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BMJ open. 2022 Apr 1;12(4):e052247. doi: 10.1136/bmjopen-2021-052247.
OBJECTIVE: The objective of this study was to determine the prevalence of blindness and its determinants in the Bangladeshi adult population.
STUDY DESIGN: A population-based cross-sectional survey conducted at the household level with national representation. Samples were drawn from the 2011 National Census base using a multi-stage stratified cluster sampling method.
BACKGROUND AND PARTICIPANTS: The survey was conducted in urban and rural areas in 2013 using a probability proportional to size sampling approach to locate participants from 72 primary sampling units. A male or female aged ≥ 40 years was randomly selected from their household to recruit 7200. In addition to sociodemographic data, information on medications for hypertension and diabetes was obtained. Blood pressure and capillary blood glucose were measured. The eyelids, cornea, lens and retina were examined in addition to visual acuity and refraction tests.
MAIN OUTCOME MEASURES: The following definition was used to categorize subjects with (1) blindness: visual acuity
RESULTS: We were able to recruit 6391 (88.8%) people of which 2955 (46.2%) were men. Among them, 1,922 (30.1%) came from urban areas and 4,469 (69.9%) from rural areas. The mean age was 54.3 (SD 11.2) years. The age-standardized prevalence, after best correction, of blindness and low vision was 1.0% (95% CI 0.5% to 1.4%) and 12.1% (CI 95% 10.5% to 13.8%), respectively. Multivariate logistic regression indicated that cataract, age-related macular degeneration, and diabetic retinopathy were significantly associated with low vision and blindness after adjusting for age and sex. The population-attributable cataract risk for low vision and blindness was 79.6%.
CONCLUSIONS: Low vision and blindness are common problems in people aged 40 or older. Extensive screening and eye care services are needed for broader coverage engaging all levels of the health system, especially focusing on cataract.