Gender, Blindness, and Cataracts: An Analysis of 11 Rapid Assessment of Avoidable Blindness Surveys in Africa Open Access

Dewey-Mattia, Daniel (2012)

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Purpose: The objective of this study was to examine the prevalence of blindness, causes of blindness, and the possible association between gender, blindness, and cataract across 11 regions of Africa.

Methods: Raw data were analyzed from Rapid Assessment for the Avoidable Blindness (RAAB) surveys conducted in Eritrea, The Gambia, Kericho Kenya, Kilimanjaro Tanzania, Southern Malawi, Koulikor Mali, Nakuru Kenya, Western Rwanda, South Africa, South Nyanza Kenya, and Sudan among individuals age 50 and older.

Results: The overall (all 11 surveys) prevalence of bilateral blindness (presenting visual acuity <3/60 in the better eye) was 5.7% (95% CI: 5.2-6.2) for males and 5.0% (95% CI: 4.6-5.5) for females. Comparing male blindness to female blindness, the unadjusted odds ratio (OR) was 1.14 (95% CI: 1.05-1.25) and the age-adjusted OR was 1.07 (95% CI: 0.97-1.17). The overall prevalence of untreated cataract was 9.4% (95% CI: 8.8-9.9). The unadjusted odds ratio (OR) of male cataract to female cataract was 1.00 (95% CI: 0.93-1.07, p=0.9846), while the adjusted OR of male to female cataract controlling for age group was 0.91 (95% CI: 0.85-0.98, p=0.0129). Overall cataract surgical coverage at visual acuity level <6/60 in the better eye was 60.5% for males and 54.5% for females.

Conclusions: The RAAB provides a relatively quick, cost-effective method for estimating the prevalence of blindness, visual impairment, and cataract within district populations. Further validation of the RAAB survey methodology is needed to determine the extent to which previous estimates of blindness and visual impairment may or may not have been overestimated in previous large population-based surveys.

Table of Contents

Table of Contents

I. Chapter I: Background (1)
a. Gender, Blindness, and Visual Impairment
b. Vision 2020 - The Right to Sight
c. Rapid Assessment of Avoidable Blindness
d. Cataract Surgical Rate and Coverage
e. Research Question and Implications
f. References
II. Chapter II: Manuscript (8)
a. Title, Authors, Abstract
b. Introduction (9)
c. Methods (11)
i. Examination and Data Collection
ii. Statistical Analyses
iii. Ethical Approval
d. Results (15)
i. Prevalence of Blindness and Visual Impairment
ii. Gender and Visual Impairment
iii. Causes of Visual Impairment
iv. Gender and Visual Impairment due to Cataract
v. Cataract Surgical Coverage
e. Discussion (19)
i. Limitations

ii. Conclusion
f. References (23)
g. Tables (26)

III. Chapter III (31)
a. Public Health Implications
i. Access to Eye Care Services
ii. Gender Barriers
iii. Analysis of Cluster Sampling
b. Summary/Future Directions
c. References

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