Prevalence of Visual Impairment Among People Aged 50 Years and Older and Related Factors in Nangarhar Province of Afghanistan

Abstract

Abdianwall, M. H. Prevalence of Visual Impairment among People Aged 50 Years and Older and Related Factors In Nangarhar Province of Afghanistan, Hacettepe Unıversity, Institute of Health Science, Epidemiology Program Doctor of Philosophy Thesis, Ankara, 2018. The study was aimed to determine the prevalence, main causes, and related factors of visual impairment among 50 years and over population in Jalalabad City and four surrounding districts, Nangarhar Province of Afghanistan. The data of this population based cross-sectional study was gathered in the year 2015. The sample size was calculated as 1,353 and allocated to urban and rural strata using probability proportion to size method. Visual impairment was defined as presenting visual acuity of less than 6/18 and blindness as visual acuity less than 3/60 in the better eye by using Snellen chart only. Data was analyzed using IBM SPSS 21.0 computer software program. At the end of the field study, 1,281 eligible completed the interview and eye examination. The prevalence of visual impairment was 22.6% (95% CI, 20–25) of which 13.9% (95% CI, 12–16) was low vision and 8.7% (95% CI, 7–10) was blindness. The most common causes of the visual impairment were cataract (52.8%), followed by refractive error (RE) (26.9%) and glaucoma (8.6%). Number one cause of the low vision was RE (42%), followed by cataract, glaucoma, age related macular degeneration (AMD) and diabetic retinopaty (DR), while for blindness cataract (72%), other posterior segment disorders, glaucoma, RE and AMD. Illiteracy, bad economic status, hypertension and overweight were factors independently associated with both visual impairment and low vision, whereas, age, illiteracy, bad economic status, hypertension and using of sunglasses were independently associated with blindness. Cataract, RE, glaucoma, AMD and DR were the leading causes of visual impairment and blindness in the study area, which are avoidable mostly. For decreasing the burden of visual impairment and blindness, applying already developed policies concerning prevention of visual impairment and blindness is strongly recommended for the area as well as the whole country.