Prevalence of blindness and distance vision impairment in the Gambia across three decades of eye health programming

Abstract

Background/aimsThe 1986 Gambia National Eye Health Survey provided baseline data for a National Eye Health Programme. A second survey in 1996 evaluated changes in population eye health a decade later. We completed a third survey in 2019, to determine the current state of population eye health, considering service developments and demographic change.MethodsWe estimated prevalence and causes of vision impairment (VI) in a nationally representative population-based sample of adults 35 years and older. We used multistage cluster random sampling to sample 10 800 adults 35 and above in 360 clusters of 30. We measured monocular distance visual acuity (uncorrected and with available correction) using Peek Acuity. Participants with either eye uncorrected or presenting (with available correction) acuity <6/12 were retested with pinhole and refraction, and dilated exams were completed on all eyes by ophthalmologists using a direct ophthalmoscope, slit lamp and 90 D lens.ResultsWe examined 9188 participants (response rate 83%). The 2013 census age–sex adjusted prevalence of blindness (presenting acuity<3/60 in better seeing eye) was 1.2% (95% CI 0.9 to 1.4) and of moderate or severe VI (MSVI,<6/18 to ≥3/60) was 8.9% (95% CI 9.1 to 9.7). Prevalence of all distance VI (<6/12) was 13.4% (12.4–14.4). Compared with 1996, the relative risk of blindness decreased (risk ratio 0.7, 95% CI 0.5 to 1.0) and MSVI increased (risk ratio 1.5, 95% CI 1.2 to 0.17).ConclusionSignificant progress has been made to reduce blindness and increase access to eye health across the Gambia, with further work is needed to decrease the risk of MSVI.

Exploring the Use of Washington Group Questions to Identify People with Clinical Impairments Who Need Services including Assistive Products: Results from Five Population-Based Surveys

“…This study uses data from five cross-sectional surveys undertaken in Cameroon, Chile, India, The Gambia and Turkey between 2013 and 2020 ( Table 1 ) [ 12 , 13 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Four were regional/district surveys (Cameroon, Chile, India and Turkey) and one was a national survey (The Gambia).…”

Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys

“…In this paper, we aimed to assess whether one objective asset-based measure and three subjective measures of relative SEP demonstrated a socioeconomic gradient or inequality in key eye health outcomes in the population 50 years and older using data from the 2019 Gambia National Eye Health Survey, a comprehensive cross-sectional survey with an embedded RAAB 21 22. Further, we aimed to assess the level of association between the objective asset-based measure and three subjective measures of relative SEP and recommend one or more indicators to pilot test in other locations.…”