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Rapid assessment of cataract blindness in an urban district of Gujarat  [cached]
Limburg Hans,Vasavada Abhay,Muzumdar Gautam,Khan M
Indian Journal of Ophthalmology , 1999,
Abstract: Purpose: To estimate the prevalence of bilateral cataract blindness in persons ≥50 years of age in Ahmedabad district, Gujarat. Methods: A total of 1,962 persons ≥50 years of age were examined in clusters of 45 people or less. The survey design used a systematic random cluster sampling. The sample size was calculated assuming a prevalence of bilateral cataract blindness (visual acuity <3/60) of at least 3% and design effect of 1.6, to estimate the actual prevalence of cataract blindness with a sampling error of ≤20 at 80% confidence level. Visual acuity was assessed with glasses, where available, and pinhole was used for visual acuity <6/18. Distant direct ophthalmoscopy in semidark condition with undilated pupil was used to assess the lens status. Results: The age-gender-adjusted prevalence of all blindness was 2.9% in persons ≥50 years of age (6.7% for visual acuity<6/60). The age-gender-adjusted prevalence of bilateral cataract blindness ( visual acuity <3/60) was 1.2% in persons ≥50 years of age. For visual acuity <6/60, the prevalence was 3.1%. The prevalence in females was slightly higher than in males. The prevalence of bilateral and unilateral aphakia and pseudophakia was high. The cataract surgical coverage, an indicator for coverage and service utilization, was 92.9% for persons and 83.1% for eyes. Conclusion: Rapid assessment of cataract blindness in persons ≥50 years of age can be conducted in urban settings with existing resources and at affodable costs, to provide district level data for assessment and monitoring of cataract intervention programs.
The Resolution of the World Health Assembly on the Elimination of Avoidable Blindness
Fifty-sixth World Health Assembly
Community Eye Health Journal , 2003,
Abstract: WHA 56.26. Agenda Item 14.17: 28 May 2003. Elimination of Avoidable Blindness
The Resolution of the World Health Assembly on the Elimination of Avoidable Blindness
R Pararajasegaram
Community Eye Health Journal , 2003,
Abstract: The word ‘resolution’, is a derivative of the French word, ‘soluere’, meaning ‘to solve’, and is defined by The Oxford Dictionary as: ‘The formal expression of opinion or intention by a legislative body or public meeting’. The Resolution on the Elimination of Avoidable Blindness adopted by the Fifty-sixth World Health Assembly meeting in Geneva on the 28 May 2003, therefore, has special significance.The Resolution was adopted by the member states unanimously and testifies first and foremost to the fact that the Right to Sight is not a contentious issue.
Prevalence and Causes of Blindness and Visual Impairment and Their Associated Risk Factors, in Three Tribal Areas of Andhra Pradesh, India  [PDF]
Nakul Singh, Shiva Shankar Eeda, Bala Krishna Gudapati, Srinivasa Reddy, Pushkar Kanade, Ghanshyam Palamaner Subash Shantha, Padmaja Kumari Rani, Subhabrata Chakrabarti, Rohit C Khanna
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0100644
Abstract: Objective To assess the prevalence of blindness and visual impairment (VI), their associated causes and underlying risk factors in three tribal areas of Andhra Pradesh, India and compare this data in conjunction with data from other countries with low and middle income settings. Methods Using a validated Rapid Assessment of Avoidable Blindness methodology, a two stage sampling survey was performed in these areas involving probability proportionate to size sampling and compact segment sampling methods. Blindness, VI and severe visual impairment (SVI) were defined as per the WHO guidelines and Indian definitions. Results Based on a prior enumeration, 7281 (97.1%) subjects were enrolled (mean age = 61.0+/?7.9 years). Based on the presenting visual acuity (PVA), the prevalences of VI, SVI and blindness were 16.9% (95% CI: 15.7–18.1), 2.9% (95% CI: 2.5–3.4), and 2.3% (95% CI: 1.9–2.7), respectively. When based on the Pinhole corrected visual acuity (PCVA), the prevalences were lower in VI (6.2%, 95% CI: 5.4–6.9), SVI (1.5%, 95% CI: 1.2–1.9) and blindness (2.1%, 95% CI: 1.7–2.5). Refractive error was the major cause of VI (71.4%), whereas, cataract was the major cause of SVI and blindness (70.3%). Based on the PVA, the odds ratio (OR) of blindness increased in the age groups of 60–69 years (OR = 3.8, 95% CI: 2.8, 5.1), 70–79 years (OR = 10.6, 95% CI: 7.2, 15.5) and 80 years and above (OR = 30.7, 95% CI: 19.2, 49). The ORs were relatively higher in females (OR = 1.3, 95% CI: 1.0, 1.6) and illiterate subjects (OR = 4.3, 95% CI: 2.2, 8.5), but lower in those wearing glasses (OR = 0.2, 95% CI: 0.1, 0.4). Conclusions This is perhaps the first study to assess the prevalence of blindness and VI in these tribal regions and the majority of the causes of blindness and SVI were avoidable (88.5%). These findings may be useful for planning eye care services in these underserved regions.
The role of avoidable mortality in health assessment
Management in Health , 2010,
Abstract: Measuring the health status of the population is difficult, since many aspects have to be considered. In present, the emphasis is on using tools that includes as many dimensions of health as is possible; also, calculating synthetic and comprehensive indicators covering many aspects of health has become a common practice. Avoidable mortality (with its two components: treatable and preventable causes) is useful in measuring the health status of the population, but also in planning and assessing the healthcare services.In Romania, the avoidable mortality is less studied and data existing at international level require deepening in researching this phenomenon, in order to identify potential weaknesses of the health system and healthcare impact of different policies. For Romania, the level (first place in the EU countries) and increasing trend of phenomenon (mainly for diseases that are treatable) should alert policy makers and politicians. Scientific evidence must accurately reflect reality and decision making process must be supported by a good understanding of the phenomenon.
Prevalence and causes of blindness and Low Vision in Ethiopia
Y Berhane, A Worku, A Bejiga, L Adamu, W Alemayehu, A Bedri, Z Haile, A Ayalew, Y Adamu, T Gebre, T D Kebede, E West, S West
Ethiopian Journal of Health Development , 2007,
Abstract: Background: Ethiopia lacked accurate recent national estimates of blindness and low vision. Therefore, prevention and control programs face serious problem of lack of recognition of the problem and challenges in tracking achievements towards program goals. Objective: To determine the prevalence of blindness and low vision at the national and regional levels in Ethiopia. Method: A national survey was conducted on a representative population in all nine regional states and two city administrations of the country. The LogMar chart was used to determine the presenting visual acuity and ophthalmologists determined the primary cause of low vision and blindness. Results: Based on the assessment of the presenting visual acuity, the national prevalence of blindness is 1.6% (1.1% for urban and 1.6% for rural populations) and that of low vision is 3.7% (2.6% for urban and 3.8% for rural populations). Blindness and Low vision are more prevalent among females. The major causes of blindness are cataract and trachomatous corneal opacity. The major causes of low vision are cataract and refractive error. Prevalence of childhood blindness is 0.1% and accounts for over 6% of the total blindness burden in Ethiopia. The national prevalence of Bitot\'s spots is 0.7%. Conclusion: Blindness and low vision are major public health problems in Ethiopia. The large proportion of low vision (91.2%) and blindness (87.4%) are due to avoidable (either preventable or treatable) causes. Females and rural residents carry greater risk for eye problems. Adequate emphasis needs to be given to prevent blindness among children and avert millions of years of unnecessary blindness. Recognizing the severity of the magnitude of eye problems (blindness and low vision) and enhancing the government commitment to improve the situation is critical. Ethiopian Journal of Health Development Vol. 21 (3) 2007: pp. 204-210
CONSORT 2010 and Controversies Regarding Assessment of Blindness in RCTs
Jafar Kolahi,Heejung Bang,Jongbae Park,Norman A. Desbiens
Dental Hypotheses , 2010,
Abstract: Blinding is one of the key design features of randomized clinical trials (RCTs). Studies not involving blinding could yield biased estimates of the effect of treatment. A meta-analysis found that double blind RCTs found 14% lower treatment effect on average than similar RCTs not described as double-blind. During past years many researchers have emphasized that more efforts are needed for blinding research. For example, sub-item 11b of the 2007 CONSORT statement suggested assessment of blinding. We were waiting for revision and extension of this item that would encourage people to collect and report more data and share their lessons. Yet disappointingly, it was eliminated from CONSORT 2010.As stated by the CONSORT authors, the rationale for this elimination was interpretational and measurement difficulties. Since the claim of internal validity for RCTs with a control arm rests on the assumption of appropriate blinding, we cannot afford to lose the CONSORT’s incentive for improvement and change. It seems contrary to an evidence-based approach to avoid obtaining data because we have to struggle with interpretation and measurement, which is common and natural in various scientific fields and problems.The philosophy of “let us give up because it is difficult to do or interpret” may not be well justified in professional scientific communities, especially when some reasonable statistical methods and clinical guidelines are available or can be developed.
Rapid trachoma assessment in Kersa District, Southwest Ethiopia
M Ejigu, MM Kariuki, DR Ilako, Y Gelaw
Ethiopian Journal of Health Sciences , 2013,
Abstract: Background: Trachoma is the leading cause of infectious blindness worldwide. Though trachoma can be treated with antibiotics (active trachoma) or surgery (trachomatous trichiasis), it is still endemic in most parts of Ethiopia. Despite the prevalence of this infectious disease in different parts of the country, district level data is lacking. This study was thus conducted to assess the prevalence estimate of trachoma and its risk factors in Kersa District, Southwest Ethiopia. Methods: A community based cross sectional Rapid Assessment of Trachoma was conducted using a WHO guideline. Six sub-districts were selected from Kersa District based on primary high risk assessment and from each sub-district; 21-27 households were randomly selected. Active trachoma for children aged 1-9 years, trachomatous trichiasis for people above 15 years old and environmental risk factors for trachoma were assessed. Data were analyzed using SPSS version 16. Results: The overall prevalence estimate of active trachoma was 25.2% (95% CI: 20.7-30.4%). Forty three percent of children had unclean faces, 11.5% of households had water source at more than half hour walking distance, 18.2% did not have functional latrine, and 95.3% of the households had solid waste disposal within a distance of 20 meters. Households with environmental risk factors were at an increased risk to active trachoma, but the association was not statistically significant (p>0.05). The prevalence estimate of trachomatous trichiasis inclusive of “trachoma suspects” was 4.5%. Conclusion: Trachoma is endemic in Kersa District with active trachoma being a public health problem in the studied sub-districts. Hence, SAFE strategy should be implemented.
Why are we addressing gender issues in vision loss?
Paul Courtright,Susan Lewallen
Community Eye Health Journal , 2009,
Abstract: In the last decade, there has been increasing evidence that women are affected by blindness and visual impairment to a much greater degree than men. A systematic review of global population-based blindness surveys carried out between 1980 and 2000 showed that blindness is about 40 per cent more common in women compared to men (in persons older than 50 years). Since then, there have also been a number of large national surveys (for example, in Pakistan and Nigeria), as well as many rapid assessment of avoidable blindness studies (RAABs), which have confirmed the earlier findings. We now know that being a woman is a significant risk factor for some eye diseases; it is also an important factor in the use of eye care services.
Removal of avoidable blindness, our mission
Abdul Kalam APJ
Indian Journal of Ophthalmology , 2007,
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