Disability-related-distress in primary school learners with vision impairment due to uncorrected refractive error in KwaZulu-Natal Province, South Africa – a qualitative study

Globally, over 300 million people are estimated to be visually impaired. Uncorrected refractive error is the primary cause of almost half of all visual impairment, resulting in the global economy losing $269 billion in productivity annually. There is a definitive level of urgency in the treatment of refractive error in children as uncorrected refractive error results in the failure of normal visual maturation, termed amblyopia, which cannot be corrected in adult life. In South Africa, the lack of appropriatechild eye care strategies has posed a serious problem to the visual health of children. In 2006, the International Centre for Eye Care Education (ICEE) conducted a situational analysis of child eye care services in the province of KwaZulu-Natal (KZN). The findings of this analysis indicated a dire need for comprehensive services in the province. Stakeholders (the KwaZulu-Natal Department of Healthand the KwaZulu-Natal Department of Education) were advised on the value of a short-term strategy as the underpinning of a long-term sustainable approach. This resulted in the formation of a trialliance to implement the KZN Child Eye Care Programme. Eighty (80) individuals who were previously volunteers for the KZN Department of Health were trained in vision screening. These vi-sion screeners screened 239 606 primary school children from February 2007 to May 2008. Seven percent (15 944) of the children failed the vision screening and were referred for optometric assessments. Of the 15 944 children that failed the vision screening, 10 707 children were examined by optometrists and 1083 were found to have a refractive error and were therefore supplied with spectacles. The study indicates that a short-term programme to address a backlog of services can reach many underserved children. This programme identified many challenges of implementing a vision screening programme such as poor uptake of refractive services by learners in the absence of an appropriate referral system and high attrition of trained vision screeners. (S Afr Optom 2011 70(2) 61-68)

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Physical fitness profile of rural versus urban primary school children in eThekwini district, KwaZulu-Natal, South Africa

Human Movement ◽

10.5114/hm.2022.107974 ◽

2022 ◽

Author(s):

Oladapo Michael Olagbegi ◽

Thayananthee Nadasan ◽

Yoliswa Mazibuko ◽

Esethu Mfenga ◽

Khanyani Rangana ◽

...

Keyword(s):

South Africa ◽

Physical Fitness ◽

Primary School ◽

School Children ◽

Primary School Children ◽

Kwazulu Natal

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Rapid assessment of avoidable blindness in Papua New Guinea: a nationwide survey

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311802 ◽

2018 ◽

Vol 103 (3) ◽

pp. 338-342 ◽

Cited By ~ 5

Author(s):

Ling Lee ◽

Fabrizio D'Esposito ◽

Jambi Garap ◽

Geoffrey Wabulembo ◽

Samuel Peter Koim ◽

...

Keyword(s):

Papua New Guinea ◽

Refractive Error ◽

Rapid Assessment ◽

New Guinea ◽

Nationwide Survey ◽

Population Based ◽

Vision Impairment ◽

Cross Sectional ◽

National Capital ◽

Uncorrected Refractive Error

ObjectiveTo estimate the prevalence and main causes of blindness and vision impairment in people aged 50 years and older in Papua New Guinea (PNG).DesignNational cross-sectional population-based survey in National Capital District (NCD), Highlands, Coastal and Islands regions.MethodsAdults aged 50 years and above were recruited from 100 randomly selected clusters. Each participant underwent monocular presenting and pinhole visual acuity (VA) assessment and lens examination. Those with pinhole VA<6/12 in either eye had a dilated fundus examination to determine the primary cause of reduced vision. Those with obvious lens opacity were interviewed on barriers to cataract surgery.ResultsA total of 4818 adults were examined. The age-adjusted and sex-adjusted prevalence of blindness (VA <3/60), severe vision impairment (SVI, VA <6/60 but ≥3/60), moderate vision impairment (MVI, VA <6/18 but ≥6/60) and early vision impairment (EVI, VA <6/12 but ≥6/18) was 5.6% (95% CI 4.9% to 6.3%), 2.9% (95% CI 2.5% to 3.4%), 10.9% (95% CI 9.9% to 11.9%) and 7.3% (95% CI 6.6% to 8.0%), respectively. The main cause of blindness, SVI and MVI was cataract, while uncorrected refractive error was the main cause of EVI. A significantly higher prevalence of blindness, SVI and MVI occurred in the Highlands compared with NCD. Across all regions, women had lower cataract surgical coverage and spectacle coverage than men.ConclusionsPNG has one of the highest reported prevalence of blindness globally. Cataract and uncorrected refractive error are the main causes, suggesting a need for increased accessible services with improved resources and advocacy for enhancing eye health literacy.

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Prevalence and causes of vision loss in North Africa and Middle East in 2015: magnitude, temporal trends and projections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312068 ◽

2018 ◽

Vol 103 (7) ◽

pp. 863-870 ◽

Cited By ~ 3

Author(s):

Rim Kahloun ◽

Moncef Khairallah ◽

Serge Resnikoff ◽

Maria Vittoria Cicinelli ◽

Seth R Flaxman ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Middle East ◽

North Africa ◽

Refractive Error ◽

Vision Loss ◽

Corneal Opacity ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

Age Related ◽

Uncorrected Refractive Error

BackgroundTo assess the prevalence and causes of vision impairment in North Africa and the Middle East (NAME) from 1990 to 2015 and to forecast projections for 2020.MethodsBased on a systematic review of medical literature, the prevalence of blindness (presenting visual acuity (PVA) <3/60 in the better eye), moderate and severe vision impairment (MSVI; PVA <6/18 but ≥3/60) and mild vision impairment (PVA <6/12 but ≥6/18) was estimated for 2015 and 2020.ResultsThe age-standardised prevalence of blindness and MSVI for all ages and genders decreased from 1990 to 2015, from 1.72 (0.53–3.13) to 0.95% (0.32%–1.71%), and from 6.66 (3.09–10.69) to 4.62% (2.21%–7.33%), respectively, with slightly higher figures for women than men. Cataract was the most common cause of blindness in 1990 and 2015, followed by uncorrected refractive error. Uncorrected refractive error was the leading cause of MSVI in the NAME region in 1990 and 2015, followed by cataract. A reduction in the proportions of blindness and MSVI due to cataract, corneal opacity and trachoma is predicted by 2020. Conversely, an increase in the proportion of blindness attributable to uncorrected refractive error, glaucoma, age-related macular degeneration and diabetic retinopathy is expected.ConclusionsIn 2015 cataract and uncorrected refractive error were the major causes of vision loss in the NAME region. Proportions of vision impairment from cataract, corneal opacity and trachoma are expected to decrease by 2020, and those from uncorrected refractive error, glaucoma, diabetic retinopathy and age-related macular degeneration are predicted to increase by 2020.

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“I have to provide for another life emotionally, physically and financially”: understanding pregnancy, motherhood and the future aspirations of adolescent mothers in KwaZulu-Natal South, Africa

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03319-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Desiree Govender ◽

Saloshni Naidoo ◽

Myra Taylor

Keyword(s):

South Africa ◽

Qualitative Study ◽

Adolescent Pregnancy ◽

Adolescent Mothers ◽

Healthcare Services ◽

Early Childbearing ◽

Body Experience ◽

Future Aspirations ◽

Healthcare Needs ◽

Kwazulu Natal

Abstract Background Adolescent pregnancy and motherhood has been a controversial and much disputed subject within the field of public health. Early childbearing is not only characterized as a physical body experience but also embodies the experiences and perceptions of the social norms, discourses, conflict and moral judgement. There is an increasing concern that the psychosocial challenges facing adolescent mothers remains in the background since research in this field has mainly focused on the medical and physical complications of early childbearing. The aim of this qualitative study was to explore adolescent pregnancy and motherhood in order to understand this phenomenon from the perspective of adolescent mothers and to gain insight into their future aspirations. Methods This descriptive qualitative study was based on data from four focus group discussions with adolescent mothers utilising healthcare services at a district hospital in Ugu district, KwaZulu Natal, South Africa. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. Results Some adolescent mothers’ partners were in denial and rejected them and the child while others’ partners were happy and supported them during their pregnancy. Families’ reactions to the pregnancies ranged between anger and disappointment to abandonment, the silent treatment, and acceptance and forgiveness. The psychological issues experienced by some of the adolescent mothers included suicidal ideation, guilt, loneliness, anxiety, and stress. They also experienced financial constraints, difficulty in returning to school, and stigmatisation in society. The participants envisioned completing their education, focusing on their dream careers, and contributing positively to society. Conclusion Experiences of adolescent pregnancy and parenting are multifaceted and the healthcare needs of pregnant and parenting adolescents extend beyond information and knowledge. A multidisciplinary approach is required in the care of adolescent mothers. A key policy priority should encompass the collaboration of different professionals from various healthcare sectors to assist adolescent mothers in achieving better health and psychosocial and socio-economic outcomes as steps to securing a better future for them.

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Prevalence and causes of vision loss in East Asia in 2015: magnitude, temporal trends and projections

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313308 ◽

2019 ◽

Vol 104 (5) ◽

pp. 616-622 ◽

Cited By ~ 2

Author(s):

Ching-Yu Cheng ◽

Ningli Wang ◽

Tien Y Wong ◽

Nathan Congdon ◽

Mingguang He ◽

...

Keyword(s):

Visual Acuity ◽

East Asia ◽

Macular Degeneration ◽

Refractive Error ◽

Temporal Trends ◽

Vision Impairment ◽

Age Related Macular Degeneration ◽

Public Healthcare ◽

Age Related ◽

Uncorrected Refractive Error

BackgroundTo determine the prevalence and causes of blindness and vision impairment (VI) in East Asia in 2015 and to forecast the trend to 2020.MethodsThrough a systematic literature review and meta-analysis, we estimated prevalence of blindness (presenting visual acuity <3/60 in the better eye), moderate-to-severe vision impairment (MSVI; 3/60≤presenting visual acuity <6/18), mild vision impairment (mild VI: 6/18≤presenting visual acuity <6/12) and uncorrected presbyopia for 1990, 2010, 2015 and 2020. A total of 44 population-based studies were included.ResultsIn 2015, age-standardised prevalence of blindness, MSVI, mild VI and uncorrected presbyopia was 0.37% (80% uncertainty interval (UI) 0.12%–0.68%), 3.06% (80% UI 1.35%–5.16%) and 2.65% (80% UI 0.92%–4.91%), 32.91% (80% UI 18.72%–48.47%), respectively, in East Asia. Cataract was the leading cause of blindness (43.6%), followed by uncorrected refractive error (12.9%), glaucoma, age-related macular degeneration, corneal diseases, trachoma and diabetic retinopathy (DR). The leading cause for MSVI was uncorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, corneal disease, trachoma and DR. The burden of VI due to uncorrected refractive error, cataracts, glaucoma and DR has continued to rise over the decades reported.ConclusionsAddressing the public healthcare barriers for cataract and uncorrected refractive error can help eliminate almost 57% of all blindness cases in this region. Therefore, public healthcare efforts should be focused on effective screening and effective patient education, with access to high-quality healthcare.

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