Abstract
Purpose :
While developing countries have attempted to provide vision healthcare to patients, most have not conducted baseline assessments to identify regional differences in eye health needs. We studied patients in 3 regions of Mwanza, Tanzania using a cross-sectional survey design to test the hypothesis that there are significant regional differences in vision health and access to vision services.
Methods :
We enrolled 644 adult patients from 3 regional hospitals in Mwanza—Buzuruga Health Center, Mwananchi Hospital (with access to optometry services), and Kisesa Health Center—to complete a modified Visual Functioning Questionnaire 25 (VFQ-25). Responses were categorized into General Health (GH), General Vision (GV), Ocular Pain (OP), Near Activities (NA), Distance Activities (DA), Social Function (SF), Mental Health (MH), Role Difficulties (RD), Color Vision (CV), Peripheral Vision (PV), and Dependency, with higher scores indicating better functioning in that subscale. One-way ANOVA analyses were conducted to compare differences in responses among the hospitals.
Results :
Patients visiting Buzuruga reported the lowest scores on all subscales except OP and RD. There was a statistically significant effect of the hospital on all VFQ-25 subscales (p<0.05), so patients had varying degrees of vision impairment and daily functioning among the 3 regions. Of 100 employed patients, 37 (37%) claimed to have at least a little difficulty in performing their job duties due to their eyesight. Of 467 unemployed patients, 67 (14.4%) had at least some difficulty in becoming employed due to their eyesight.
At Kisesa, 146 patients (66.1%) have never had an eye exam, compared to 134 (59.0%) at Buzuruga and 69 (39.9%) at Mwananchi (p<0.01)—despite available optometry services at Mwananchi. The most common reason for not seeing an eye doctor was a lack of perception of vision problems at Mwananchi and expense at Kisesa and Buzuruga.
Conclusions :
There are significant regional differences in the burden of vision impairment in Mwanza, with poor vision affecting employment and daily functioning. Therefore, a single national effort for vision health cannot be entirely successful without addressing specific local needs and severity of vision impairment. The cost of vision check-ups, not access to services, was a common cause of infrequent eye checkups, so reducing the cost of vision care appointments may expand patient utilization of vision healthcare in Mwanza.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.