MVZ Jung-Stilling Hospital, Ziegeleistr. 27, Siegen, Germany; Kwale District Eye Centre, Mombasa, Kenya; Department of Ophthalmology, University of Bonn, Bonn, Germany; Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
Briesen, S., MVZ Jung-Stilling Hospital, Ziegeleistr. 27, Siegen, Germany, Kwale District Eye Centre, Mombasa, Kenya; Roberts, H., Kwale District Eye Centre, Mombasa, Kenya; Finger, R.P., Department of Ophthalmology, University of Bonn, Bonn, Germany, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
Purpose: To assess the impact of visual impairment (VI) on utility values in Sub-Saharan Africa and compare findings with other studies from low- and high-income countries. Methods: Patients with normal vision and various levels of VI were recruited from a secondary eye clinic in rural Kenya and interviewed using time trade-off (TTO). VI was classified using the World Health Organization definition of (normal vision, visual acuity ≥20/60, VI 20/80-20/200, severe VI 20/240-20/400, and blindness <20/400). Results: Mean age of the total sample (N=303) was 50.3 years (standard deviation, SD, ±18.17 years), and 51.5% of patients were male. Most were small-scale farmers and illiteracy was high at 40%. Mean TTO scores per group were: normal vision 0.93 (SD±0.10), VI 0.88 (SD±0.14), severe VI 0.86 (SD±0.13), blindness 0.73 (SD±0.17; p≤0.001). Lower TTO scores were independently associated with worse visual acuity (p≤0.001), longer duration of disease (p≤0.001) and illiteracy (p=0.011), but not with cause of VI, age, sex, marital status, socioeconomic status, or systemic comorbidities in multivariate analyses. Overall, TTO scores were considerably higher than those reported from high-income countries at similar levels of VI. Conclusion: In this rural African population, duration and extent of vision loss, rather than cause, socioeconomic factors and comorbidities affected vision-related quality of life. Our findings underline the importance of providing sight-restoring treatment as timely as possible and the necessity of enhancing rehabilitation efforts for those with non-curable eye diseases. © Informa Healthcare USA, Inc.
adult; age; aged; agricultural worker; amblyopia; Article; blindness; cataract; comorbidity; controlled study; cornea disease; developed country; disease duration; female; gender; glaucoma; human; interview; Kenya; life expectancy; lowest income group; major clinical study; male; marriage; mathematical and statistical procedures; optic nerve injury; quality of life; reading; refraction error; retina disease; rural population; social status; time trade off; vision; visual acuity; visual impairment; adolescent; devices; epidemiology; health status; middle aged; patient; physiology; psychology; psychometry; rural population; Sickness Impact Profile; South Africa; statistics and numerical data; very elderly; visual disorder; Adolescent; Adult; Aged; Aged, 80 and over; Female; Health Status; Humans; Male; Middle Aged; Psychometrics; Quality of Life; Rural Population; Sickness Impact Profile; South Africa; Vision Disorders; Visual Acuity; Visually Impaired Persons