Publications (3)10.91 Total impact
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Article: Population-based study of presbyopia in rural Tanzania.
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ABSTRACT: To determine the prevalence of presbyopia in a rural African population. Cross-sectional prevalence study. One thousand seven hundred nine persons age 40 years and older who resided in 3 villages and randomly selected neighborhoods of Kongwa town, Tanzania. Eligible persons were refracted and given best distance correction. Near vision was tested and corrected to the nearest 0.5 diopter. Presbyopia was defined as at least 1 line of improvement on a near visual acuity chart with an addition of a plus lens. A total of 61.7% of eligible participants were presbyopic. A higher prevalence of presbyopia was associated with increased age, female gender, higher educational level, and residence in town (odds ratio = 3.09; 95% confidence interval: 2.46-3.90). The odds of developing presbyopia increased 16% per year of age from age 40 to 50, but the increase was nonsignificant at 1% per year after age 50. More severe presbyopia was associated with female gender and less with education. This study provides the first population-based data on prevalence of presbyopia in a large, random sample of older Africans and suggests a high rate of presbyopia. Presbyopia plateaus after age 50, and it is more common in females. In addition, the 3-fold increased odds in town versus village dwellers was unexpected and suggests that research of other factors, including environmental factors, is warranted.Ophthalmology 06/2006; 113(5):723-7. · 5.45 Impact Factor -
Article: Impact of presbyopia on quality of life in a rural African setting.
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ABSTRACT: To determine the impact of uncorrected presbyopia on quality of life in rural Tanzania. Cross-sectional study. Population-based sample of 1709 village and town-dwelling adults aged 40 and older in the Kongwa district in rural Tanzania. Subjects underwent distance and near visual acuity testing to determine presbyopia. A near vision-related quality of life questionnaire was administered by trained interviewers to determine the degree of self-rated difficulty with tasks appropriate to life in a rural African setting, and how much near vision loss contributed to this difficulty. Near vision-related quality of life. Complete data were available for 1564 (92%) of the subjects. The prevalence rate of presbyopia was 62%. The majority of presbyopes (94%) did not have corrective near vision glasses. Compared with nonpresbyopes, being presbyopic increased the odds of reporting some difficulty with near vision tasks by 2-fold (odds ratio [OR], 2.04; 95% confidence interval [CI]: 1.57-2.66), odds of reporting moderate difficulty by 5-fold (OR 5.01; 95% CI: 3.19-7.89), and odds of reporting high difficulty by >8-fold (OR 8.52; 95% CI 3.13-23.10). The degree of presbyopia was associated with increasing difficulty with daily tasks (P<0.0001). This is the first study to demonstrate that uncorrected presbyopia has a significant impact on vision-related quality of life in a rural African setting. The high prevalence of presbyopia, and increased aging of the population in developing countries, suggests that the World Health Organization's Vision 2020 refraction agenda should place greater emphasis on presbyopia.Ophthalmology 06/2006; 113(5):728-34. · 5.45 Impact Factor -
Article: Risk Factors for Constant, Severe Trachoma among Preschool Children in Kongwa, Tanzania
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ABSTRACT: Trachoma, an ocular infection caused by Chlamydia trachomatis , is the second leading cause of blindness worldwide. The blinding sequelae, which occur in middle age, are felt to be the result of numerous or lengthy episodes of severe inflammatory trachoma in childhood. Risk factors for constant, severe trachoma were identified in a group of children enrolled in a longitudinal study in Kongwa, Tanzania, where villages were randomized in a clinical trial of mass treatment and a behavior modification campaign. In 1989, each of 1,417 randomly selected children had photographs taken of an upper eyelid for determination of their trachoma status. The photographs were graded by a reader who was masked as to the village and date of each photograph. Risk factor data on the family's socioeconomic status, distance to water, and hygiene practices were obtained at baseline. Follow-up examinations occurred 2, 6, and 12 months from baseline. Data from all four time points were available for 82% of the children enrolled. Overall, 10% of the children had constant, severe trachoma, defined as severe trachoma at three or four examinations. The odds ratio for severe trachoma was 1.9 for female children (95% confidence interval 1.3–2.7). Familial cattle ownership and having one or more siblings with trachoma at baseline were also significantly related to the odds of having severe trachoma. Children with a sustainably clean face had lower odds (odds ratio = 0.4, 95% confidence interval 0.3–0.7). A subgroup of 10% of children in these hyperendemic communities always seemed to have severe trachoma, despite enrollment in a mass treatment campaign. Improved face-washing plus antibiotic treatment may decrease the likelihood that these children will be at risk for blinding complications in adulthood. Am J Epidemiol 1996;143:73–8
