June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Determination of the cost and quality of life impact due to glaucoma in Tanzania, East Africa.
Author Affiliations & Notes
  • Andrew F Smith
    Medmetrics Inc., Ottawa, Ontario, Canada
    Department of Ophthalmology, King's College London, London, United Kingdom
  • Kazim Dhalla
    Dr Agarwals Eye Hospital, Dar Es Salaam, Tanzania, United Republic of
  • Helen Baker
    Institute of Ophthalmology, UCL, London, United Kingdom
  • Bernadetha Shilio
    Community Development, Gender, Elderly and Children, National Eye Care Program, Ministry of Health, Dodoma, Tanzania, United Republic of
  • Ian Murdoch
    Institute of Ophthalmology, UCL, London, United Kingdom
    Moorfield's Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Andrew Smith, Medmetrics Inc. (F); Kazim Dhalla, None; Helen Baker, None; Bernadetha Shilio, None; Ian Murdoch, None
  • Footnotes
    Support  British Council for the Prevention of Blindness, London, England
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3093. doi:
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      Andrew F Smith, Kazim Dhalla, Helen Baker, Bernadetha Shilio, Ian Murdoch; Determination of the cost and quality of life impact due to glaucoma in Tanzania, East Africa.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3093.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the cost and quality of life impact due to glaucoma in Tanzania, East Africa.

Methods : An expert panel of eye health professionals was convened to agree current glaucoma practice in Tanzania. In addition, a structured patient survey was developed and administered. Supplemental cost and quality of life information was collected using cost questionnaires and validated quality of life measures, including the EQ5D and VFQ-25. Participants were drawn from both urban and rural parts of Tanzania attending a private specialist glaucoma clinic in the capital Dar Es Salaam.

Results : Non-adherence with any form of glaucoma treatment, be it medical or surgical was a major obstacle, especially in rural settings where over 50% of the patients failed to return for review and follow up. While medical therapy is overwhelmingly the first line treatment, the cost of maintaining this represents up to 25% of a patient’s income. There is a deleterious impact of glaucoma on patient’s general well-being as determined by the EQ-5D and more tellingly on visual function. Forty percent (40%) of participants experienced either moderate or extreme impact on their overall quality of life as measured by the EQ-5D and there was a particularly negative impact on role limitations as determined by the VFQ-25 with a mean value of 52 (SD=32). Despite our sample being taken from a private clinic and thus containing a much larger proportion of professionals than the general population, some 33% of this population earned less than TzS 170,000 (< US$ 75) per month, which is well below the minimum living wage.

Conclusions : These findings are of great importance for eye health planners seeking to determine cost-effective and acceptable methods for identifying and treating this major cause of preventable blindness.

This is a 2020 ARVO Annual Meeting abstract.

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