Prevalence of blindness and cataract surgical coverage in Narayani Zone, Nepal: a rapid assessment of avoidable blindness (RAAB) study

Pradhan, Sangita; Deshmukh, Avnish; Shrestha, Puspa Giri; Basnet, P.; Kandel, Ram Prasad; Lewallen, Susan; Sapkota, Yuddha Dhoj; Bassett, Ken; Yin, Vivian T.

doi:10.1136/bjophthalmol-2017-310716

Cited by 24 publications

(12 citation statements)

References 4 publications

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“… 7 In all three places, about 50%–60% of blindness and SVI was due to cataract. The prevalence of blindness and visual impairment in Kandze prefecture also resembled findings from RAAB studies in Jiangxi Province and Chaonan Region in China 8 9 and in Nepal 10 but lower than the Hainan Province in China. 11 …”

Section: Discussionsupporting

confidence: 69%

Blindness and eye disease in a Tibetan region of China: findings from a Rapid Assessment of Avoidable Blindness survey

Jiachu¹,

Jiang²,

Luo³

et al. 2018

BMJ Open Ophth

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IntroductionThe only population-based survey of blindness and visual impairment of a Tibetan population was conducted in the Tibet Autonomous Region in 1999.Methods and analysisThe Rapid Assessment of Avoidable Blindness methodology was used to conduct a survey of Kandze Tibetan Autonomous Prefecture, Sichuan Province of China in the Fall 2017. Using the 2010 census, 100 clusters of 50 participants aged 50 years or older were randomly sampled using probability proportionate to size.ResultsAmong the 5000 people enumerated, 4763 were examined (95.3% response). The age-adjusted and sex-adjusted prevalence of blindness, severe visual impairment, moderate visual impairment and early visual impairment (EVI) were 1.6% (95% CI: 1.08 to 2.38)), 0.9% (95% CI:0.7 to 1.5), 5.1% (95% CI:4.4 to 5.7), and 7.45% (95% CI:6.67 to 8.2), respectively. The prevalence of blindness among Tibetans was significantly higher than that among Han Chinese (2.2% (95% CI:1.8 to 2.6) and 0.6 (95% CI:0.2 to 1.7), respectively, p<0.05). Women bore a significant excess burden of EVI compared with men (8.5% (95% CI:7.5 to 9.6) and 6.1% (95% CI:5.1 to 7.2), respectively, p<0.05). Cataract was the primary cause of blindness (39.4%) followed by macular degeneration (10.6%) and corneal opacity (5.3%).ConclusionBlindness and visual impairment in Kandze Tibetan Autonomous Prefecture is substantially less than an earlier study of a Tibetan region and now resembles other regions of China. About 58% of blindness and 67% of SVIwere avoidable, primarily by providing cataract services. Eighty-three percent of EVI was avoidable by providing refractice services throughout the region.

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Section: Discussionsupporting

confidence: 69%

Blindness and eye disease in a Tibetan region of China: findings from a Rapid Assessment of Avoidable Blindness survey

Jiachu¹,

Jiang²,

Luo³

et al. 2018

BMJ Open Ophth

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“…A 2016 population-based survey in the study area estimated a 3.7% prevalence of severe visual impairment or blindness among individuals ≥50 years of age, with the most common causes being cataract (76.2%), refractive error (6.9%), corneal opacity (3.0%), glaucoma (2.5%), AMD (2.5%), DR (1.5%) and other posterior segment disease (4.0%). 14…”

Section: Study Settingmentioning

confidence: 99%

Cluster-randomised trial of community-based screening for eye disease in adults in Nepal: the Village-Integrated Eye Worker Trial II (VIEW II) trial protocol

et al. 2020

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IntroductionThe majority of blindness worldwide could be prevented or reversed with early diagnosis and treatment, yet identifying at-risk and prevalent cases of eye disease and linking them with care remain important obstacles to addressing this burden. Leading causes of blindness like glaucoma, diabetic retinopathy and age-related macular degeneration have detectable early asymptomatic phases and can cause irreversible vision loss. Mass screening for such diseases could reduce visual impairment at the population level.Methods and analysisThis protocol describes a parallel-group cluster-randomised trial designed to determine whether community-based screening for glaucoma, diabetic retinopathy and age-related macular degeneration reduces population-level visual impairment in Nepal. A door-to-door population census is conducted in all study communities. All adults aged ≥60 years have visual acuity tested at the census visit, and those meeting referral criteria are referred to a local eye care facility for further diagnosis and management. Communities are subsequently randomised to a community-based screening programme or to no additional intervention. The intervention consists of a single round of screening including intraocular pressure and optical coherence tomography assessment of all adults ≥60 years old with enhanced linkage to care for participants meeting referral criteria. Four years after implementation of the intervention, masked outcome assessors conduct a repeat census to collect data on the primary outcome, visual acuity. Individuals with incident visual impairment receive a comprehensive ophthalmological examination to determine the cause of visual impairment. Outcomes are compared by treatment arm according to the originally assigned intervention.Ethics and disseminationThe trial has received ethical approval from the University of California San Francisco Institutional Review Board, Nepal Netra Jyoti Sangh and the Nepal Health Research Council. Results of this trial will be disseminated through publication in peer-reviewed journals and presentation at local and international meetings.Trial registration numberNCT03752840

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“…The prevalence of visual impairment also varies across different age groups [11]. The Rapid Assessment of Avoidable Blindness (RAAB) survey conducted during 2008 to 2010 found that the prevalence of VI was 13.2% in the Bagmati and Janakpur zones of Nepal in those aged 50 years and above [12,13]. This study indicated the high magnitude of visual problems in Nepal.…”

Section: Introductionmentioning

confidence: 96%

Prevalence and causes of visual impairment and blindness in three ecological regions of Nepal

Shrestha

Sun

Limbu

et al. 2019

Preprint

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Background: Visual impairment and blindness are significant public health issues worldwide. The study aims to explore is the prevalence and causes of moderate to severe visual impairment and blindness across three ecological regions of Nepal. Methods: A comparative cross-sectional study was conducted in three districts covering all ecological regions of Nepal. Intensive training for health workers was provided to conduct door-to-door visits for visual acuity testing using Snellen chart and refer the abnormal cases for comprehensive ocular examination by technicians and ophthalmologists to diagnose and treat ocular morbidities. Collected data were analyzed using Statistical Package for Social Sciences and Stata software. Results: Altogether 5234 participants were enrolled in the study. The overall prevalence of moderate to severe visual impairment was 9.5% (4.7% in the Mountain district, 11.2% in the Hill district and 21.2% in the Tarai district), though the prevalence of MSVI was 1.5% in participants aged 15-49 years and 25.1% in those aged ≥50. The overall prevalence of blindness was 0.9%, and the prevalence of blindness in the 15-49 and ≥50 age groups was 0.2% and 2.3% respectively. Most cases of visual impairment and blindness (95.5%) were an avoidable cause, of which 93.7% were treatable and 1.8% were preventable. Overall, cataract was the leading cause of visual impairment and blindness (53.5%), followed by uncorrected refractive error (39.5%). Conclusion: The prevalence of visual impairment and blindness varied significantly with age, ethnicity and locality. The correction of refractive error and cataract surgery would reduce nine in ten cases of moderate to severe visual impairment and blindness. Key words: Epidemiology, Public health, visual, Optic and refraction

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Prevalence of blindness and cataract surgical coverage in Narayani Zone, Nepal: a rapid assessment of avoidable blindness (RAAB) study

Abstract: The prevalence of blindness in people over the age of 50 years has decreased from 6.9% in 2006 to 1.2%, a level in keeping with the national average; however, significant gender inequity persists. CSC has improved but continues to favour men.

Cited by 24 publications

References 4 publications

Blindness and eye disease in a Tibetan region of China: findings from a Rapid Assessment of Avoidable Blindness survey

Blindness and eye disease in a Tibetan region of China: findings from a Rapid Assessment of Avoidable Blindness survey

Cluster-randomised trial of community-based screening for eye disease in adults in Nepal: the Village-Integrated Eye Worker Trial II (VIEW II) trial protocol

Prevalence and causes of visual impairment and blindness in three ecological regions of Nepal

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