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Prevalence of Blindness in Tribal region of Maharashtra Electronic Poster No. FP284

Prevalence of Blindness in Tribal region of Maharashtra Electronic Poster No. FP284. Dr.Kuldeep Dole MS,MSc(ICEH) ( AIOS No: D10501  ) Head ,Lions Juhu Community Ophthalmology Institute ,Pune H.V.DESAI EYE HOSPITAL, PUNE Dr.(Col)Madan Deshpande MS,DO Dr.Praful Dhake DO Mr.Mohsin Khan

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Prevalence of Blindness in Tribal region of Maharashtra Electronic Poster No. FP284

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  1. Prevalence of Blindness in Tribal region of MaharashtraElectronic Poster No. FP284 Dr.Kuldeep Dole MS,MSc(ICEH) (AIOS No: D10501 ) Head ,Lions Juhu Community Ophthalmology Institute ,Pune H.V.DESAI EYE HOSPITAL, PUNE Dr.(Col)Madan Deshpande MS,DO Dr.Praful Dhake DO Mr.Mohsin Khan Mr.Jitesh Kharat Dr.Praveen Nirmalann MS ,MPH

  2. Tribal Region& population OfNandurbar • Tribal population is one of the most marginalized section of Indian society • 8 to 10 percent population of India is tribal In Nandurbar District - 64.62% tribal population Main occupation is farming during rainy season. Rest of the year migrate in search of work to Gujarat

  3. Rapid Assessment of Avoidable Blindness (RAAB) • A epidemiological method using systematic cluster random sampling to collect data on avoidable blindness in an age group commonly affected by blindness • Easy and less expensive. • A survey was planned in Nandurbar district between July 2009 – Sep 2009

  4. OBJECTIVES • To assess the prevalence of blindness among the 50+ population in Nandurbar (tribal) district • To identify the major causes of blindness in this region • To evaluate cataract surgical services MATERIALS AND METHODS • SAMPLING • PLANNING • TRAINING OF STAFF • FIELD WORK • DATA ENTRY • ANALYSIS

  5. Sample Size Calculation • Stratified cluster random sampling • Prevalence of blindness 4.4 -6.6% • C.I. - 95% • Cluster size - 40 • Design effect -1.4 • Non compliance-10% • Sample size – 2549 in 64 clusters

  6. Socio - Demographics RESULTS AND DISCUSSION • A total of 2549 was sample population (50 years above) out of which 2300 subjects could be enumerated in 64 clusters and 2005 (response rate-87.17%) persons underwent complete examination using modified RAAB protocol.

  7. Examination Status (n=2300) • 2005 (87.17%) subjects underwent examination • 12 (0.53%) partially refused • 237(10.30% ) totally refused examination • 46 (2 %) were not available • No statistically significant difference was observed between those who underwent exam and those who did not • Further analysis is of 2017 participants (2005+12)

  8. Vision by person (Presenting Vision)WHO Definitions • Normal (VA>/=6/18 in better eye) -59.89% • Vision Impairment(<6/18 to 6/60)- 27.81% (95% CI: 25.86%, 29.77%) • Severe Vision Impairment (<6/60 to3/60)- 10.16%(95% CI: 8.84%, 11.48%) • Blindness(<3/60 better eye)- 2.13% (95% CI: 1.50%, 2.76%.) In previous 2007 RAAB survey- Based on presenting vision, • 16.8% (95% CI: 16.0,17.5 ) was the prevalence of visual impairment(<6/18 to 6/60 in the better eye) , • 4.4% (95% CI: 4.1,4.8) were severely visually impaired (vision<6/60 to 3/60 in the better eye) and • 3.6% (95% CI: 3.3,3.9) were blind (vision<3/60 in the better eye).

  9. PRINCIPLE CAUSE OF VISUAL IMPAIRMENT VA<6/18

  10. Cataract Blindness & Cataract Surgical Services • No. of eyes operated on for cataract=306 • Cataract surgical complications in 69(22.55%) of 306 eyes • Number of persons operated on for cat.=34 • Eyes with cause of blindness attributed to cataract=177 (69.14%) of 256 blind eyes • CSC by eyes (306/177)=63.35% • Persons with cause of blindness attributed to cataract= 34 (79.07%) of 43 blind Persons • CSC by persons(238/34)=87.5% • Visually impairing PCO =59 eyes • 12 (25.53%) of 47 aphakic eyes had uncorrected aphakia

  11. Barriers for cataract surgery • First reason -unaware of cataract 39.73%, -told to wait to mature cataract 26.59% • Second reason • -no one to accompany17.53% • Third reason • -waiting for camp 53.33%,

  12. Conclusions • The prevalence of blindness had wide geographical and age variation in the district. Strategies to continuously reach old, remotely located persons with transport • Cataract services were available but need close quality monitoring and also coverage needs to improve • Refractive error services are needed in the periphery –vision centers approach needs to be augmented • Post segment diseases need to figure in future strategies

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