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

2021 ◽  
pp. bjophthalmol-2021-320008
Author(s):  
Abba Hydara ◽  
Islay Mactaggart ◽  
Suzannah J Bell ◽  
John A Okoh ◽  
Segun I Olaniyan ◽  
...  
Keyword(s):  
Risk Ratio ◽  
Population Based ◽  
The Gambia ◽  
Vision Impairment ◽  
Eye Health ◽  
Current State ◽  
Increased Risk ◽  
Health Programming ◽  
Nationally Representative ◽  
Health Programme

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.

scholarly journals The Gambia National Eye Health Survey 2019: survey protocol

2021 ◽  
Vol 6 ◽  
pp. 10
Author(s):  
Abba Hydara ◽  
Andrew Bastawrous ◽  
Suzannah Bell ◽  
Dorothy Boggs ◽  
Tess Bright ◽  
...  
Keyword(s):  
Health Services ◽  
Health Survey ◽  
Population Based ◽  
Assistive Technologies ◽  
The Gambia ◽  
Vision Impairment ◽  
Eye Disease ◽  
Eye Health ◽  
Nationally Representative ◽  
Survey Protocol

Two national surveys of vision impairment and blindness were undertaken in The Gambia in 1986 and 1996. These provided data for the inception of The Gambia’s National Eye Health Programme (NEHP) within the Ministry of Health and Social Welfare. There have been important developments in the eye health services provided by the NEHP in the last 20 years. At the same time, the population has also undergone major demographic changes that may have led to substantial changes in the burden of eye disease. We conducted a National Eye Health Survey of vision impairment, blindness and its comorbidities in adults in The Gambia in 2019. We examined a nationally representative population-based sample of adults 35 years and above to permit direct comparison with the data available from the previous surveys. Alongside a comprehensive vision and eye examination, the survey provides nationally representative data on important comorbidities in this population: diabetes, hypertension, obesity, hearing impairment, disability and mental health. Secondly, it estimates access to assistive technologies and eye health services. Thirdly, it is powered to allow a five-year follow up cohort study to measure the incidence and progression of eye disease.

scholarly journals The Gambia National Eye Health Survey 2019: survey protocol

2021 ◽  
Vol 6 ◽  
pp. 10
Author(s):  
Abba Hydara ◽  
Andrew Bastawrous ◽  
Suzannah Bell ◽  
Dorothy Boggs ◽  
Tess Bright ◽  
...  
Keyword(s):  
Health Services ◽  
Health Survey ◽  
Population Based ◽  
Assistive Technologies ◽  
The Gambia ◽  
Vision Impairment ◽  
Eye Disease ◽  
Eye Health ◽  
Nationally Representative ◽  
Survey Protocol

Two national surveys of vision impairment and blindness were undertaken in The Gambia in 1986 and 1996. These provided data for the inception of The Gambia’s National Eye Health Programme (NEHP) within the Ministry of Health and Social Welfare. There have been important developments in the eye health services provided by the NEHP in the last 20 years. At the same time, the population has also undergone major demographic changes that may have led to substantial changes in the burden of eye disease. We conducted a National Eye Health Survey of vision impairment, blindness and its comorbidities in adults in The Gambia in 2019. We examined a nationally representative population-based sample of adults 35 years and above to permit direct comparison with the data available from the previous surveys. Alongside a comprehensive vision and eye examination, the survey provides nationally representative data on important comorbidities in this population: diabetes, hypertension, obesity, hearing impairment, disability and mental health. Secondly, it estimates access to assistive technologies and eye health services. Thirdly, it is powered to allow a five-year follow up cohort study to measure the incidence and progression of eye disease.

scholarly journals Association between handgrip strength and the risk of new-onset metabolic syndrome: a population-based cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e041384
Author(s):  
Chao Shen ◽  
Jiangting Lu ◽  
Zhijie Xu ◽  
Yuanyuan Xu ◽  
Ying Yang
Keyword(s):  
Metabolic Syndrome ◽  
Abdominal Obesity ◽  
Longitudinal Research ◽  
Handgrip Strength ◽  
Population Based ◽  
Study Data ◽  
Simple Index ◽  
Increased Risk ◽  
Nationally Representative ◽  
New Onset

ObjectivesA lower relative handgrip strength (HGS) may disrupt metabolic homeostasis and then lead to metabolic syndrome (MetS). There is a paucity of longitudinal studies to examine whether relative HGS at baseline is linked to incident MetS. Thus, the purpose of the present study was to explore the association between relative HGS and new-onset MetS.DesignThis is an observational and longitudinal research.A nationally representative sample of population in China.ParticipantsA total of 3350 subjects without MetS were selected for analysis in the present study. Data are from the China Health and Retirement Longitudinal Study (2011–2015).Outcome measuresWe calculated the relative HGS by dividing the HGS by body weight. Participants were divided into gender-specific quartiles. We estimated HRs for MetS and its components using Cox proportional hazard models according to the relative HGS categories.ResultsAfter multiple adjustment, the risk of MetS increased with the lower quartile of relative HGS in both sexes. Using the highest quartile (Q4) as a reference, the HR for quartile Q3–1 was 1.49 (0.95, 2.34), 1.67 (1.08, 2.59) and 1.76 (1.12, 2.78), respectively, in men, and 1.14 (0.82, 1.58), 1.30 (1.02, 1.57) and 1.28 (1.03, 1.55), respectively, in women. Additionally, we observed that relative HGS was negatively or inversely associated with the risk of abdominal obesity in both sexes.ConclusionsThe current study demonstrated that relative HGS was inversely and independently associated with an increased risk of MetS and abdominal obesity, suggesting a possible role of relative HGS as a useful and simple index for muscle strength in the prediction of occurrence of MetS.

Depression and the risk of autoimmune disease: a nationally representative, prospective longitudinal study

2015 ◽  
Vol 45 (16) ◽  
pp. 3559-3569 ◽  
Author(s):  
N. W. Andersson ◽  
L. N. Gustafsson ◽  
N. Okkels ◽  
F. Taha ◽  
S. W. Cole ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Dose Response ◽  
Disease Incidence ◽  
Population Based ◽  
Prospective Longitudinal Study ◽  
Increased Risk ◽  
Autoimmune Conditions ◽  
Nationally Representative ◽  
Prospective Longitudinal

Background.Autoimmune diseases are associated with substantial morbidity and mortality, yet the etiology remains unclear. Depression has been implicated as a risk factor for various immune-related disorders but little is known about the risk of autoimmune disease. This study examined the association between depression and the risk of autoimmune disease, and investigated the temporal and dose-response nature of these relationships.Method.A prospective population-based study including approximately 1.1 million people was conducted using linked Danish registries. Depression and autoimmune diseases were diagnosed by physicians and documented in medical records. In total, 145 217 individuals with depression were identified between 1995 and 2012. Survival analyses were used to estimate the relative risk of autoimmune disease among those with, compared to without, depression. Analyses were adjusted for gender, age, and co-morbid mental disorders.Results.Depression was associated with a significantly increased risk of autoimmune disease [incidence rate ratio (IRR) 1.25, 95% CI 1.19–1.31], compared to those without a history of depression. Results suggest a general increased risk of autoimmune diseases following the onset of depression during first year (IRR 1.29, 95% CI 1.05–1.58), which remained elevated for the ensuing 11 years and beyond (IRR 1.53, 95% CI 1.34–1.76). Findings did not support a dose-response relationship.Conclusions.Depression appears to be associated with an increased risk of a range of autoimmune diseases. Depression may play a role in the etiology of certain autoimmune conditions. If replicated, findings could highlight additional clinical implications in the treatment and management of depression. Future studies are needed to investigate the possible social, genetic, and neurobiological underpinnings of these relationships.

scholarly journals Understanding the Sensory Loss–Cognitive Function Relationship in Older Adults: Biomarker or Causal Risk Factor?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 804-804
Author(s):  
Jennifer Deal ◽  
Heather Whitson
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Microvascular Disease ◽  
Population Based ◽  
Vision Impairment ◽  
Sensory Loss ◽  
Current Evidence ◽  
Sensory Impairment ◽  
Increased Risk ◽  
Function Relationship

Abstract Sensory impairment in older adults is common, over 55% of Americans 60 years and older have either hearing or vision impairment, and it is linked to accelerated cognitive decline and increased risk of incident dementia in population-based observational studies. However, whether sensory impairment is a marker or a cause of cognitive decline and dementia is unknown. Both sensory impairment and cognitive decline/dementia may be caused by a common underlying pathology (e.g., microvascular disease), or sensory impairment may be a marker of dementia-related pathological changes in the brain. Alternatively, causal mechanisms include increased cognitive load, changes brain structure/function, depression, social isolation and/or reduced activity. This session will investigate the role of sensory impairment in cognitive decline and dementia in older adults and discuss the ramifications of these different possibilities for risk prediction and stratification, and potentially, for disease prevention. The co-occurrence of multiple sensory deficits will be described, and the potential utility of the use of retinal signs as predictive markers for cognitive decline/dementia will be discussed. We will also describe current evidence for both non-causal and causal relationships between sensory impairment and cognition with a focus on hearing impairment. Finally, we will describe the relationship of dual sensory (both hearing and vision) impairment on cognitive performance and dementia in a biracial population-based study.

scholarly journals Moral injury and substance use disorders among US combat veterans: results from the 2019–2020 National Health and Resilience in Veterans Study

2021 ◽  
pp. 1-7
Author(s):  
Shira Maguen ◽  
Brandon Nichter ◽  
Sonya B. Norman ◽  
Robert H. Pietrzak
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
National Health ◽  
Combat Veterans ◽  
Population Based ◽  
Moral Injury ◽  
Increased Risk ◽  
Assessment And Treatment ◽  
Multivariable Analyses ◽  
Nationally Representative

Abstract Background Exposure to potentially morally injurious events (PMIEs) is associated with increased risk for substance use disorders (SUDs), although population-based studies remain limited. The goal of this study was to better understand the relationships between PMIE exposure and lifetime and past-year alcohol use disorder (AUD), drug use disorder (DUD), and SUD. Methods Data were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 1321 combat veterans. Multivariable analyses examined associations between three types of PMIE exposure (perpetration, witnessing, and betrayal), and lifetime and past-year AUD, DUD, and SUD, adjusting for sociodemographic variables, combat exposure severity, prior trauma, and lifetime posttraumatic stress disorder and major depressive disorder. Results Perpetration was associated with increased odds of lifetime AUD (OR 1.15; 95% CI 1.01–1.31) and lifetime SUD (OR 1.18; 95% CI 1.03–1.35). Witnessing was associated with greater odds of past-year DUD (OR 1.20; 95% CI 1.04–1.38) and past-year SUD (OR 1.14; 95% CI 1.02–1.28). Betrayal was associated with past-year AUD (OR 1.20; 95% CI 1.03–1.39). A large proportion of the variance in past-year AUD was accounted for by betrayal (38.7%), while witnessing accounted for 25.8% of the variance in past-year DUD. Conclusions Exposure to PMIEs may be a stronger contributor to SUDs among veterans than previously known. These findings highlight the importance of targeted assessment and treatment of moral injury among veterans with SUDs, as well as attending to specific types of morally injurious experiences when conceptualizing and planning care.

scholarly journals Estimating Need for Glasses and Hearing Aids in The Gambia: Results from a National Survey and Comparison of Clinical Impairment and Self-Report Assessment Approaches

2021 ◽  
Vol 18 (12) ◽  
pp. 6302
Author(s):  
Dorothy Boggs ◽  
Abba Hydara ◽  
Yaka Faal ◽  
John Atta Okoh ◽  
Segun Isaac Olaniyan ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Population Level ◽  
Population Based ◽  
Accurate Estimate ◽  
The Gambia ◽  
Self Report ◽  
Clinical Impairment ◽  
Study Population ◽  
Nationally Representative ◽  
Low Coverage

Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Health Survey is a nationally representative population-based sample of 9188 adults aged 35+ years. Participants underwent standardised clinical vision assessments including the need for glasses (distance and near). Approximately 25% of the sample underwent clinical assessment of hearing and hearing aid need. Data were also collected on self-reported awareness, need and access barriers to vision and hearing ADs. Overall, 5.6% of the study population needed distance glasses (95% CI 5.0–6.3), 45.9% (95% CI 44.2–47.5) needed near glasses and 25.5% (95% CI 22.2–29.2) needed hearing aids. Coverage for each AD was very low (<4%). The agreement between self-report and clinical impairment assessment for AD need was poor. In conclusion, there is high prevalence and very low coverage for distance glasses, near glasses and hearing aids in The Gambia. Self-report measures alone will not provide an accurate estimate of AD need.

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