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Prevalence and causes of vision loss in sub-Saharan Africa: 1990–2010
  1. Kovin Naidoo1,
  2. Stephen Gichuhi2,
  3. María-Gloria Basáñez3,
  4. Seth R Flaxman4,
  5. Jost B Jonas5,
  6. Jill Keeffe6,
  7. Janet L Leasher7,
  8. Konrad Pesudovs8,
  9. Holly Price9,
  10. Jennifer L Smith10,
  11. Hugo C Turner3,
  12. Richard A White11,
  13. Tien Y Wong12,
  14. Serge Resnikoff13,
  15. Hugh R Taylor14,
  16. Rupert R A Bourne9,
  17. on behalf of the Vision Loss Expert Group of the Global Burden of Disease Study
  1. 1African Vision Research Institute, University of Kwazulu-Natal, South Africa and Brien Holden Vision Institute, Sydney, NSW, Australia
  2. 2Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
  3. 3Faculty of Medicine, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
  4. 4School of Computer Science & Heinz College, Carnegie Mellon University, Pittsburgh, USA
  5. 5Department of Ophthalmology, Universitätsmedizin, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  6. 6L V Prasad Eye Institute, Hyderabad, India
  7. 7Nova Southeastern University, Fort Lauderdale, USA
  8. 8NHMRC Centre for Clinical Eye Research, Flinders University, Adelaide, Australia
  9. 9Vision & Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, UK
  10. 10London School of Hygiene & Tropical Medicine, London, UK
  11. 11Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
  12. 12Singapore Eye Research Institute, Singapore National Eye Centre, National University of Singapore, Singapore, Singapore
  13. 13Brien Holden Vision Institute, Sydney, Australia
  14. 14Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
  1. Correspondence to Professor Rupert R A Bourne, Vision and Eye Research Unit, Postgraduate Medical Institute, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK; rb{at}rupertbourne.co.uk

Abstract

Aim To estimate the magnitude, temporal trends and subregional variation in the prevalence of blindness, and moderate/severe vision impairment (MSVI) in sub-Saharan Africa.

Methods A systematic review was conducted of published and unpublished population-based surveys as part of the Global Burden of Disease, Risk Factors and Injuries Study 2010. The prevalence of blindness and vision impairment by country and subregion was estimated.

Results In sub-Saharan Africa, 52 studies satisfied the inclusion criteria. The estimated age-standardised prevalence of blindness decreased by 32% from 1.9% (95% CI 1.5% to 2.2%) in 1990 to 1.3% (95% CI 1.1% to 1.5%) in 2010 and MSVI by 25% from 5.3% (95% CI 0.2% to 0.3%) to 4.0% (95% CI 0.2% to 0.3%) over that time. However, there was a 16% increase in the absolute numbers with blindness and a 28% increase in those with MSVI. The major causes of blindness in 2010 were; cataract 35%, other/unidentified causes 33.1%, refractive error 13.2%, macular degeneration 6.3%, trachoma 5.2%, glaucoma 4.4% and diabetic retinopathy 2.8%. In 2010, age-standardised prevalence of MSVI in Africa was 3.8% (95% CI 3.1% to 4.7%) for men and 4.2% (95% CI 3.6% to 5.3%) for women with subregional variations from 4.1% (95% CI 3.3% to 5.4%) in West Africa to 2.0% (95% CI 1.5% to 3.3%) in southern Africa for men; and 4.7% (95% CI 3.9% to 6.0%) in West Africa to 2.3% (95% CI 1.7% to 3.8%) in southern Africa for women.

Conclusions The age-standardised prevalence of blindness and MSVI decreased substantially from 1990 to 2010, although there was a moderate increase in the absolute numbers with blindness or MSVI. Significant subregional and gender disparities exist.

  • Vision
  • Glaucoma
  • Epidemiology
  • Retina
  • Lens and zonules

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