Longitudinal Studies of Aging in Sub-Saharan Africa: Review, Limitations, and Recommendations in Preparation of Projected Aging Population

Background and Objectives

The United Nations has projected a 218% increase in older people in Sub-Saharan Africa (SSA) between 2019 and 2050, underscoring the need to explore changes that would occur over this time. Longitudinal studies are ideal for studying and proffering solutions to these changes. This review aims to understand the breadth and use of longitudinal studies on aging in the SSA regions, proffering recommendations in preparation for the projected aging population.

Research Design and Methods

This paper is the third of a four-part series paper of a previous systematic mapping review of aging studies in SSA. We updated the search (between 2021 and 2023) and screened the titles/abstracts and full-text articles by a pair of independent reviewers. Data were extracted using a standardized data-charting form, identifying longitudinal studies in SSA.

Results

We identified 193 studies leveraging 24 longitudinal study data sets conducted at 28 unique sites. The World Health Organization's Study on Global AGEing and Adult Health (WHO-SAGE) (n = 59, 30.5%) and Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) (n = 51, 26.4%) were the most used longitudinal data sets. Four studies used more than one longitudinal study data set. Eighteen of the longitudinal study data sets were used only in 1-4 studies. Most (n = 150, 77.7%) of the studies used a cross-sectional analytical approach.

Discussion and Implications

Longitudinal studies on aging are sparingly being utilized in SSA. Most analyses conducted across the longitudinal data set were cross-sectional, which hindered the understanding of aging changes that occurred over time that could better inform aging policy and interventions. We call for funding bodies, such as WHO-SAGE, to develop funding competitions that focus on conducting longitudinal analyses, such as structural equation modeling, highlighting changes occurring among the aging population in SSA.

Awareness and knowledge of eye care providers among government workers in Ilorin, Nigeria

OBJECTIVES

Often the public cannot differentiate among eye care providers with adverse effect on ocular health. This is to ascertain awareness and knowledge of Nigerian public workers about eye care providers.

METHODS

Structured self administered questionnaire on respondents' socio-demography, awareness and knowledge about eye care providers was distributed to 500 consenting public workers in Ilorin, Nigeria.

RESULTS

Four hundred and fifty one respondents, aged 20 to 57 years comprising 213 (50.8%) men and 206 (49.2%) women participated. Majority 348 (87.9%) had tertiary education while the remaining had at least primary education. Most respondents 392 (88.9%) were aware of the availability of eye care providers while 49 (11.1%) were unaware. Based on their knowledge of the eye care providers, three categories of respondents emerged: majority had correct perception, some had wrong perception and some knew nothing about eye care providers. The level of education was found to be significantly associated with the level of awareness and knowledge of the respondents (p< 0.05) while gender was not (p>0.05).

CONCLUSION

Despite the majority of the respondents having good perception of eye care providers, the respondents who had wrong perception and those who were oblivious of eye care providers could be draw backs to eye health care.

Chemical eye injuries: presentation and management difficulties

BACKGROUND/PURPOSE

To review the pattern of presentation and management difficulty of patients with ocular chemical bums.

METHOD

Retrospective study of all patients with ocular burns seen over 8-year period (March 1998-April 2006) in the eye clinic as well as the plastic and reconstructive surgery unit of our hospital. Case files were retrieved and relevant information extracted and analyzed.

RESULTS

There were a total of 23 patients (n=33 eyes) seen in the period under review consisting of 19 males and 4 females. The age ranged from 6-52 years with mean age of 31.87years. The chemical injuries were accidental in 73.9% of the cases and of these 76.5% were work related. The remaining 26.1% resulting from assault were bilateral and led to blindness in all the patients. Main injurious agents were acid and alkali.

CONCLUSION

Major cause of chemical injury was work related; although blindness and disability occurred more in the cases of assault. Occupational health issues need a revisit, preparedness of health institutions to take adequate care of people with ocular burns is presently poor.

Ophthalmology training in Nigeria: the trainee ophthalmologists' perspective

OBJECTIVE

To know the perspective of trainee Ophthalmologists on the present state of Ophthalmology training in Nigeria.

MATERIALS AND METHODS

Semi structured questionnaires were administered on trainee ophthalmologists from 13 different training centres across Nigeria during revision courses and Fellowship examination in year 2004. Included were age, sex, training levels and number of year in training. Also assessed were information on acquisition of theoretical knowledge, surgical and managerial skills as well as availability of relevant ophthalmic resource materials and equipment in their training institutions. Suggestions on the ways to improve the training in Nigeria were also noted.

RESULTS

There were 51 trainees with ages ranging from 29 to 51 years, with a mean of 34.65 (S.D+4.76) year. The male to female ratio was 1.6:1. There were 18 (36%) senior registrars, 31 (62%) registrars and 1 (2%) senior house officer. The period spent in training varied from 2 months to 10 years with a mean of. 3.6 years (S.D+2.2). Acquisition of theoretical knowledge was judged to be adequate by 48 (98%) of trainees. Also acquisition of surgical and managerial skills as well as availability of qualitative ophthalmic resource material were judged to be adequate by 35 (68.7%), 40 (81.6%) and 38 (74.5%) trainees respectively. Suggestions among others include improvement in quantity and quality of ophthalmic resource materials, high volume ophthalmic surgery to aid surgical skill acquisition and structured training programme.

CONCLUSION

Ophthalmology training in Nigeria offers adequate theoretical knowledge and managerial skills acquisition. However, there is the need for further improvement in the area of surgical and diagnostic skills transfer and acquisition as well as availability of quality ophthalmic resources and a well-structured training programme in all the centres.

The choice of ophthalmology as a career among Nigerian medical interns

To determine the choice of ophthalmology as a career among Nigerian medical interns, structured questionnaire was administered to a set of medical interns at the University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara State in the year 2003. The key information sought included the University attended, duration of undergraduate ophthalmology posting, perception of ophthalmology as a specialty, and the choice of postgraduate specialty in order of preference. Also included were improvements they would like to see in the undergraduate teaching of ophthalmology and whether they support the view that interns should have mandatory clinical rotation in other surgical subspecialties like Ophthalmology and Otorhinolaryngology. Seventy-six interns who graduated from seven Nigerian medical schools participated in the study. Average duration of their undergraduate posting in Ophthalmology was 4 weeks. (SD = 3.327). Fifty (67.6%) considered Ophthalmology as an interesting and important specialty, 6 (8.1%) regarded it as a boring specialty, while 18 (24.3%) considered it as just one specialty in their curriculum. Only 5 (6.6%) of the respondents chose Ophthalmology as first choice career while 16 (21%), 14 (18.4%), 13 (17.1%) and 10 (13.2%) chose Surgery, Paediatrics, Community Health and Obstetrics and Gynaecology respectively. 78% of the respondent suggested that interns should have clinical rotation in surgical subspecialties such as Ophthalmology. Other suggestions offered included the need to increase the duration of undergraduate Ophthalmology posting, provision of audiovisual aids and more equipment like Ophthalmoscope for teaching. The interns considered Ophthalmology posting as an important and interesting specialty even though only a few chose it as their future career. There is therefore an urgent need to improve the undergraduate teaching of Ophthalmology. The Medical and Dental Council of Nigeria (MDCN) should make rotation through Ophthalmology a part of the internship curriculum. These measures may increase the interest of medical students and interns alike in Ophthalmology as a career.