Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study

Objectives To establish the prevalence of self-reported vision impairment (VI) in Southwest Cameroon and describe associated care-seeking practices, functional limitations and economic hardships.Design A three-stage clustered sampling household community-based survey.Setting The Southwest region of...

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Main Authors: Melissa Carvalho, Susan N Mbeboh, Sabrinah Ariane Christie, Drusia Dickson, Theophile Nana, Frida Embolo, Rochelle Dicker, Catherine Juillard, Alain Chichom Mefire
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e041367.full
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author Melissa Carvalho
Susan N Mbeboh
Sabrinah Ariane Christie
Drusia Dickson
Theophile Nana
Frida Embolo
Rochelle Dicker
Catherine Juillard
Alain Chichom Mefire
author_facet Melissa Carvalho
Susan N Mbeboh
Sabrinah Ariane Christie
Drusia Dickson
Theophile Nana
Frida Embolo
Rochelle Dicker
Catherine Juillard
Alain Chichom Mefire
author_sort Melissa Carvalho
collection DOAJ
description Objectives To establish the prevalence of self-reported vision impairment (VI) in Southwest Cameroon and describe associated care-seeking practices, functional limitations and economic hardships.Design A three-stage clustered sampling household community-based survey.Setting The Southwest region of Cameroon.Participants 8046 individuals of all ages residing in the Southwest region of Cameroon.Primary and secondary outcome measures Prevalence of self-reported VI, onset of vision loss, care-seeking practices, diagnosis and treatment, functional limitations, economic hardships on household, beliefs about surgical treatability of blindness and barriers to surgical care.Results The estimated prevalence of self-reported VI in Southwest Cameroon was 0.87% (95% CI 0.62 to 1.21). Among participants aged ≥40 years, the prevalence increased to 2.61% (95% CI 1.74 to 3.90). Less than a quarter of affected participants reported difficulty working (20.5%) or trouble going to school (12.0%) as a result of their VI. Yet, over half (52%, n=43) of affected households experienced significant economic hardships due to the VI. Residing in an urban setting (aOR 1.16, 95% CI 1.04 to 1.30) and belonging to a higher socioeconomic status (aOR 1.13, 95% CI 1.02 to 1.26) were factors associated with the belief that certain types of blindness were surgically reversible. Formal care was not sought by 16.3% (n=8) of affected participants. Cataracts was the leading diagnosis among participants who did seek formal care (43.2%, n=16), although 93.8% of these cases were not surgically treated, primarily due to a lack of perceived need.Conclusion The prevalence of individuals who report vision impairment in Southwest Cameroon is considerably lower than prior published estimates based on visual physical examinations. Routine community-level screening and cost financing schemes could improve detection of pre-clinical eye disease and the utilisation of surgical care. It could also pre-empt disability and economic hardships associated with advanced VI in the region.
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spelling doaj-art-dddaee47eac742f1a28fc13ea6e28b2f2024-11-23T12:20:08ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-041367Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based studyMelissa Carvalho0Susan N Mbeboh1Sabrinah Ariane Christie2Drusia Dickson3Theophile Nana4Frida Embolo5Rochelle Dicker6Catherine Juillard7Alain Chichom Mefire8Department of Surgery, University of California Los Angeles, Los Angeles, California, USAFaculty of Health Sciences, University of Buea, Buea, CameroonProgram for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California, USADepartment of Surgery, University of California San Francisco, San Francisco, California, USADepartment of Surgery, Limbe Regional Hospital, Limbe, CameroonFaculty of Health Sciences, University of Buea, Buea, CameroonDepartment of Surgery, University of California Los Angeles, Los Angeles, California, USADepartment of Surgery, University of California Los Angeles, Los Angeles, California, USAFaculty of Health Sciences, University of Buea, Buea, CameroonObjectives To establish the prevalence of self-reported vision impairment (VI) in Southwest Cameroon and describe associated care-seeking practices, functional limitations and economic hardships.Design A three-stage clustered sampling household community-based survey.Setting The Southwest region of Cameroon.Participants 8046 individuals of all ages residing in the Southwest region of Cameroon.Primary and secondary outcome measures Prevalence of self-reported VI, onset of vision loss, care-seeking practices, diagnosis and treatment, functional limitations, economic hardships on household, beliefs about surgical treatability of blindness and barriers to surgical care.Results The estimated prevalence of self-reported VI in Southwest Cameroon was 0.87% (95% CI 0.62 to 1.21). Among participants aged ≥40 years, the prevalence increased to 2.61% (95% CI 1.74 to 3.90). Less than a quarter of affected participants reported difficulty working (20.5%) or trouble going to school (12.0%) as a result of their VI. Yet, over half (52%, n=43) of affected households experienced significant economic hardships due to the VI. Residing in an urban setting (aOR 1.16, 95% CI 1.04 to 1.30) and belonging to a higher socioeconomic status (aOR 1.13, 95% CI 1.02 to 1.26) were factors associated with the belief that certain types of blindness were surgically reversible. Formal care was not sought by 16.3% (n=8) of affected participants. Cataracts was the leading diagnosis among participants who did seek formal care (43.2%, n=16), although 93.8% of these cases were not surgically treated, primarily due to a lack of perceived need.Conclusion The prevalence of individuals who report vision impairment in Southwest Cameroon is considerably lower than prior published estimates based on visual physical examinations. Routine community-level screening and cost financing schemes could improve detection of pre-clinical eye disease and the utilisation of surgical care. It could also pre-empt disability and economic hardships associated with advanced VI in the region.https://bmjopen.bmj.com/content/10/11/e041367.full
spellingShingle Melissa Carvalho
Susan N Mbeboh
Sabrinah Ariane Christie
Drusia Dickson
Theophile Nana
Frida Embolo
Rochelle Dicker
Catherine Juillard
Alain Chichom Mefire
Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study
BMJ Open
title Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study
title_full Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study
title_fullStr Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study
title_full_unstemmed Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study
title_short Prevalence, care-seeking practices and impact of self-reported vision impairment in Southwest Cameroon: a community-based study
title_sort prevalence care seeking practices and impact of self reported vision impairment in southwest cameroon a community based study
url https://bmjopen.bmj.com/content/10/11/e041367.full
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