Prevalence and causes of vision loss in Sub-Saharan Africa: 1990-2010.

Abstract

Purpose: To estimate the magnitude, temporal trends and sub-regional variation in the prevalence of blindness and moderate/severe vision impairment (MSVI) in Sub-Saharan Africa.

Methods: A systematic review was conducted of published and unpublished population-based surveys as part of the Global Burden of Disease, Risk Factors and Injuries Study 2010. The prevalence of blindness and vision impairment by country and subregion was estimated.

Results: In Sub-Saharan Africa, 52 studies satisfied the inclusion criteria. The estimated age-standardised prevalence of blindness decreased by 32% from 1.9% (95% confidence interval (CI): 1.5-2.2) in 1990 to 1.3% (95%CI: 1.1-1.5) in 2010 and MSVI by 25% from 5.3% (95%CI: 0.2-0.3) to 4.0% (95%CI: 0.2-0.3) over that time. However, there was a 16% increase in the absolute numbers with blindness and a 28% increase in those with MSVI. The major causes of blindness in 2010 were; cataract 35%, other/unidentified causes 33.1%, refractive error 13.2%, macular degeneration 6.3%, trachoma 5.2%, glaucoma 4.4% and diabetic retinopathy 2.8%. In 2010, age-standardized prevalence of MSVI in Africa was 3.8% (95%CI: 3.1-4.7) for men and 4.2% (95%CI: 3.6-5.3) for women with sub-regional variations from 4.1% (95%CI: 3.3-5.4) in West Africa to 2.0% (95%CI: 1.5-3.3) in Southern Africa for men; and 4.7% (95%CI: 3.9-6.0) in West Africa to 2.3% (95%CI: 1.7-3.8) in Southern Africa for women.

Conclusions: The age-standardised prevalence of blindness and MSVI decreased substantially from 1990 to 2010, although there was a moderate increase in the absolute numbers with blindness or MSVI. Significant sub-regional and gender disparities exist.

Keywords: 754 visual acuity • 445 cataract