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Faroog Z, Faroog S, Zia Zaidi AR. First Assessment of Awareness and Knowledge of Glaucoma Among Citizens of Addu City, Maldives: A Cross-Sectional Study. Cureus 2023; 15:e44931. [PMID: 37818521 PMCID: PMC10560861 DOI: 10.7759/cureus.44931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/12/2023] Open
Abstract
Background Glaucoma is a progressive optic neuropathy characterized by visual field loss and potentially irreversible blindness, which poses a significant global health challenge. The Maldives, renowned for its unique geography and vibrant culture, faces unique challenges in healthcare access and delivery due to its scattered islands. Limited access to specialized healthcare services, coupled with cultural and socioeconomic factors, can contribute to disparities in glaucoma awareness and early detection. Understanding glaucoma awareness is paramount due to its potential impact on public health and the healthcare system. The aim of this study is to assess the awareness and knowledge about glaucoma among the citizens of Addu City, Maldives. Methods A cross-sectional study was conducted among 390 residents of Addu City, Maldives. The online survey questionnaire assessed demographic information, knowledge and awareness of glaucoma, and risk factors associated with the disease. Results The majority of participants (66.9%) had never heard of glaucoma. Among those who had heard of glaucoma, only 22.6% knew that it could cause irreversible blindness. Logistic regression analysis and multivariate analysis showed that age, gender, socioeconomic status, and education level were significantly associated with awareness and knowledge of glaucoma (p<0.05). Conclusion Findings suggest a high likelihood of low awareness and knowledge of glaucoma among residents of Addu City, Maldives. The study highlights the urgent need for policymakers, program implementers, and the health sector to conduct awareness programs in the community and provide facilities for annual eye examinations, as well as to organize systematic screening plans for glaucoma across the Maldives.
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Takkar B, Das T, Thamarangsi T, Rani PK, Thapa R, Nayar PD, Rajalakshmi R, Choudhury N, Hanutsaha P. Development of Diabetic retinopathy screening guidelines in South-East Asia region using the context, challenges, and future technology. Semin Ophthalmol 2021; 37:97-104. [PMID: 34003720 DOI: 10.1080/08820538.2021.1925308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: To formulate guidelines for screening of diabetic retinopathy (DR) for the World Health Organization (WHO) South-East Asia Region (SEAR) aligned with the current infrastructure and human resources for health (HRH).Design: A consultative group discussion of technical experts of the International Agency for the Prevention of Blindness (IAPB) from SEAR.Participants: IAPB country chairs and DR technical experts from SEAR countries.Methods: Data related to DR in SEAR was collected from published literature on available DM and DR guidelines and the participating experts. The 10 SEAR countries (the Democratic Republic of Korea was not included for lack of sufficient data) were divided into 3 resource levels (low, medium, and high) based on gross national income/per capita, cataract service indicators (cataract surgical rate and cataract surgical service), current infrastructure and available HRH. Two countries each were assigned to low (Myanmar, Timor-Leste) and high resource (India, Thailand) levels, and the remaining 6 countries (Bangladesh, Bhutan, Indonesia, Maldives, Nepal, Sri Lanka) were assigned the medium resource level. The DR care system was divided into 3 levels of care (essential, recommended, and desirable) and 3 levels of service delivery (primary, secondary, and tertiary).Main outcome measures: Primary, secondary, and tertiary level guidelines for screening of DRResults: Nine WHO SEAR countries participated in the formulation of the new country-specific DR screening guidelines. The DR screening recommendations were: advocacy at the community level, visual acuity measurement, and non-mydriatic fundus photography at the primary level, comprehensive eye examination and retinal laser at the secondary level, and intravitreal therapy and vitrectomy at the tertiary level. The systemic care of DM and hypertension are recommended at all levels commiserating with their care capabilities.Conclusions: The DR guidelines for the SEAR region are the first region-specific and resource-aligned recommendations for comprehensive DR care in each country of the region. In the future, the new technological advances in retinal camera technology, teleophthalmology, and artificial intelligence should be included within the structure of the public DR care system.
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Affiliation(s)
- Brijesh Takkar
- Srimati Kanuri Santamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India.,Indian Health Outcomes, Public Health and Economics Research (IHOPE) Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Taraprasad Das
- Srimati Kanuri Santamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India.,Regional Chair, International Agency for Prevention of Blindness, Hyderabad, India
| | - Thaksaphon Thamarangsi
- Healthier Populations and Non-Communicable Disease, WHO Regional Office for South- East Asia Region, New Delhi, India
| | - Padmaja K Rani
- Srimati Kanuri Santamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India
| | - Raba Thapa
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Patanjali D Nayar
- Disability & Injury Prevention and Rehabilitation, Healthier Populations and Non-Communicable Disease, WHO Regional Office for South- East Asia Region, New Delhi, India
| | - Ramachandran Rajalakshmi
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | | | - Prut Hanutsaha
- Department of Ophthalmology, Mahidol University, Nakhon Pathom, Thailand
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Lepcha NT, Sharma IP, Sapkota YD, Das T, Phuntsho T, Tenzin N, Shamanna BR, Peldon S. Changing trends of blindness, visual impairment and cataract surgery in Bhutan: 2009-2018. PLoS One 2019; 14:e0216398. [PMID: 31071127 PMCID: PMC6508732 DOI: 10.1371/journal.pone.0216398] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/20/2019] [Indexed: 11/26/2022] Open
Abstract
Purpose To obtain new rapid assessment of avoidable blindness (RAAB) data on the prevalence, causes and trends of blindness, visual impairment and cataract surgery; and compare the new 2018 data with the older RAAB 2009 data. Methodology The second nationwide RAAB used android based mRAAB technique and technology for data collection. Using the compact segment sampling probability proportionate to size, 5,050 participants from 101 clusters of 50 people aged 50 years and older were enrolled through house-to-house visits. Eligible participants received ophthalmic examination and interview by the ophthalmologist-led emuneration team as per the RAAB protocol. Results The age-sex adjusted magnitude of bilateral blindness in Bhutan was 1.0% (95% Confidence Interval, CI 0.5–1.4) with relatively higher prevalence in rural population (Odds Ratio, OR 1.5, p = 0.13) and women (OR 1.6, p = 0.06). Untreated cataract accounted for the most of blindness (53.8%), severe vision impairment (57.1%), and moderate visual impairment (65.3%); uncorrected refractive error was the main cause of early visual impairment (46.7%). Cataract Surgical Coverage was 86.1% with relatively better coverage in men (76.7% men; 73.1% female) and urban population (79.2% urban; 70.2% rural). Good cataract surgical outcome was achieved in 67.3% and leading cause of poor outcome was ocular comorbidity (43.6%). Accessibility was a significant barrier to the uptake of cataract surgical services. Conclusion There is a 33% reduction in blindness from 1.5% to 1.0%, since the first RAAB survey in 2009. In order to further reduce blindness and visual impairment, Bhutan should continue to implement long-term strategic action plan for eye health focused on strengthening primary eye care and comprehensive eye care service.
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Affiliation(s)
- Nor Tshering Lepcha
- Department of Ophthalmology, JDW National Referral Hospital, Thimphu, Bhutan
- * E-mail:
| | - Indra Prasad Sharma
- Department of Ophthalmology, JDW National Referral Hospital, Thimphu, Bhutan
| | - Yuddha Dhoj Sapkota
- International Agency for Prevention of Blindness, South East Asia Regional Office, Banjara Hills, Hyderabad, India
| | - Taraprasad Das
- International Agency for Prevention of Blindness, South East Asia Region, Kallam Anji Reddy Campus, L V Prasad Marg, Hyderabad, India
| | - Tshering Phuntsho
- Department of Ophthalmology, JDW National Referral Hospital, Thimphu, Bhutan
| | - Ngawang Tenzin
- Department of Ophthalmology, JDW National Referral Hospital, Thimphu, Bhutan
| | | | - Sonam Peldon
- Primary Eye Care Program, Ministry of Health, Thimphu, Bhutan
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