Abstract
Purpose :
Vision impairment (VI), affects 2.2 billion people globally, but is not evenly distributed between countries. Understanding country-specific determinants of VI is important. We aimed to investigate associations of VI in The Gambia to help in the future planning of eye services.
Methods :
A national eye survey was conducted in The Gambia in adults aged ≥35 years (February-July 2019). Multistage cluster random sampling of 10,800 adults was performed. Monocular distance visual acuity was recorded and VI reported (all VI ≤6/12, moderate or severe visual impairment (MSVI) =VA 6/18 to ≥3/60 and blindness <3/60 in the better seeing eye). Participants underwent dilated slit-lamp examination and were asked demographic and general health questions. Associations between vision impairment and predictors were examined with logistic regression.
Results :
We examined 9,188 participants (85% response rate). Prevalence of all levels of VI was higher in people aged ≥50 years; odds of VI increased with age (aOR 2.44, p<0.001). Adjusted prevalence of all VI and MSVI was higher in women than men (all VI 14.0% (95% CI 13.2-14.9) vs 10.8% (95% CI 9.7- 12.0); MSVI 11.2% (95% CI 10.2-12.4) vs 6.5% (95% CI 5.7- 7.5); aOR of all VI in women 2.44, p<0.001). Prevalence of mild VI and blindness were similar by sex. VI prevalence was lower in those who completed primary and secondary education, compared to no formal schooling (aOR 0.50, p<0.001). Participants with VI were more likely to have another disability (aOR 4.35, p<0.001) and over half of blind participants had another disability (55.7% (95% CI 44.4-66.5); aOR 14.0, p<0.001). There were no differences between rural and urban settings for any VI category.
Conclusions :
VI was associated with increasing age, and MSVI was associated with being female. There was no association between VI and living in rural areas, in contrast to some other African countries. Rates of physical disabilities were higher in participants with VI and over half of blind participants had another disability. These findings help identify at risk sub-groups and will lead to better targeted provision of eye care.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.