Epidemiology of glaucoma in Sub-Saharan Africa: Prevalence, incidence and risk factors

Abstract

Purpose:The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness.Methods:Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa.Results:Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition.Conclusion:Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma.

Nigeria Normative Data for Defining Glaucoma in Prevalence Surveys

“…There is a need for more rigorous population-based data from African countries where glaucoma is often the second most frequent cause of blindness after cataract. 52 It is noteworthy that longer eyes did not necessarily have larger VCDRs. However, as predicted VCDR increased with increasing VDD, VCDR was moderately disc-size dependent.…”

Improving services for glaucoma care in Nigeria: implications for policy and programmes to achieve universal health coverage

“…Glaucoma in Africa is sometimes referred to as the silent thief of sight ,5 and available evidence indicates that the health system in Nigeria is failing to meet the needs of patients with glaucoma. Based on our findings6–10 (summarised in figure 1), we propose future directions for improving services for glaucoma care in Nigeria, and the implications for policy and programmes to control glaucoma blindness, using a health system-oriented approach.…”

Phacoemulsification compared with phacotrabeculectomy surgery: a within-person observational cohort study

“…This study addresses an important question for African populations in which most patients present very late when one eye is nearly lost from glaucoma and the other eye has advanced disease 24. In this context, surgery is often the first line of treatment.…”