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Marmamula S, Saha R, Khanna RC. Effective Cataract Surgical Coverage in Four Large Districts in Telangana, India - Results from Rapid Assessment of Visual Impairment Study. Ophthalmic Epidemiol 2024:1-7. [PMID: 38569085 DOI: 10.1080/09286586.2024.2336498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE To report cataract surgical coverage (CSC) and effective Cataract Surgical Coverage (eCSC) from four districts in Telangana, India. METHODS Individuals aged ≥40 years were recruited from Adilabad, Mahbubnagar, Warangal and Khammam districts using two stage cluster sampling methodology. All participants had detailed eye examinations including visual acuity assessment using a standard Snellen chart at a distance of six meters, anterior segment examination and fundus imaging by trained professionals. CSC and eCSC were calculated for persons using a 6/12 visual acuity cut-off. RESULTS Of 12,150 individuals enumerated from four districts 11,238 (92.5%) were examined. The mean (standard deviation) age of the participants was 54.1 (±11.2) years (range: 40 to 102 years) and 54.6% (n = 6137) were women. Overall, the CSC (%) was 54.2%. It ranged from a highest of 59% in Khammam followed by 57.5% in Adilabad, 51.7% in Warangal, and a least of 49.7% in Mahbubnagar district. Overall, the eCSC (%) was 39.9%. It ranged from a highest of 46.1% in Adilabad followed by 43.2% in Khammam, 36.2% in Warangal district and a least of 35.8% in the Mahbubnagar district. CONCLUSIONS CSC and eCSC varied across the districts. A significant gap between CSC and eCSC is noted suggestive of challenges with quality of services. District-wise planning of cataract surgical services with a focus on quality care is recommended to improve coverage and contribute towards achieving the goal of universal eye health coverage in the Telangana State in India.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
- Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Ranindita Saha
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Poddar AK, Khan TA, Sweta K, Tiwary MK, Borah RR, Ali R, Sil AK, Sheeladevi S. Prevalence and causes of avoidable blindness and visual impairment, including the prevalence of diabetic retinopathy in Siwan district of Bihar, India: A population-based survey. Indian J Ophthalmol 2020; 68:375-380. [PMID: 31957732 PMCID: PMC7003600 DOI: 10.4103/ijo.ijo_1709_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose: The aim of this study was to estimate the prevalence and causes of visual impairment (VI) and blindness and diabetic retinopathy (DR) in Siwan district, Bihar. Methods: A population-based cross-sectional study was done from January to March 2016 using the Rapid Assessment of Avoidable Blindness 6 (RAAB 6, incorporating DR module) methodology. All individuals aged ≥50 years were examined in 57 randomly selected clusters within the district. Results: A total of 3476 individuals were enumerated and 3189 (92%) completed examination. The overall prevalence of blindness and severe VI was 2.2% (95% confidence interval (CI): 1.6–2.8) and 3.4% (95% CI: 2.6–4.3), respectively. Untreated cataract was the leading cause of blindness (73%) and severe VI (93%). The cataract surgical coverage (CSC) at <3/60 was 71.5% for eyes and 89.3% for persons in this sample and the CSC was similar between the genders. Refractive error (71%) was the primary cause of early VI. The overall prevalence of known and newly diagnosed diabetes was 6.3% (95% CI, 5.4–7.2%). Prevalence of any DR, maculopathy, and sight-threatening DR was 15, 12.4, and 6%, respectively. Conclusion: To conclude, as compared to previous reports, the prevalence of blindness and DR in Siwan district of Bihar was found to be lower and the CSC was higher. However, the problem of avoidable blindness remains a major problem in this region.
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Affiliation(s)
- Ajit Kumar Poddar
- Department of Ophthalmology, Akhand Jyoti Eye Hospitals, Bihar, India
| | - Tanwir Ahmed Khan
- Department of Ophthalmology, Akhand Jyoti Eye Hospitals, Bihar, India
| | - Kumari Sweta
- Department of Ophthalmology, Akhand Jyoti Eye Hospitals, Bihar, India
| | | | - Rishi R Borah
- Orbis India Country Office, Vivekanand Mission Ashram, Netra Niramaya Niketan, Haldia, West Bengal, India
| | - Rahul Ali
- Orbis India Country Office, Vivekanand Mission Ashram, Netra Niramaya Niketan, Haldia, West Bengal, India
| | - Asim Kumar Sil
- Department of Ophthalmology, Vivekanand Mission Ashram, Netra Niramaya Niketan, Haldia, West Bengal, India
| | - Sethu Sheeladevi
- Orbis India Country Office, Vivekanand Mission Ashram, Netra Niramaya Niketan, Haldia, West Bengal, India
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Mohanty S, Jolley E, Mohanty RN, Buttan S, Schmidt E. Integrating Geospatial Data and Measures of Disability and Wealth to Assess Inequalities in an Eye Health Survey: An Example from the Indian Sunderbans. Int J Environ Res Public Health 2019; 16:ijerph16234869. [PMID: 31816932 PMCID: PMC6926603 DOI: 10.3390/ijerph16234869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 11/16/2022]
Abstract
The Sunderbans are a group of delta islands that straddle the border between India and Bangladesh. For people living on the Indian side, health services are scarce and the terrain makes access to what is available difficult. In 2018, the international non-governmental organisation Sightsavers and their partners conducted a population-based survey of visual impairment and coverage of cataract and spectacle services, supplemented with tools to measure equity in eye health by wealth, disability, and geographical location. Two-stage cluster sampling was undertaken to randomly select 3868 individuals aged 40+ years, of whom 3410 were examined. Results were calculated using standard statistical processes and geospatial approaches were used to visualise the data. The age-sex adjusted prevalence of blindness was 0.8%, with higher prevalence among women (1.1%). Cataract Surgical Coverage for eyes at visual acuity (VA) 3/60 was 86.3%. The study did not find any association between visual impairment and wealth, however there were significant differences by additional (non-visual) disabilities at all levels of visual impairment. Geospatial mapping highlighted blocks where higher prevalence of visual impairment was identified. Integrating additional tools in population-based surveys is critical for measuring eye health inequalities and identifying population groups and locations that are at risk of being left behind.
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Affiliation(s)
- Soumya Mohanty
- Monitoring Evaluation Research and Learning, Sightsavers India 110020, India;
| | - Emma Jolley
- Research, Sightsavers, Haywards Heath RH16 3BW, UK
- Correspondence: ; Tel.: +44-1444-446686
| | - RN Mohanty
- India Directorate Sightsavers India 110020, India;
| | - Sandeep Buttan
- Programme Development and Innovation Team, Sightsavers India 110020, India;
| | - Elena Schmidt
- Programme Development, Evidence and Research, Sightsavers, Haywards Heath RH16 3BW, UK;
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Taryam MO, Rabiu MM, Muhammad N, Oladigbolu K, Abdurrahman H. Prevalence and causes of blindness and visual impairment; and cataract surgical services in Katsina state of Nigeria. Br J Ophthalmol 2019; 104:752-756. [PMID: 31488429 PMCID: PMC7286039 DOI: 10.1136/bjophthalmol-2019-314572] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/24/2019] [Accepted: 08/20/2019] [Indexed: 11/20/2022]
Abstract
Aim To generate data on blindness and visual impairment for planning and monitoring a comprehensive eye care programme in Katsina state of Nigeria. Method A rapid assessment of avoidable blindness (RAAB) survey methodology was used to select 3120 persons aged 50 years and over. The sample was selected using a multistage cluster randomised sampling. Each participant had visual acuity and lens assessment. Persons with vision less than 6/12 in any eye were assessed for the cause of visual impairment. Persons with cataract were asked why they had not had surgery. Data were captured electronically with the mRAAB Android-based software and analysed with STATA V.14 software. Results A response rate of 90.1% was achieved. The age-sex adjusted blindness prevalence was 5.3% (95% CI 5.2% to 5.3%). Women were 30% more likely to be blind (OR 1.3, 95% CI 1.2 to 1.3). The principal causes of blindness were cataract (70%), other posterior segment (12%) and glaucoma (7%); 86.7% of blindness was avoidable. The prevalence of cataract blindness is 2.6% (95% CI 2.5% to 2.6%) with higher odds in women (OR 1.2, 95% CI 1.2 to 1.3, p<0.005). The cataract surgical coverage <6/60 for persons was 28.2% and women were 45% less likely to have had cataract surgery (OR 0.55, 95% CI 0.34 to 0.78, p<0.005). The major barriers to cataract surgery are lack of felt need and the cost of services. Conclusion Katsina state of Nigeria has high burden of avoidable blindness affecting more women. The state eye care programme should have cataract services that are more accessible, affordable and gender sensitive.
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Affiliation(s)
- Manal Omran Taryam
- Noor Dubai Foundation, Dubai Health Authority, Dubai, United Arab Emirates
| | - Muhammad M Rabiu
- Noor Dubai Foundation, Dubai Health Authority, Dubai, United Arab Emirates
| | - Nasiru Muhammad
- Ophthalmology Unit, Surgery Department, Usmanu Danfodiyo University, Sokoto, Nigeria.,Ophthalmology Department, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Kehinde Oladigbolu
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Thoufeeq U, Das T, Limburg H, Maitra M, Panda L, Sil A, Trevelyan J, Sapkota Y. First Rapid Assessment of Avoidable Blindness Survey in the Maldives: Prevalence and Causes of Blindness and Cataract Surgery. Asia Pac J Ophthalmol (Phila) 2018; 7:316-320. [PMID: 29165934 DOI: 10.22608/apo.2017332] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE A nationwide rapid assessment of avoidable blindness survey was undertaken in the Maldives among people aged 50 years or more to assess the prevalence and causes of blindness and visual impairment, cataract surgical coverage, cataract surgery outcome, and barriers to uptake of cataract surgical services. DESIGN Prospective population-based study. METHODS In the cluster sampling probability proportionate to size method, 3100 participants in 62 clusters across all 20 atolls were enrolled through house-to-house visits. They were examined in clusters by an ophthalmologist-led team. Data was recorded in mRAAB version 1.25 software on a smartphone. RESULTS The age-sex standardized prevalence of blindness was 2.0% [95% confidence interval (CI), 1.5-2.6]. Cataract was the leading cause of blindness (51.4%) and uncorrected refractive error was the leading cause of visual impairment (50.9%). Blindness was more prevalent in higher age groups and women (16.3%). Cataract surgical coverage was 86% in cataract blind eyes and 93.5% in cataract blind persons. Good visual outcome in cataract operated eyes was 67.9% (presenting) and 76.6% (best corrected visual acuity). In this study, 48.1% of people had received cataract surgery in neighboring countries. Important barriers for not using the services were "did not feel the need" (29.7%) and "treatment deferred" (33.3%). CONCLUSIONS Cataract surgical coverage is good, though nearly half the people received surgery outside the Maldives. Cataract surgery outcomes are below World Health Organization standards. Some barriers could be overcome with additional human resources and training to improve cataract surgical outcomes, which could encourage greater uptake of services within the country.
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Affiliation(s)
| | - Taraprasad Das
- International Agency for Prevention of Blindness South East Asia Regional Office, L V Prasad Eye Institute, Hyderabad, India
- L V Prasad Eye Institute, Hyderabad, India
| | | | | | - Lapam Panda
- L V Prasad Eye Institute, Bhubaneshwar, Odisha, India
| | - Asim Sil
- Netra Niramaya Niketan, Purba Medinipur, West Bengal, India
| | - John Trevelyan
- International Agency for the Prevention of Blindness, London, UK
| | - Yuddha Sapkota
- International Agency for Prevention of Blindness South East Asia Regional Office, L V Prasad Eye Institute, Hyderabad, India
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Abstract
Background: Globally, and in Africa, after adjusting for age, women are about 1.4 times more likely to be blind than men. While women generally live longer than men, the lack of accessibility to and use of services is likely the most important reason for excess blindness in women in Africa. Aim: We sought to review the literature on vision loss in Africa and summarize the findings related to gender equity. Materials and Methods: Information from across sub-Saharan Africa was collected on the evidence of gender inequity and reasons for this inequity. Finally, the results were used to generate suggestions on how gender equity could be improved. Results: In all published surveys (except one), cataract surgical coverage among women was lower than cataract surgical coverage among men. Although data available are limited, similar findings appeared in the use of services for other disease conditions, notably, childhood cataract and glaucoma. Evidence suggests that a variety of approaches are needed to improve the use of eye care services. Three main strategies are needed to address gender inequity in vision loss in Africa. First, it is important to address transport needs. Second, counseling of patients and family members is required. Finally, programs need to put in place pricing systems that make the services affordable the population. Conclusions: VISION 2020 can be achieved in Africa, but investment is needed in a variety of strategies that will ensure that eye care services are affordable, accessible, and acceptable to women and girls.
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Affiliation(s)
- Herrieth Mganga
- Kilimanjaro Centre for Community Ophthalmology, Good Samaritan Foundation, Moshi, Tanzania
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