countries, with the major cause being treatable. AIM To determine the barriers to accessing childhood eye care services and to develop an eye care plan for children in South Darfur State, Sudan. SETTING The study took place in South Darfur State, Sudan. METHODS The classical Delphi technique was used to build consensus on a list of statements, which were generated based on the themes established by the experts, as well as on an extensive literature review. RESULTS Response rates ranged from 90% in the first round (n = 18), 100% in the second round (n = 18) to 89% in the third and final round (n = 16). The total number of statements recommended by the Delphi panellists for development of the paediatric eye care plan, was 60 based on a consensus level of 80% agreement or more. The expert's consensus on the following key elements for promotion and improvement of child eye care: The main barriers to accessing child eye care were high poverty rate, unavailability of child eye services and a lack of community awareness. The challenges facing visually impaired children were an absence of paediatric ophthalmologists, low vision and orthoptic services. CONCLUSION The main barriers to accessing child eye care services were financial, clinical access and lack of knowledge. There should be greater collaboration between the Ministries of Health, Education and non-governmental organisations (NGOs), to work together in addressing these barriers.
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Affiliation(s)
- Saif H Alrasheed
- Faculty of Optometry and Visual Science, Al Neelain University Khartoum, Sudan; and, African Vision Research Institute, University of KwaZulu-Natal, South Africa.
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Adamptey B, Naidoo KS, Govender P. Vision-specific and psychosocial impacts of low vision among patients with low vision at the eastern regional Low Vision Centre. AFRICAN VISION AND EYE HEALTH 2018. [DOI: 10.4102/aveh.v77i1.401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Purpose: To determine vision-specific and psychosocial implications of low vision among patients with low vision visiting the Low Vision Centre of the Eastern Regional Hospital in Ghana.Methodology: This was a descriptive case-control study of 41 patients with low vision and 41 patients with normal vision recruited from the Low Vision Centre of the Eastern Regional Hospital by simple random sampling. Data on vision-specific and psychosocial impacts of low vision was collected using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Biographical and clinical characteristics such as age, gender, educational status, marital status, employment and income status were gathered from consenting patients. Mann–Whitney U analysis using Statistical Package for Social Scientists (SPSS) was conducted to compare scores on vision-specific and psychosocial subscales of the NEI VFQ-25 between patients with low vision and patients with normal vision.Results: Patients with low vision recorded the lowest score on the driving subscale (median = 8.33, IQR [interquartile range]: 8.33–41.67, n = 41, p < 0.001), as well as on distance activities (median = 35.42, IQR = 16.70–58.80). Psychosocial implications of low vision included high dependency (median = 33.33, IQR = 25.00–50.00), reduced mental health (median = 37.50, IQR = 25.00–50.00) and limitation in partaking in social activities (median = 50.00, IQR = 37.50–78.00).Conclusion: Low vision has both vision-specific and psychosocial implications for the patients. Low vision management and services should therefore be tailored to meet these psychosocial and vision-specific needs to enable patients better accept their visual changes and to be better prepared to use their remaining vision to achieve their daily goals.
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Abstract
A number of factors and conditions hinder and restrict access to the health care system and its different services; these barriers to access put at risk the health of people by affecting adequate processes. Objective: To carry out a literature review on barriers to access to the health care system and visual health services in Colombia and around the world. Methodology: A literature review was carried out based on a search of the Medline, ScienceDirect, and Pubmed databases, as well as indexed public health journals and the websites of the Local Health Authority, the World Health Organization, the Pan American Health Organization, the UNESCO, and the Brien Holden Vision Institute. Results: The main barriers related to demand, both in general services and in visual health, are the lack of perception on the need for service and lack of economic resources; at the offer level, the existing policies constitute a real obstacle. Conclusions: Awareness-raising in the population, together with the implementation of health policies that grant equal access to health care services, are fundamental to prevent people from being affected, to a large extent, by barriers related to demand or offer, regardless of their location or level of income.
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Sitompul R, Lestari YD, Siregar S, Ayudianingrum A, Isfiyanto I, Kusumowidagdo G, Sari DP, Matiur EB, Sungkar S. The burden of ocular diseases in an underdeveloped village in Southwest Sumba, Eastern Indonesia, 2016. MEDICAL JOURNAL OF INDONESIA 2018. [DOI: 10.13181/mji.v26i4.1808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Background: Prevalence estimates of ocular diseases in a given district are important to plan the programs of eye care services. This study aimed to describe the burden of ocular diseases as an initial step in improving eye care services in underdeveloped areas in Indonesia.Methods: A cross-sectional study was performed among residents of Perobatang Village in Southwest Sumba district in July 2016. Eye examinations were conducted by ophthalmologists, and visual acuity was measured by optometrists. Participants were provided with appropriate treatment according to diagnosis. Surgical services were offered two months after the examination.Results: After eximining a total of 667 of 1,459 (46%) residents, the result showed that the most frequent ocular problems were presbyopia (30.8%), cataract (12.8%), refractive error (11.3%), and pterygium (10.7%). The proportion of myopia was 5.9%, hyperopia was 5.0%, and astigmatism was 2.2%. Moreover, the proportion of blindness was 10%. Cataract caused blindness in 44 participants. Other causes of blindness included age-related macular degeneration, retinopathy, optic atrophy, glaucoma, retinal detachment and trauma.Conclusion: The burden of ocular problems in Perobatang Village, Southwest Sumba, Eastern Indonesia was high. These findings showed the importance of public health action from local government and non-governmental organizations to improve eye care services in Southwest Sumba district.
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Chintende GN, Sitali D, Michelo C, Mweemba O. Situational analysis of communication of HIV and AIDS information to persons with visual impairment: a case of Kang'onga Production Centre in Ndola, Zambia. BMC Res Notes 2017; 10:150. [PMID: 28376854 PMCID: PMC5381018 DOI: 10.1186/s13104-017-2473-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 03/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background Despite the increases in health promotion and educational programs on HIV and AIDS, lack of information and communication on HIV and AIDS for the visually impaired persons continues. The underlying factors that create the information and communication gaps have not been fully explored in Zambia. It is therefore important that, this situational analysis on HIV and AIDS information dissemination to persons with visual impairments at Kang’onga Production Centre in Ndola was conducted. The study commenced in December 2014 to May 2015. Methods A qualitative case study design was employed. The study used two focus group discussions with males and females. Each group comprised twelve participants. Eight in-depth interviews involving the visually impaired persons and five key informants working with visually impaired persons were conducted. Data was analysed thematically using NVIVO 8 software. Ethical clearance was sought from Excellency in Research Ethics and Science. Reference Number 2014-May-030. Results It was established that most visually impaired people lacked knowledge on the cause, transmission and treatment of HIV and AIDS resulting in misconceptions. It was revealed that health promoters and people working with the visually impaired did not have specific HIV and AIDS information programs in Zambia. Further, it was discovered that the media, information education communication and health education were channels through which the visually impaired accessed HIV and AIDS information. Discrimination, stigma, lack of employment opportunities, funding and poverty were among the many challenges identified which the visually impaired persons faced in accessing HIV and AIDS information. Integration of the visually impaired in HIV and AIDS programs would increase funding for economic empowerment and health promotions in order to improve communication on HIV and AIDS information. The study showed that, the visually impaired persons in Zambia are not catered for in the dissemination of HIV and AIDS information. Available information is not user-friendly because it is in unreadable formats thereby increasing the potential for misinformation and limitations to their access. This calls for innovations in the communication on HIV and AIDS information health promotion to the target groups.
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Affiliation(s)
- Grace Nsangwe Chintende
- Department of Public Health, School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia.
| | - Doreen Sitali
- Department of Public Health, School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Charles Michelo
- Department of Public Health, School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Oliver Mweemba
- Department of Public Health, School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
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Lodhia V, Karanja S, Lees S, Bastawrous A. Acceptability, Usability, and Views on Deployment of Peek, a Mobile Phone mHealth Intervention for Eye Care in Kenya: Qualitative Study. JMIR Mhealth Uhealth 2016; 4:e30. [PMID: 27160779 PMCID: PMC4877502 DOI: 10.2196/mhealth.4746] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 10/15/2015] [Accepted: 11/05/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Portable Eye Examination Kit (Peek) is a mobile phone-based ophthalmic testing system that has been developed to perform comprehensive eye examinations. Shortages in ophthalmic personnel, the high cost, and the difficulty in transporting equipment have made it challenging to offer services, particularly in rural areas. Peek offers a solution for overcoming barriers of limited access to traditional ophthalmic testing methods and has been pilot tested on adults in Nakuru, Kenya, and compared with traditional eye examination tools. OBJECTIVE This qualitative study evaluated the acceptability and usability of Peek in addition to perceptions regarding its adoption and nationwide deployment. METHODS Semistructured interviews were conducted with patients and analyzed using a framework approach. This included analysis of interviews from 20 patients, 8 health care providers (HCPs), and 4 key decision makers in ophthalmic health care provision in Kenya. The participants were purposefully sampled. The coding structure involved predefined themes for assessing the following: (1) the context, that is, environment, user, task, and technology; (2) patient acceptability, that is, patients' perceived benefits, patient preference, and patient satisfaction; (3) usability, that is, efficiency, effectiveness, learnability, and flexibility and operability of Peek; and (4) the benefits of Peek in strengthening eye care provision, that is, capabilities enhancer, opportunity creator, social enabler, and knowledge generator. Emerging themes relating to the objectives were explored from the data using thematic analysis. RESULTS Patients found Peek to be acceptable because of its benefits in overcoming the barriers to accessing ophthalmic services. Most thought it to be fast, convenient, and able to reach a large population. All patients expressed being satisfied with Peek. The HCPs perceived it to satisfy the criteria for usability and found Peek to be acceptable based on the technology acceptance model. Peek was also found to have features required for strengthening ophthalmic delivery by aiding detection and diagnosis, provision of decision support, improving communication between provider and patient and among providers, linking patients to services, monitoring, and assisting in education and training. Some of the deployment-related issues included the need for government and community involvement, communication and awareness creation, data protection, infrastructure development including capacity creation, and training and maintenance support. CONCLUSIONS According to all parties interviewed, Peek is an acceptable solution, as it provides a beneficial service, supports patients' needs, and fulfills HCPs' roles, overall contributing to strengthening eye health.
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Affiliation(s)
- Vaishali Lodhia
- London School of Hygiene and Tropical Medicine, London, United Kingdom.
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15
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Norris KL, Beckles GL, Chou CF, Zhang X, Saaddine J. Association of Socioeconomic Status with Eye Health Among Women With and Without Diabetes. J Womens Health (Larchmt) 2016; 25:321-6. [DOI: 10.1089/jwh.2015.5255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Keri L. Norris
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gloria L. Beckles
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chiu-Fang Chou
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Xinzhi Zhang
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jinan Saaddine
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Naidoo KS, Jaggernath J, Ramson P, Chinanayi F, Zhuwau T, Øverland L. The prevalence of self-reported vision difficulty in economically disadvantaged regions of South Africa. Afr J Disabil 2015; 4:136. [PMID: 28730022 PMCID: PMC5433470 DOI: 10.4102/ajod.v4i1.136] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 01/21/2015] [Indexed: 11/05/2022] Open
Abstract
Background Vision impairment, resulting in vision difficulties, is a leading cause of disability, and hence one of the key barriers for people to access education and employment, which may force them into poverty. Objectives The objective of this study was to determine the prevalence of self-reported vision difficulties as an indicator of vision impairment in economically disadvantaged regions in South Africa, and to examine the relationship between self-reported vision difficulties and socio-economic markers of poverty, namely, income, education and health service needs. Methods A cross-sectional study was conducted in economically disadvantaged districts to collect data from households on poverty and health, including vision difficulty. As visual acuity measurements were not conducted, the researchers used the term vision difficulty as an indicator of vision impairment. Data were collected from 27 districts (74 901 respondents). Logistic regression analysis and chi-square tests were used to determine bivariate relationships between variables and self-reported vision difficulty. Kernel density estimators were used for age, categorised by self-reported and not reported vision difficulty. Results Prevalence of self-reported vision difficulty was 11.2% (95% CI, 8.7% – 13.7%). More women (12.7%) compared to men (9.5%) self-reported vision difficulty (p < 0.01). Self-reported vision difficulty was higher (14.2%) for respondents that do not spend any money. A statistically significant relationship was found between the highest level of education and self-reporting of vision difficulty; as completed highest level of education increased, self-reporting of vision difficulty became lower (p < 0.01). A significantly higher prevalence of self-reported vision difficulty was found in respondents who are employed (p < 0.01), 17% (95% CI: 12.8% – 21.1%). Conclusion The evidence from this study suggests associations between socio-economic factors and vision difficulties that have a two-fold relationship (some factors such as education, and access to eye health services are associated with vision difficulty whilst vision difficulty may trap people in their current poverty or deepen their poverty status). The results are thus indicative of the need for further research in South Africa.
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Affiliation(s)
- Kovin S Naidoo
- Brien Holden Vision Institute, Durban, South Africa.,African Vision Research Institute, University of KwaZulu-Natal, South Africa
| | - Jyoti Jaggernath
- African Vision Research Institute, University of KwaZulu-Natal, South Africa.,Vision Cooperative Research Centre, Sydney, Australia
| | | | - Farai Chinanayi
- Brien Holden Vision Institute, Durban, South Africa.,African Vision Research Institute, University of KwaZulu-Natal, South Africa
| | - Tom Zhuwau
- Department of Rural Development and Land Reform, South Africa
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