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

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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The Gambia National Eye Health Survey 2019: survey protocol

Wellcome Open Research ◽

10.12688/wellcomeopenres.16531.2 ◽

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.

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The Gambia National Eye Health Survey 2019: survey protocol

Wellcome Open Research ◽

10.12688/wellcomeopenres.16531.1 ◽

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

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Posttraumatic stress symptoms and associated comorbidity during the COVID-19 pandemic in Ireland: A population based study

10.31234/osf.io/mnbxf ◽

2020 ◽

Author(s):

Philip Hyland ◽

Mark Shevlin ◽

Jamie Murphy ◽

Orla McBride ◽

Menachem Ben-Ezra ◽

...

Keyword(s):

General Population ◽

Posttraumatic Stress ◽

Traumatic Stress ◽

Perceived Risk ◽

Population Based ◽

Self Report ◽

Stress Symptoms ◽

Younger Age ◽

Nationally Representative ◽

The Republic

The prevalence of posttraumatic stress disorder (PTSD) as it relates to people’s experiences of the COVID-19 pandemic has yet to determined. This study was conducted to determine rates of COVID-19 related PTSD in the Irish general population, the level of comorbidity with depression and anxiety, and sociodemographic risk factors associated with COVID-19 related PTSD. A nationally representative sample of adults from the general population of the Republic of Ireland (N = 1,041) completed self-report measures of all study variables. The rate of COVID-19 related PTSD was 17.7% (95% CI = 15.35 - 19.99%: n=184), and comorbidity with generalized anxiety (49.5%) and depression (53.8%) was high. Meeting the diagnostic requirement for COVID-19 related PTSD was associated with younger age, male sex, living in a city, living with children, moderate and high perceived risk of COVID-19 infection, and screening positive for anxiety or depression. Traumatic stress problems related to the COVID-19 pandemic are common in the general population. Our results show that health professionals responsible for responding to the COVID-19 pandemic should expect to routinely encounter traumatic stress problems.

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

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-320008 ◽

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.

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Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey

International Journal of Hypertension ◽

10.1155/2020/8082341 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Neo M. Tapela ◽

Lei Clifton ◽

Gontse Tshisimogo ◽

Moagi Gaborone ◽

Tebogo Madidimalo ◽

...

Keyword(s):

Population Based ◽

Self Report ◽

Sub Saharan Africa ◽

Health Concern ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Adherence Support ◽

Hypertension Awareness ◽

Nationally Representative ◽

And Control

Introduction. Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objectives. We aimed to determine the prevalence and correlates of hypertension, awareness, treatment, and control among adults in Botswana, a middle-income African country undergoing rapid demographic transition and with high HIV burden. Methods. In this 2014 cross-sectional survey of adults aged 15–69 years, information on sociodemographic characteristics, lifestyle behavior, and medical history was collected through in-person interviews and physical measurements (body mass index and triplicate blood pressure (BP)). Hypertension was defined as self-report of use of antihypertensives in the previous two weeks and/or having elevated BP (≥140/90 mmHg). Multivariable logistic regression was employed to explore factors associated with hypertension, awareness (report of previous diagnosis), treatment (antihypertensives), and control (BP < 140/90). Results. Our analysis (N = 4,007) yielded an age-standardized hypertension prevalence of 30% (95% CI: 28%–32%, N = 1,393). Among hypertensives, 54% (50–58%) were unaware of their condition, 45% (40–50%) of those aware were untreated, and 63% (55–70%) of those on medications were suboptimally treated (BP ≥ 140/90 mmHg). A fifth of hypertensives who were diagnosed but not on medications had BP ≥ 180/110 mmHg. Diabetes was the strongest correlate of hypertension and awareness (aOR 4.00, 1.86–8.59; aOR 3.30, 1.44–7.55, respectively). Males were less likely to be aware (aOR 0.62, 0.41–0.94) or controlled (aOR 0.36, 0.16–0.83). Obese individuals were more likely to be treated (aOR 2.17, 1.12–4.22), yet less likely to be controlled (aOR 0.32, 0.15–0.66). Conclusions. We report the first nationally representative estimates of the hypertension care cascade performance in Botswana, which will support planning and future policy evaluations. Findings contribute to the relatively sparse evidence on this subject and may inform development of innovations that improve quality of hypertension management and adherence support in similar settings.

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Estimating assistive product need in Cameroon and India: results of population‐based surveys and comparison of self‐report and clinical impairment assessment approaches

Tropical Medicine & International Health ◽

10.1111/tmi.13523 ◽

2020 ◽

Author(s):

Dorothy Boggs ◽

Hannah Kuper ◽

Islay Mactaggart ◽

GVS Murthy ◽

Joseph Oye ◽

...

Keyword(s):

Population Based ◽

Self Report ◽

Clinical Impairment ◽

Assistive Product

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Use of Hearing Aids and Assistive Listening Devices in an Older Australian Population

Journal of the American Academy of Audiology ◽

10.3766/jaaa.21.10.4 ◽

2010 ◽

Vol 21 (10) ◽

pp. 642-653 ◽

Cited By ~ 85

Author(s):

David Hartley ◽

Elena Rochtchina ◽

Philip Newall ◽

Maryanne Golding ◽

Paul Mitchell

Keyword(s):

Hearing Loss ◽

Older People ◽

Hearing Aids ◽

Hearing Aid ◽

Significant Proportion ◽

Pure Tone Audiometry ◽

Population Based ◽

Self Report ◽

Australian Population ◽

Factors Associated

Background: Hearing loss is a common sensory impairment experienced by older persons. Evidence shows that the use of hearing aids and/or assistive listening devices (ALDs) can benefit those with a hearing loss but that historically the uptake and use of these technologies has remained relatively low compared with the number of people who report a hearing loss. Purpose: The aim of this study was to determine the prevalence, usage, and factors associated with the use of hearing aids and ALDs in an older representative Australian population. Research Design: A population-based survey. Study Sample: A total of 2956 persons out of 3914 eligible people between the ages of 49 and 99 yr (mean age 67.4 yr), living in the Blue Mountains, west of Sydney, completed a hearing study conducted from 1997 to 2003. Data Collection and Analysis: Hearing levels were assessed using pure tone audiometry, and subjects were administered a comprehensive hearing survey by audiologists, which included questions about hearing aid and ALD usage. Logistic regression analysis was used to identify factors associated with hearing aid and ALD usage. Results: Of the surveyed population, 33% had a hearing loss as measured in the better ear. 4.4% had used an ALD in the past 12 mo, and 11% owned a hearing aid. Of current hearing aid owners, 24% never used their aids. ALD and hearing aid usage were found to be associated with increasing age, hearing loss, and self-perceived hearing disability. Conclusions: These results indicate that hearing aid ownership and ALD usage remains low in the older population. Given the significant proportion of older people who self-report and have a measured hearing loss, it is possible that more could be helped through the increased use of hearing aid and/or ALD technology. Greater efforts are needed to promote the benefits of these technologies and to support their use among older people with hearing loss.

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Have socio-economic inequalities in sugar purchasing widened? A longitudinal analysis of food and beverage consumer data from British households, 2014–2017

Public Health Nutrition ◽

10.1017/s1368980020005029 ◽

2020 ◽

pp. 1-12

Author(s):

Nicolas Berger ◽

Steven Cummins ◽

Richard D Smith ◽

Laura Cornelsen

Keyword(s):

Panel Study ◽

Population Level ◽

Population Based ◽

Food Groups ◽

Household Level ◽

Food And Beverages ◽

Sweetened Beverages ◽

Food And Beverage ◽

Nationally Representative ◽

Economic Inequalities

Abstract Objective: To examine socio-economic inequalities in decreases in household sugar purchasing in Great Britain (GB). Design: Longitudinal, population-based study. Setting: Data were obtained from the GB Kantar Fast-Moving Consumer Goods (FMCG) panel (2014–2017), a nationally representative panel study of food and beverages bought and brought into the home. We estimated changes in daily sugar purchases by occupational social grade from twenty-three food groups, using generalised estimating equations (household-level clustering). Participants: British households who regularly reported food and beverages to the GB Kantar FMCG (n 28 033). Results: We found that lower social grades obtained a lower proportion of sugar from healthier foods and a greater proportion of sugar from less healthy foods and beverages. In 2014, differences in daily sugar purchased between the lowest and the highest social grades were 3·9 g/capita/d (95 % CI 2·9, 4·8) for table sugar, 2·4 g (95 % CI 1·8, 3·1) for sugar-sweetened beverages, 2·2 g (95 % CI 1·5, 2·8) for chocolate and confectionery and 1·0 g (95 % CI 0·7, 1·3) for biscuits. Conversely, the lowest social grade purchased less sugar from fruits (2·1 g (95 % CI 1·5, 2·8)) and vegetables (0·7 g (95 % CI 0·5, 0·8)) than the highest social grade. We found little evidence of change in social grade differences between 2014 and 2017. These results suggest that recent overall declines in sugar purchases are largely equally distributed across socio-economic groups. Conclusions: This suggests that recent population-level policy activity to reduce sugar consumption in GB does not appear to exacerbate or reduce existing socio-economic inequalities in sugar purchasing. Low agency, population-level policies may be the best solution to improving population diet without increasing inequalities.

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The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Home-based antibody testing results, October 2020. An emphasis on self-screening at a population level

Wellcome Open Research ◽

10.12688/wellcomeopenres.16616.2 ◽

2021 ◽

Vol 6 ◽

pp. 34

Author(s):

Kate Northstone ◽

Daniel Smith ◽

Claire Bowring ◽

Amanda Hill ◽

Richard Hobbs ◽

...

Keyword(s):

Longitudinal Study ◽

Antibody Test ◽

Population Level ◽

Sociodemographic Factors ◽

Population Based ◽

Self Report ◽

Antibody Testing ◽

Home Based ◽

Parents And Children ◽

Avon Longitudinal Study

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort study which recruited pregnant women in 1990-1992 and has followed these women, their partners (Generation 0; G0) and offspring (Generation 1; G1) ever since. The study reacted rapidly to the COVID-19 pandemic, deploying online questionnaires in March and May 2020. Home-based antibody tests and a further questionnaire were sent to 5220 participants during a two-week period of October 2020. 4.2% (n=201) of participants reported a positive antibody test (3.2% G0s [n=81]; 5.6% G1s [n=120]). 43 reported an invalid test, 7 did not complete and 3 did not report their result. Participants uploaded a photo of their test to enable validation: all positive tests, those where the participant could not interpret the result and a 5% random sample were manually checked against photos. We report 92% agreement (kappa=0.853). Positive tests were compared to additional COVID-19 status information: 58 (1.2%) participants reported a previous positive test, 73 (1.5%) reported that COVID-19 was suspected by a doctor, but not tested and 980 (20.4%) believed they had COVID-19 due to their own suspicions. Of those reporting a positive result on our antibody test, 55 reported that they did not think they had had COVID-19. Results from antibody testing and questionnaire data will be complemented by health record linkage and results of other biological testing– uniting Pillar testing data with home testing and self-report. Data have been released as an update to the original datasets released in July 2020. It comprises: 1) a standard dataset containing all participant responses to all three questionnaires with key sociodemographic factors and 2) as individual participant-specific release files enabling bespoke research across all areas supported by the study. This data note describes the antibody testing, associated questionnaire and the data obtained from it.

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Migration in Namibia and its association with HIV acquisition and treatment outcomes

PLoS ONE ◽

10.1371/journal.pone.0256865 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256865

Author(s):

Andrea Low ◽

Karam Sachathep ◽

George Rutherford ◽

Anne-Marie Nitschke ◽

Adam Wolkon ◽

...

Keyword(s):

Viral Load ◽

Hiv Infection ◽

Population Level ◽

Population Based ◽

Hiv Prevalence ◽

Self Report ◽

Viral Load Suppression ◽

Recent Infection ◽

Effective Prevention ◽

Hiv Test

Background In the 21st century, understanding how population migration impacts human health is critical. Namibia has high migration rates and HIV prevalence, but little is known about how these intersect. We examined the association between migration and HIV-related outcomes using data from the 2017 Namibia Population-based HIV Impact Assessment (NAMPHIA). Methods and findings The NAMPHIA survey selected a nationally representative sample of adults in 2017. All adults aged 15–64 years were invited to complete an interview and home-based HIV test. Recent infection (<130 days) was measured using HIV-1 LAg avidity combined with viral load (>1000 copies/mL) and antiretroviral analyte data. Awareness of HIV status and antiretroviral use were based on self-report and/or detectable antiretrovirals in blood. Viremia was defined as having a viral load ≥1000 copies/mL, including all participants in the denominator regardless of serostatus. We generated community viremia values as a weighted proportion at the EA level, excluding those classified as recently infected. Significant migrants were those who had lived outside their current region or away from home >one month in the past three years. Recent cross-community in-migrants were those who had moved to the community <two years ago. Separate analyses were done to compare significant migrants to non-migrants and recent cross-community in-migrants to those who in-migrated >two years ago to determine the association of migration and timing with recent infection or viral load suppression (VLS). All proportions are weighted. Of eligible adults, we had HIV results and migration data on 9,625 (83.9%) of 11,474 women and 7,291 (73.0%) of 9,990 men. Most respondents (62.5%) reported significant migration. Of cross-community in-migrants, 15.3% were recent. HIV prevalence was 12.6% and did not differ by migration status. Population VLS was 77.4%. Recent cross-community in-migration was associated with recent HIV infection (aOR: 4.01, 95% CI 0.99–16.22) after adjusting for community viremia. Significant migration (aOR 0.73, 95% CI: 0.55–0.97) and recent cross-community in-migration (aOR 0.57, 95% CI: 0.35–0.92) were associated with lower VLS, primarily due to lack of awareness of HIV infection. The study was limited by lack of precise data on trajectory of migration. Conclusions Despite a high population-level VLS, Namibia still has migrant populations that are not accessing effective treatment for HIV. Targeting migrants with effective prevention and testing programs in communities with viremia could enable further epidemic control.

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