Prevalence and causes of vision loss in sub-Saharan Africa in 2015: magnitude, temporal trends and projections.
epidemiology
public health
Journal
The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
09
09
2019
revised:
03
02
2020
accepted:
19
02
2020
pubmed:
2
4
2020
medline:
3
3
2021
entrez:
2
4
2020
Statut:
ppublish
Résumé
This study aimed to assess the prevalence and causes of vision loss in sub-Saharan Africa (SSA) in 2015, compared with prior years, and to estimate expected values for 2020. A systematic review and meta-analysis assessed the prevalence of blindness (presenting distance visual acuity <3/60 in the better eye), moderate and severe vision impairment (MSVI; presenting distance visual acuity <6/18 but ≥3/60) and mild vision impairment (MVI; presenting distance visual acuity <6/12 and ≥6/18), and also near vision impairment (<N6 or N8 in the presence of ≥6/12 best-corrected distance visual acuity) in SSA for 1990, 2010, 2015 and 2020.In SSA, age-standardised prevalence of blindness, MSVI and MVI in 2015 were 1.03% (80% uncertainty interval (UI) 0.39-1.81), 3.64% (80% UI 1.71-5.94) and 2.94% (80% UI 1.05-5.34), respectively, for male and 1.08% (80% UI 0.40-1.93), 3.84% (80% UI 1.72-6.37) and 3.06% (80% UI 1.07-5.61) for females, constituting a significant decrease since 2010 for both genders. There were an estimated 4.28 million blind individuals and 17.36 million individuals with MSVI; 101.08 million individuals were estimated to have near vision loss due to presbyopia. Cataract was the most common cause of blindness (40.1%), whereas undercorrected refractive error (URE) (48.5%) was the most common cause of MSVI. Sub-Saharan West Africa had the highest proportion of blindness compared with the other SSA subregions. Cataract and URE, two of the major causes of blindness and vision impairment, are reversible with treatment and thus promising targets to alleviate vision impairment in SSA.
Sections du résumé
BACKGROUND
This study aimed to assess the prevalence and causes of vision loss in sub-Saharan Africa (SSA) in 2015, compared with prior years, and to estimate expected values for 2020.
METHODS
A systematic review and meta-analysis assessed the prevalence of blindness (presenting distance visual acuity <3/60 in the better eye), moderate and severe vision impairment (MSVI; presenting distance visual acuity <6/18 but ≥3/60) and mild vision impairment (MVI; presenting distance visual acuity <6/12 and ≥6/18), and also near vision impairment (<N6 or N8 in the presence of ≥6/12 best-corrected distance visual acuity) in SSA for 1990, 2010, 2015 and 2020.In SSA, age-standardised prevalence of blindness, MSVI and MVI in 2015 were 1.03% (80% uncertainty interval (UI) 0.39-1.81), 3.64% (80% UI 1.71-5.94) and 2.94% (80% UI 1.05-5.34), respectively, for male and 1.08% (80% UI 0.40-1.93), 3.84% (80% UI 1.72-6.37) and 3.06% (80% UI 1.07-5.61) for females, constituting a significant decrease since 2010 for both genders. There were an estimated 4.28 million blind individuals and 17.36 million individuals with MSVI; 101.08 million individuals were estimated to have near vision loss due to presbyopia. Cataract was the most common cause of blindness (40.1%), whereas undercorrected refractive error (URE) (48.5%) was the most common cause of MSVI. Sub-Saharan West Africa had the highest proportion of blindness compared with the other SSA subregions.
CONCLUSIONS
Cataract and URE, two of the major causes of blindness and vision impairment, are reversible with treatment and thus promising targets to alleviate vision impairment in SSA.
Identifiants
pubmed: 32229517
pii: bjophthalmol-2019-315217
doi: 10.1136/bjophthalmol-2019-315217
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1658-1668Investigateurs
Rupert Bourne
(R)
Peter Ackland
(P)
Aries Arditi
(A)
Yaniv Barkana
(Y)
Banu Bozkurt
(B)
Braithwaite Tasanee
(B)
Alain Bron
(A)
Donald Budenz
(D)
Feng Cai
(F)
Robert Casson
(R)
Usha Chakravarthy
(U)
Jaewan Choi
(J)
Maria Vittoria Cicinelli
(MV)
Nathan Congdon
(N)
Reza Dana
(R)
Rakhi Dandona
(R)
Lalit Dandona
(L)
Aditi Das
(A)
Iva Dekaris
(I)
M D Monte Del Monte
(MD)
Jenny Deva
(J)
Mohamed Dirani
(M)
Laura Dreer
(L)
Leon Ellwein
(L)
Marcela Frazier
(M)
Kevin Frick
(K)
David Friedman
(D)
Joao Furtado
(J)
Hua Gao
(H)
Andrew Gazzard
(A)
Ronnie George
(R)
Stephen Gichuhi
(S)
Victor Gonzalez
(V)
Billy Hammond
(B)
Mary Elizabeth Hartnett
(ME)
Minguang He
(M)
James Hejtmancik
(J)
Flavio Hirai
(F)
John Huang
(J)
April Ingram
(A)
Jonathan Javitt
(J)
Jost Jonas
(J)
Charlotte Joslin
(C)
Jill Keeffe
(J)
John Kempen
(J)
Moncef Khairallah
(M)
Rohit Khanna
(R)
Judy Kim
(J)
George Lambrou
(G)
Van Charles Lansingh
(VC)
Paolo Lanzetta
(P)
Janet Leasher
(J)
Jennifer Lim
(J)
Limburg Hans
(L)
Kaweh Mansouri
(K)
Anu Mathew
(A)
Alan Morse
(A)
Beatriz Munoz
(B)
David Musch
(D)
Kovin Naidoo
(K)
Vinay Nangia
(V)
Palaiou Maria
(P)
Maurizio Battaglia Parodi
(MB)
Fernando Yaacov Pena
(FY)
Konrad Pesudovs
(K)
Tunde Peto
(T)
Harry Quigley
(H)
Murugesan Raju
(M)
Pradeep Ramulu
(P)
Serge Resnikoff
(S)
Dana Reza
(D)
Alan Robin
(A)
Luca Rossetti
(L)
Jinan Saaddine
(J)
Mya Sandar
(M)
Janet Serle
(J)
Tueng Shen
(T)
Rajesh Shetty
(R)
Pamela Sieving
(P)
Juan Carlos Silva
(JC)
Alex Silvester
(A)
Rita S Sitorus
(RS)
Dwight Stambolian
(D)
Gretchen Stevens
(G)
Hugh Taylor
(H)
Jaime Tejedor
(J)
James Tielsch
(J)
Fotis Topouzis
(F)
Miltiadis Tsilimbaris
(M)
Jan van Meurs
(JV)
Rohit Varma
(R)
Gianni Virgili
(G)
Jimmy Volmink
(J)
Ya Xing Wang
(YX)
Sheila West Ning-Li Wang
(SW)
Peter Wiedemann
(P)
Tien Wong
(T)
Richard Wormald
(R)
Yingfeng Zheng
(Y)
Seth Flaxman
(S)
Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: KN: employed by Essilor International. JBJ: patent holder with Biocompatibles UK (Farnham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and / or anti-angiogenic factor; Patent number: 20120263794), and Patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4. JHK: consultant for Gilead (DSMC Chair), Santen, Clearside. SR: consultant for Brien Holden Vision Institute.