Prevalence and Characteristics of Ophthalmic Problems Reported by East African Refugees: A Cross-Sectional Survey

Abstract

Purpose : Despite global efforts to address gaps in eye care, there is limited research on eye health among forced migrant and refugee populations, especially in east Africa. We aimed to determine the demographic characteristics and care sought by refugees impacted by eye problems in Nyarugusu refugee camp (Kigoma, western Tanzania).

Methods : We used cluster random sampling and the cross-sectional Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool to assess prevalence of surgical disease and baseline access to health services among Nyarugusu refugees. We conducted descriptive analysis and used multivariable logistic regression to explore associations between specific covariates and the presence of a current unresolved eye problem.

Results : Among 3574 interviewed refugees, 429 (12%; mean age 36 ± 20 yr) reported ophthalmic issues. 296 (69%) specified a type of eye problem; acquired disability (44%) and non-injury-related wound (42%) were the most common. Of the 368 (86.4%) who characterized their eye problem as disabling, 78.8% endorsed a negative impact on ability to work and 27.7% required help with daily living. 84.6% [357 of 427] endorsed being currently affected and 88.3% [378 of 427] reported a chronic (>12 months) condition. On multivariable analysis, having a non-injury-related wound and being a housewife were associated with having a current unresolved eye problem; use of primary health services was negatively associated.
Of the 312 (72.7%) respondents who sought healthcare for their eye condition, 13 (4.2%) underwent surgery. Barriers to receiving surgical care included lack of available services, financial constraints, difficulty accessing treatment, and inability to take time off work.

Conclusions : Nearly 1 in 8 refugees endorse eye problems which are often chronic and disabling in nature, with negative impacts on work and daily living. Most refugees who may benefit from surgery have not received surgical care, citing various barriers including lack of available surgical services. Furthermore, current understanding of specific ophthalmic etiologies among marginalized refugee populations is poor; future research on this topic can guide resource allocation to address unmet eye care needs in this setting and help reduce the global burden of eye disease.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Characteristics of eye problems

 

Reasons for not receiving surgery in refugees with current vs resolved eye problems