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Salam AS, Qayumi R, Majeed Siddiqi A, Naseem M, Mansoor M, Butcher R, Bakhtiari A, Renneker K, Willis R, Jimenez C, Dejene M, Safi N, Heggen A, Solomon AW, Harding-Esch EM, Alizoi N. Prevalence of Trachoma in 72 Districts of Afghanistan in 2018-2019: Results of 35 Population-based Prevalence Surveys. Ophthalmic Epidemiol 2023; 30:608-618. [PMID: 35272540 PMCID: PMC10581673 DOI: 10.1080/09286586.2021.2015784] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/16/2021] [Accepted: 12/05/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND To determine where interventions are needed to eliminate trachoma as a public health problem, prevalence data are needed. We aimed to generate baseline population-based data on trachoma prevalence in suspected-endemic areas of Afghanistan. METHODS Cross-sectional population-based prevalence surveys designed according to World Health Organization (WHO) recommendations were conducted in 35 evaluation units (EUs) covering 72 districts. In selected households, all resident individuals aged ≥1 year were examined for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) according to the WHO simplified trachoma grading system. Water, sanitation and hygiene access was assessed in households of survey participants. RESULTS 104,104 people aged ≥1 year were examined, including 43,774 children aged 1-9 years and 46,439 people aged ≥15 years. The age-adjusted prevalence of TF in 1-9-year-olds was ≥5% in 3 EUs, with the highest EU TF prevalence being 7.8%. The age- and gender-adjusted prevalence of TT unknown to the health system in ≥15-year-olds was <0.2% in all EUs. The majority of households had access to an improved water source within 30 minutes of the house. However, only a minority of households had an improved latrine and/or a handwash station. CONCLUSIONS Trachoma is not a public health problem in the majority of EUs surveyed. However, antibiotic mass drug administration, promotion of facial cleanliness and environmental improvement (the A, F and E components of the SAFE strategy) are needed for trachoma elimination purposes in three of the EUs surveyed in Afghanistan.
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Affiliation(s)
| | | | | | | | | | - Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | | | - Naimullah Safi
- Afghanistan Country Office, World Health Organization, Kabul, Afghanistan
| | | | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emma M. Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
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Khatami K, Estedlal A, Vali M, Kamalipour A, Mahmoudinezhad G, Nejabat M, Nowroozzadeh MH, Vardanjani HM. Prevalence and secular trends of four causes of blindness and visual impairment in Iran (1990-2019): a comparative study based on the Global Burden of Disease project's data. Int Ophthalmol 2023; 43:4719-4728. [PMID: 37713146 DOI: 10.1007/s10792-023-02872-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE The purpose of this study was to investigate the prevalence of cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma, as well as their trends from 1990 to 2019 in Iran, in comparison with high-middle socio-demographic index (HMSDI) countries and the world, using the Global Burden of Disease (GBD) 2019 study. METHODS The GBD study provided data on the prevalence of blindness and visual impairment (VI), as well as four of their causes including cataracts, refractive disorders, age-related macular disease (AMD), and glaucoma. Using Joinpoint analysis, the annual percent change (APC) was calculated to assess the trend of change in prevalence in each category of diseases from 1990 to 2019, stratified by sex and age, for Iran, HMSDI countries, and the world. RESULTS In 2019, refractive errors and cataracts were the most common causes of blindness and VI for both genders in Iran, HMSDI countries and the world. Iran had a higher age-standardized prevalence in all four categories of ophthalmologic disorders compared to HMSDI countries and the world for both genders in 2019. Additionally, the age-specific prevalence of all four disorders in 2019 was higher in Iran compared to HMSDI countries. However, in terms of trends of prevalence from 1990 to 2019, the rate of reduction for the four ophthalmologic disorders in Iran was higher than in HMSDI and the world for both males and females. Furthermore, Iran had a greater percentage of reduction in prevalence for all age groups in all four disorders compared to HMSDI countries. CONCLUSION The prevalence of cataracts, refractive errors, AMD, and glaucoma in Iran was higher compared to HMSDI countries in 2019 for both sexes and all age groups, but the trends of prevalence for all four disorders from 1990 to 2019 in Iran had a higher slope of reduction compared to HMSDI countries for all ages and sexes.
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Affiliation(s)
- Kiana Khatami
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - AliReza Estedlal
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - AliReza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Mahmood Nejabat
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hossein Molavi Vardanjani
- MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- MD-MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Soleimani M, Saberzadeh-Ardestani B, Hakimi H, Fotouhi A, Alipour F, Jafari F, Lashay A, Hashemi H. Risk Factors for Uncorrected Refractive Error: Persian Cohort Eye Study - Rafsanjan Center. J Curr Ophthalmol 2022; 34:421-427. [PMID: 37180530 PMCID: PMC10170991 DOI: 10.4103/joco.joco_160_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 01/09/2023] [Accepted: 01/18/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose To determine the prevalence of visually significant uncorrected refractive error (URE) in Rafsanjan and investigate the related factors. URE is the leading cause of visual impairment (VI) which causes the second-highest number of years lived with disability. The URE is a preventable health problem. Methods In this cross-sectional study participants from Rafsanjan who were 35-70 years were enrolled between 2014 and 2020. Demographic and clinical characteristics data were gathered, and eye examination was performed. Visually significant URE was defined as present if habitual visual acuity was (HVA; visual acuity with present optical correction) >0.3 logMAR in the best eye and the visual acuity of that eye showed >0.2 logMAR improvement after the best correction. Logistic regression was used to determine the association between predicting variables (age, sex, wealth, education, employment, diabetes, cataract, and refractive error characteristics) and outcome (URE). Results Among the 6991 participants of Rafsanjan subcohort of the Persian Eye Cohort, 311 (4.4%) had a visually significant URE. Diabetes was significantly more prevalent in the participants with visually significant URE, at 18.7% versus 13.1% in patients without significant URE (P = 0.004). In the final model, each year of increase in age was associated with 3% higher URE (95% confidence interval [CI]: 1.01-1.05). In comparison to low hyperopia, participants with low myopia had 5.17 times more odds of visually significant URE (95% CI: 3.38-7.93). However, antimetropia decreased the risk of visually significant URE (95% CI: 0.02-0.37). Conclusion Policymakers should pay special attention to elderly patients with myopia to effectively reduce the prevalence of visually significant URE.
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Affiliation(s)
| | | | - Hamid Hakimi
- Non-Communicable Disease Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Fateme Alipour, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Ghazvin Sq., Kargar Street, Tehran, Iran. E-mail:
| | - Fatemeh Jafari
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Lashay
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sitole BM, Obioha E. Experiences of people with curable blindness and their caregivers regarding waiting for cataract surgical intervention in the Eastern Cape, South Africa. AFRICAN VISION AND EYE HEALTH 2022. [DOI: 10.4102/aveh.v81i1.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Ye X, Wang J, Zhong X, Qiu W, Yang S, He S, Lou L, Shen L. Association of sex with the global burden of vision impairment caused by neonatal preterm birth: An analysis from the global burden of disease study 2019. Front Public Health 2022; 10:938228. [PMID: 35968463 PMCID: PMC9363690 DOI: 10.3389/fpubh.2022.938228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/08/2022] [Indexed: 12/02/2022] Open
Abstract
Aims To investigate the sex-specific global burden of neonatal preterm birth (NPB) vision impairment by year, age, and socioeconomic status using years lived with disability (YLDs). Methods The global, regional, and national sex-specific YLD numbers, crude YLD rates, and age-standardized YLD rates of NPB-related moderate and severe vision loss and blindness were obtained from the Global Burden of Disease Study 2019. The Wilcoxon test and linear regression were used to investigate the relationship between sex difference in age-standardized YLD rates and the Human Development Index (HDI). Results Between 1990 and 2019, the gender disparity in age-standardized YLD rates for NPB-related vision impairment remained stable, increasing from 10.2 [95% uncertainty interval (UI) 6.7–14.6] to 10.4 (95% UI 6.9–15.0) for men and 10.3 (95% UI 6.8–14.7) to 10.7 (95% UI 7.2–15.1) for women, with women consistently having higher age-standardized YLD rates. Between the ages of 25 and 75, women had higher YLD rates than males, with the biggest disparity in the 60–64 age group. In 2019, sex difference in age-standardized YLD rates across 195 nations was statistically significant. Women had higher age-standardized YLD rates than men in both low (Z = −3.53, p < 0.001) and very high HDI countries (Z = −4.75, p < 0.001). Additionally, age-standardized YLD rates were found to be adversely associated with HDI (male: Standardized β = −0.435, female: Standardized β = −0.440; p < 0.001). Conclusion Despite advancements in worldwide NPB health care, sexual differences in NPB-related vision impairment burden showed little change. Female had higher burden than male, particularly in low and very high socioeconomic status countries.
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Affiliation(s)
- Xin Ye
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jun Wang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiaxing Zhong
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wangli Qiu
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shangchao Yang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shucheng He
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lixia Lou
- Eye Center, School of Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China
- Lixia Lou
| | - Lijun Shen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Lijun Shen
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Sapkota Y, Alizoi N, Siddiqi AM, Naseem M, Salaam AS, Rehman AU, D'Esposito F, Das T. Rapid assessment of prevalence of blindness and cataract surgery in Kabul province, Afghanistan. BMJ Open Ophthalmol 2021; 6:e000790. [PMID: 34557590 PMCID: PMC8413960 DOI: 10.1136/bmjophth-2021-000790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/18/2021] [Indexed: 12/02/2022] Open
Abstract
Objective To estimate prevalence and causes of blindness and vision impairment and assess cataract surgical coverage and quality of cataract surgery in Kabul. Methods and analysis A total of 3751 adults aged 50 years and above were recruited from 77 randomly selected clusters. Each participant underwent presenting and pinhole visual acuity assessment and lens examination. Those with pinhole visual acuity <6/12 in either eye had a dilated fundus examination to determine the cause of reduced vision. Those with apparent lens opacity were interviewed on barriers to cataract surgery. Results The age-adjusted and sex-adjusted prevalence of blindness was 2.4% (95% CI: 1.8% to 3.0%). Prevalence of severe, moderate and mild vision impairment was 2.2% (95% CI: 1.7% to 2.7%), 6.9% (95% CI: 6.0% to 7.9%) and 8.7% (95% CI: 7.5% to 9.8%), respectively. Cataract was the main cause of blindness (36.8%), severe (54.4%) and moderate (46.1%) vision impairment. Uncorrected refractive error was the leading cause of mild vision impairment (20.3%). Age-related macular degeneration was the second leading cause of blindness (23.0%). In people with a presenting visual acuity of <3/60, cataract surgical coverage was 89.7%, and effective cataract surgical coverage was 67.8%. The major barriers to uptake of the available cataract surgical services were the need for surgery was not felt (23.7%) and cost (22.0%). Conclusion Kabul province has a high prevalence of blindness, largely due to cataract and age-related macular generation. The quality of cataract surgery is also lagging in terms of good visual outcomes. This calls for immediate efforts to improving the reach and quality of existing eye services and readiness to respond to the increasing burden of posterior eye disease.
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Affiliation(s)
- Yuddha Sapkota
- South East Asia, International Agency for the Prevention of Blindness, Kathmandu, Bagmati, Nepal
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Al-Yousuf N, Alaali H, Alsetri HM, Yusuf HE, Bhardwaj HK, Husain KA. Causes of Visual Impairment Among the Registered Visually Disabled: A Retrospective Study. Cureus 2021; 13:e17988. [PMID: 34540512 PMCID: PMC8445851 DOI: 10.7759/cureus.17988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 12/30/2022] Open
Abstract
Purpose To study the causes of visual impairment among Bahraini patients registered as visually disabled. Materials and methods A retrospective descriptive study of all patients referred to the Ministry of Social Development for visual disability from January 2014 to December 2019 was performed. Information recorded were age, gender, the cause of the visual impairment, and visual acuity in the better eye. If a patient had multiple ophthalmic diseases, the untreatable disease causing visual impairment was recorded. Patients were considered to have visual impairment according to World Health Organization criteria. Results A total of 484 Bahraini patients were included in the study. The mean age was 57.3 years of age ranging from 3 to 100 years; 63% of the total cases were males. The most common cause of visual impairment was diabetic retinopathy (DR) 201 (41.53%), followed by glaucoma 161 (33.26%). This is followed by hereditary and congenital disorders 34 (7.02%), glaucoma combined with DR 21 (4.34%), other retinal diseases 17 (3.51), retinitis pigmentosa 14 (2.89), optic atrophy 9 (1.86), corneal disorders 8 (1.65%), age-related macular degeneration 8 (1.65%), and others 11 (0.83%). Conclusion DR and glaucoma are the major causes of visual impairment among adults. Complications leading to visual impairment of both disorders are avoidable. Prevention measures to be taken control these diseases and prevent their morbidity. Congenital and hereditary disorders are the most common causes of visual impairment among children.
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Affiliation(s)
| | - Haneen Alaali
- Ophthalmology, Salmaniya Medical Complex, Manama, BHR
| | - Hassan M Alsetri
- Chemistry and Biochemistry, University of California Los Angeles, Los Angeles, USA
| | - Hasan E Yusuf
- Ophthalmology, Salmaniya Medical Complex, Manama, BHR
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Shan Y, Xu Y, Ye L, Lin X, Chen Y, Miao Q, Ye J. Socioeconomic disparity in global vision loss burden due to diabetic retinopathy: an analysis on time trends from 1990 to 2017. Endocrine 2021; 73:316-324. [PMID: 34101111 DOI: 10.1007/s12020-021-02692-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe the trends of socioeconomic disparity in global vision loss burden associated with diabetic retinopathy (DR) based on prevalence and years lived with disability (YLDs). METHODS In the Global Burden of Disease (GBD) 2017 study, we extracted global, regional, national, and World Bank categorical epidemiological data in vision impairment by time and age. We searched the Human development index (HDI) from the Human Development Report. Pearson correlation, linear regression, and Kruskal-Wallis test were conducted to analyze the correlation between YLD rates and HDI. We used the Gini coefficient and concentration index to evaluate the socioeconomic inequality trendency. RESULTS The global and World Bank categorical prevalence and YLDs increased from 1990 to 2017, and rose with ageing. The age-standardized prevalence and YLD rates varied geographically and highest in the Eastern Mediterranean countries. Higher vision loss burden of DR was concentrated in countries with medium level of socioeconomic development, including lower/upper middle-income and medium/high-HDI countries. The Gini coefficient decreased from 0.572 in 1990 to 0.542 in 2017, showing the decreasing between-country inequality. The concentration index decreased from 0.153 in 2000 to 0.061 in 2017, showing the reducing socioeconomic-associated disparity. CONCLUSION The vision loss burden of DR increased in the past few decades, with a notable declining socioeconomic disparity since 2000. Our results highlight the necessity to provide more services to reduce the vision loss burden.
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Affiliation(s)
- Yi Shan
- Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Yufeng Xu
- Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Lingxia Ye
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Xiling Lin
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Yaoyao Chen
- Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Qi Miao
- Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Juan Ye
- Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China.
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Xu Y, Wang A, Lin X, Xu J, Shan Y, Pan X, Ye J, Shan P. Global burden and gender disparity of vision loss associated with diabetes retinopathy. Acta Ophthalmol 2021; 99:431-440. [PMID: 33124190 DOI: 10.1111/aos.14644] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 08/04/2020] [Accepted: 09/17/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To assess the trend patterns and gender disparity in global burden of vision loss due to diabetic retinopathy (DR) by year, age, region and socioeconomic status using prevalence and years lived with disability (YLDs) from Global Burden of Disease (GBD) study 2017. METHODS Prevalence and YLDs data of vision loss attributable to DR were extracted from GBD Study 2017 in 195 countries and territories. Socio-demographic Index (SDI) in 2017 was cited as indicators of socioeconomic status. Kruskal-Wallis test, Dunn's multiple comparisons and Pearson linear correlation were adopted to evaluate the gender disparity and association with socioeconomic levels. RESULTS Globally, total age-standardized prevalence and YLDs rates of vision loss due to DR peaked around 2005, with prevalence rate of 58.98 [95% uncertainty interval (UI) 50.95-68.56] and YLDs rate of 5.00 (95% UI 3.51-6.84) per 100 000 population, respectively. The burden were expected to increase to 65.74 (95% UI 60.14-70.86) and 5.68 (95% UI 4.07-7.22) by 2050. The burden would increase according to our projection based on current epidemiological situation. However, gender disparity has existed since 1990 and been enlarging in recent years, with female being more heavily impacted. This pattern remained with ageing among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized prevalence rates was positively related to SDI (r = 0.1661, p = 0.0203). Diabetes has become a more important risk over the past 3 decades among the leading causes of vision loss. CONCLUSIONS The DR-related vision loss burden tended to increase under ageing population according to our projection with significant gender disparity. Public awareness of DR and gender sensitive health policy should be emphasized.
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Affiliation(s)
- Yufeng Xu
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Aihong Wang
- Department of Endocrinology PLA Strategic Support Force Characteristic Medical Center Beijing China
| | - Xiling Lin
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Jingya Xu
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Yi Shan
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Juan Ye
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Peng‐Fei Shan
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
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Shan Y, Xu Y, Lin X, Lou L, Wang Y, Ye J. Burden of vision loss due to diabetic retinopathy in China from 1990 to 2017: findings from the global burden of disease study. Acta Ophthalmol 2021; 99:e267-e273. [PMID: 32869498 DOI: 10.1111/aos.14573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/02/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE To conduct a detailed analysis on the burden of vision loss due to diabetic retinopathy (DR) by year, age and gender in China from 1990 to 2017. METHODS This is a between-country, retrospective, comparative burden-of-disease study. Prevalence and Years Lived with Disability (YLDs) data caused by DR in China and relative territories were extracted from the Global Burden of Disease (GBD) study 2017 to observe the changing trends of vision loss. RESULTS Prevalence and YLDs of DR in China increased significantly from 1990 to 2017. The age-standardized prevalence and YLDs rate witnessed a slowly declining trend recently. Higher prevalence and YLDs were observed in female subjects in the past three decades. Middle-aged and elderly people suffered from a higher burden of DR-induced vision loss. The total age-standardized prevalence rate of China in 1990 (17.68) and 2017 (21.88) was lower than that of other seven neighbouring countries. In 2017, moderate vision loss (MVL) (17.19) accounted for the largest proportion in China. The all-age YLDs of DR showed the second-highest increase (150.26%) while the age-standardized YLDs rate showed the third-highest increase (14.91%) among fifteen common causes of vision impairment (VI) from 1990 to 2017. China ranked 3rd among G20 countries in terms of all-age YLDs while ranked 18th in age-standardized YLDs rate in 2017. CONCLUSIONS In the past three decades, the prevalence and YLDs due to DR in China have improved in both genders. This study highlights the importance of prevention for DR, especially for women and the elderly.
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Affiliation(s)
- Yi Shan
- Department of Ophthalmology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Yufeng Xu
- Department of Ophthalmology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Xiling Lin
- Department of Endocrinology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Lixia Lou
- Department of Ophthalmology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Yijie Wang
- Department of Ophthalmology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Juan Ye
- Department of Ophthalmology School of Medicine The Second Affiliated Hospital of Zhejiang University Hangzhou China
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Sharififard N, Sargeran K, Gholami M. Perception of oral health and medical conditions as possible predictors of oral health status in visually impaired adolescents: a cross-sectional study. BMC Oral Health 2021; 21:89. [PMID: 33639907 PMCID: PMC7916289 DOI: 10.1186/s12903-021-01447-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/18/2021] [Indexed: 01/22/2023] Open
Abstract
Background We aimed to assess oral health and oral hygiene status among visually impaired adolescents and also to evaluate the factors related to their oral health. Methods This was a cross-sectional study among 130 visually impaired adolescents in Tehran, Iran, in December 2018. Of three schools for visually impaired children in Tehran, children in the sixth to the tenth grade (aged 12–17 years) were included after obtaining their parents’ consent. WHO oral health questionnaire for children was filled out through face to face interviews. General characteristics were age, gender, status of visual impairment, place of residence, and parental education level. Oral health-related questions were perceived dental and gingival health, dental self-care, dental visits, medical conditions, and dietary habits. Oral examinations included Decayed, Missing, and Filled Teeth (DMFT) index, the Simplified Oral Hygiene Index (OHI‑S), and Bleeding on Probing (BOP). Univariate and multiple logistic regression tests were applied using STATA. Results The mean age (SD) of the adolescents was 14.45 (1.61) years. The fully blind children were 33.8%, and those with low vision were 66.2%. Regarding the perception of dental and gingival health, nearly half of the adolescents were satisfied. The mean DMFT and decayed component (DT) were 2.43 ± 2.24 and 1.92 ± 2.12, respectively. The frequency of DMFT ≥ 3 was 45.4%. The mean OHI-S was 2.01 ± 0.70, and OHI-S > 1.8 was reported in 60% of children. The prevalence of BOP was 79.2%. DMFT was significantly associated with toothache (P = 0.003, OR = 3.70, 95% CI: 1.54–9.09), perceived dental health (P = 0.005, OR = 3.06, 95% CI: 1.40–6.67), and medical conditions (P = 0.03, OR = 3.13, 95% CI: 1.13–8.68). In addition, OHI-S was related to gender (P = 0.02, OR = 0.36, 95% CI: 0.15–0.83), perceived dental health (P = 0.006, OR = 2.87, 95% CI: 1.35–6.12) and medical conditions (P = 0.04, OR = 3.05, 95% CI: 1.04–8.97). BOP was associated with perceived gingival health (P = 0.02, OR = 2.94, 95% CI: 1.18–7.33). Conclusions Medical conditions and perceived dental and gingival health are possible predictors for oral health status in these adolescents. Although these children could not visualize caries or gingival bleeding during the brushing time, they could perceive the status of their oral health correctly. Also, being involved in medical problems can make more ignorance of oral health.
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Affiliation(s)
- Nasrin Sharififard
- Department of Community Oral Health, Research Center for Caries Prevention, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, North Kargar Ave, 1439955991, Tehran, Iran
| | - Katayoun Sargeran
- Department of Community Oral Health, Research Center for Caries Prevention, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, North Kargar Ave, 1439955991, Tehran, Iran.
| | - Mahdia Gholami
- Department of Community Oral Health, Research Center for Caries Prevention, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, North Kargar Ave, 1439955991, Tehran, Iran
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Lin X, Lou L, Miao Q, Wang Y, Jin K, Shan P, Xu Y. The pattern and gender disparity in global burden of age-related macular degeneration. Eur J Ophthalmol 2020; 31:1161-1170. [PMID: 32498618 DOI: 10.1177/1120672120927256] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the trend patterns and gender disparity in global burden of age-related macular degeneration (AMD) by year, age, and socioeconomic status using disability-adjusted life-years (DALYs) from Global Burden of Disease (GBD) study 2017. METHODS DALYs and impairment data caused by AMD were extracted from GBD Study 2017. World Bank income level (WBIL) and human development index (HDI) in 2017 were cited as indicators of socioeconomic status. The Gini coefficients and the concentration indexes were calculated to unveil trends in between-country inequality. The association between gender inequality and socioeconomic levels was analyzed by Pearson correlation. RESULTS Total age-standardized DALYs of AMD showed a slightly descending pattern in recent years. However, gender disparity has existed since 1990 for almost three decades, with female being more heavily impacted. This pattern became more obvious with aging and varied among different WHO and WBIL regions. Meanwhile, female subjects tended to have higher vision impairments. Gini coefficients of AMD burden increased from 0.423 to 0.448, while the ones of female-to-male ratio fluctuated around 0.11 between 1990 and 2017, with concentration indexes changing from 0.024 to -0.057 and 0.046 to 0.029 respectively. Female-minus-male difference (r = 0.1721, p = 0.0195) and female-to-male ratio (r = 0.2072, p = 0.0048) of age-standardized DALYs rates were positively related to HDI. CONCLUSIONS Though global AMD health care is progressing, gender imbalance in disease burden of AMD distribution barely improved. Gender sensitive health policy should be emphasized for the increasing elder population and relieving the higher AMD burden of females.
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Affiliation(s)
- Xiling Lin
- Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Lixia Lou
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Qi Miao
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Yijie Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Kai Jin
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Pengfei Shan
- Department of Endocrinology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
| | - Yufeng Xu
- Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China
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A music- and game-based oral health education for visually impaired school children; multilevel analysis of a cluster randomized controlled trial. BMC Oral Health 2020; 20:144. [PMID: 32423446 PMCID: PMC7236198 DOI: 10.1186/s12903-020-01131-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 04/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background Visually impaired children encounter some challenges for their oral health. We aimed to compare the effectiveness of oral health education using Audio Tactile Performance (ATP) technique alone, ATP combined with oral health education for mothers, and ATP along with art package on the oral health status of visually impaired children. Materials and methods This cluster, randomized trial, included visually impaired children from preschool to 10th grade (32 classes, n = 200), in Tehran, Iran, in 2018–2019. A questionnaire was filled out through face to face interviews at baseline regarding age, gender, status of visual impairment, and place of residence. The Simplified Oral Hygiene Index (OHI-S) and Bleeding on Probing (BOP) were examined afterward. Classes were randomly assigned to three groups through simple randomization: 1. Art group (ATP, game-based, and music-based education (11 classes, n = 66); 2. Mothers group (children received ATP and their mothers received education by telephone (10 classes, n = 73); and 3. Control group (children received ATP (11 classes, n = 61). Children received reinforcement after 1 and 2 weeks. Follow-up oral examinations were performed after 1 and 2 months by a blind calibrated examiner. Descriptive statistics were performed using Chi-Square, and ANOVA tests by SPSS (version 22). In analytic statistics, two-level mixed-effects models for BOP and OHI-S were fitted using the Statistical Analysis Software (SAS) version 9.4. Both models fitted with the grouping variable and time (baseline, 1, and 2 months after interventions) as the fixed effects. Results The mean age (SD) of the children was 12.29 (3.45) years (range: 6–17). Male children (67%) more than female children (33%) participated in the study. Also, 35.5% were blind, and 12% resided at the dormitory. The art and mothers groups had no statistically significant difference compared with the control group, in terms of OHI-S (P = 0.92, and 0.39, respectively) and BOP (OR = 0.64, and 0.66, respectively). The time effect was statistically significant in both BOP and OHI-S models (P < 0.0001). Conclusions ATP technique is an effective method to improve the oral health status of visually impaired school children. Oral health promotion programs can be done using this method to tackle oral hygiene problems in visually impaired children. Trial registration (https://www.irct.ir/trial/34676: Nov 29th, 2018)
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Al-Ghamdi AS. Adults visual impairment and blindness - An overview of prevalence and causes in Saudi Arabia. Saudi J Ophthalmol 2019; 33:374-381. [PMID: 31920448 PMCID: PMC6950952 DOI: 10.1016/j.sjopt.2019.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 07/27/2019] [Accepted: 10/07/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND A major socio-economic development in Saudi Arabia affected the pattern and causes of visual impairment for the past 40 years. Moreover, an up-to-date summary of available data is vital for planning, monitoring, and evaluating national blindness prevention program. AIM This study conducted to provide a summary overview of prevalence, causes, and changes in the pattern of blindness and visual impairment for the past 40 years among Saudi adults, with brief discussion of the related socio-economic and ecological factors. METHODS The review was confined to the published epidemiological studies performed in Saudi Arabia covering the age group 18 year and older from 1985 onwards. RESULTS Six epidemiological studies were included from 1985 onwards. In1986, the prevalence of blindness and visual impairment in Saudi Arabia were 1.5% and 7.8%, respectively which is 20 times the magnitude of blindness in the United States. Multiple regional population based studies conducted later in areas with disparate ecological and socio-economical determinants at different time intervals showed variable prevalence of blindness 3.3% Eastern Province 1986, 0.7% Bisha 1993. Recently, in older than 50 year population the reported prevalence was 2.6% Taif 2012 and 5.7% Jazan 2015 and 6.4% in Ahsa. Since 1986, the single leading cause of adult blindness in Saudi Arabia is cataract. Although, Trachoma reported to be the second primary cause of blindness on 1986, its burden is reduced in Jizan (2015) and minimal in Taif (2012) which is replaced by chronic diseases related etiologies i.e Diabetic Retinopathy. CONCLUSION Ecological and socio-economical determinants play critical role in the magnitude and causes of blindness and visual impairment in Saudi Arabia. Significant data gaps obscure monitoring and evaluation of the eye health. Eye health indicators should be integrated into the national health information system for dynamic monitoring and evaluation.
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Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990-2015. Int J Public Health 2018; 63:11-23. [PMID: 28776238 PMCID: PMC5973982 DOI: 10.1007/s00038-017-1017-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/30/2017] [Accepted: 07/07/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. METHODS We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. RESULTS Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. CONCLUSIONS Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.
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