scholarly journals Temporal trends in the prevalence and causes of visual impairment in the South Indian state of Telangana: a population-based cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029114 ◽  
Author(s):  
Srinivas Marmamula ◽  
Rohit C Khanna ◽  
Shashank Yellapragada ◽  
Rajesh Challa ◽  
Javed Mohd ◽  
...  

ObjectivesTo investigate the temporal trends in the prevalence and causes of visual impairment (VI) in South India.DesignPopulation-based cross-sectional studies conducted during the years 2011–2012 and 2017 using identical study methods and in geographical locations are compared. The L V Prasad Eye Institute established services in Khammam and not in Warangal district after the 2011–2012 study.SettingKhammam and Warangal districts in Telangana, India.ParticipantsIn total, 5357 participants aged ≥40 years were examined from two districts in the 2011–2012 study and 4923 participants were examined in the 2017 study.Main outcome measuresAge-adjusted and gender-adjusted temporal trends in the prevalence and causes of VI.Blindness and moderate VI (MVI) were defined as presenting visual acuity worse than 6/60 and 6/18–6/60 in the better eye, respectively. VI included MVI and blindness.ResultsNearly 2500 participants were examined in each location in both the 2011–2012 and 2017 studies. In Khammam district, overall VI declined by 2.5% from 15.5% to 13.0% (p<0.001). While there was no significant change in MVI (p=0.566), blindness declined by 3.0% from 5.4% to 2.4% (p<0.001). In Warangal district, the overall VI remained unchanged (p=0.60). While MVI increased by 3% from 9.3% to 12.3% (p=0.001), blindness declined by 3.5% from 6.5% to 3.0% (p<0.001). While MVI due to cataract increased in both districts, there was a significant decline in MVI due to refractive errors in Khammam.ConclusionThere was a significant decline in VI in Khammam district but not in Warangal district. The differential trends in prevalence and causes of VI can be explained by the availability and uptake of eye care services in these two districts.

Author(s):  
Mologadi D. Ntsoane ◽  
Olalekan A. Oduntan ◽  
Benjamin L. Mpolokeng

Background: Visual impairment and blindness are major health problems worldwide, especially in the rural and remote areas of developing countries. Utilisation of eye care services is essential to reduce the burden of visual impairment and blindness, and it is therefore important that it is monitored.Objectives: The objectives of this study were to determine the level of utilisation of public eye care services and factors that might have influenced their usage in rural communities, Capricorn district, Limpopo Province, South Africa.Method: A population-based cross-sectional study design was used. Participants were residents in selected rural villages located within approximately 5 km of six Government hospitals. Following ethical approval and receipt of informed consent, a questionnaire with closed and open-ended questions was used to collect information on the utilisation of eye care services and factors that might influence utilisation. Descriptive statistics and Pearson’s Chisquare test were used to analyse and compare the data.Results: Many (62.7%) of the respondents had used the government eye care services in the past. Over fifty-nine per cent (59.3%) of them were satisfied with the services. Factors reported to influence utilisation (such as monthly income, knowledge of available services and the need for regular eye tests) were positively associated with utilisation of eye care services in this study (p < 0.05).Conclusion: Utilisation of eye care services was relatively good, but varied significantly between sites. An awareness campaign by government and non-governmental organisations about eye care services may increase utilisation amongst rural communities.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031337 ◽  
Author(s):  
Danba Jiachu ◽  
Ling Jin ◽  
Feng Jiang ◽  
Li Luo ◽  
Hong Zheng ◽  
...  

ObjectivesTo assess the prevalence of visual impairment (VI) and blindness (BL) due to cataract and cataract surgical outcomes in remote dispersed and high-altitude Tibetan areas of China.Design and settingA cross-sectional study was conducted among people aged 50 and above in Tibetan Autonomous Prefecture of Kandze (TAPK), China, in 2017. The Rapid Assessment of Avoidable Blindness protocol was followed.ParticipantsOf 5000 eligible participants, 4764 were examined (response rate 95.3%).Primary and secondary outcome measuresCataract VI was defined as lens opacity at visual acuity (VA) levels of <3/60 (Blindness (BL)), ≥3/60 and <6/60 (severe visual impairment (SVI)), ≥6/60 and <6/18 (moderate visual impairment (MVI)), ≥6/18 and <6/12 (early visual impairment (EVI)).ResultsThe estimated prevalence of cataract BL was 0.61% (95% CI 0.42 to 0.87). With best corrected VA, the estimated prevalence of SVI from cataract was 0.86% (95% CI 0.63 to 1.17); MVI was 2.39% (95% CI 2.00 to 2.87) and EVI was 5.21% (95% CI 4.61 to 5.87). Women in TAPK had a significantly higher prevalence of cataract BL (0.82%, 95% CI 0.54 to 2.15) than men (0.34%, 95% CI 0.16 to 0.70). Women had lower cataract surgical coverage (CSC) by eyes (60.8%, 95% CI 55.5 to 65.8) compared with men (70.1%; 95% CI 63.7 to 75.7). The prevalence of cataract BL was higher among Tibetan (2.28%; 95% CI 1.98 to 2.62) than Han Chinese (1.01%%; 95% CI 0.54% to 1.87%). Overall CSC by person with BL (by better eye) was 82.0% (95% CI 75.2 to 87.6). Among cataract-operated participants, 71.2% had VA equal to or better than 6/18.ConclusionsThe study detected a low prevalence of VI and BL due to cataract with high CSC in the study area compared with many other places in China. Further actions should be taken to improve cataract surgical outcome.


2017 ◽  
Vol 17 (11) ◽  
pp. 2224-2231 ◽  
Author(s):  
Mei Feng ◽  
Ayumi Igarashi ◽  
Maiko Noguchi-Watanabe ◽  
Satoru Yoshie ◽  
Katsuya Iijima ◽  
...  

Author(s):  
Ignatios Ioakeim-Skoufa ◽  
Beatriz Poblador-Plou ◽  
Jonás Carmona-Pírez ◽  
Jesús Díez-Manglano ◽  
Rokas Navickas ◽  
...  

The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.


BMJ ◽  
1998 ◽  
Vol 316 (7145) ◽  
pp. 1643-1646 ◽  
Author(s):  
A Reidy ◽  
D C Minassian ◽  
G Vafidis ◽  
J Joseph ◽  
S Farrow ◽  
...  

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