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      Glaucoma Awareness and Knowledge Among Ethiopians in a Tertiary Eye Care Center

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          Abstract

          Introduction

          Glaucoma outcomes are closely associated with patients’ awareness of the disease. However, little is known about glaucoma awareness and knowledge in Addis Ababa, a densely populated and ethnolinguistically diverse capital city in Ethiopia, the second largest country in Africa.

          Methods

          We performed a cross-sectional survey in the ophthalmology waiting room at St. Paul’s Hospital, a tertiary care center in Addis Ababa. Respondents included patients, patient family members, and non-clinical staff. Participants were asked if they had read or heard about glaucoma to gauge basic awareness of the disease; those with awareness were asked to take a quiz to measure their objective glaucoma knowledge. We performed multivariable regression to identify factors associated with glaucoma awareness, quiz performance, and self-rated ability to use eye drops.

          Results

          Of 298 respondents, 145 (48.7%) were female, and the average age was 44.9 ± 17.2 years. A majority (167; 56.0%) had primary school or less than primary school education. Only 131 (44.0%) had basic glaucoma awareness. Of these, 95 (72.5%) knew that glaucoma causes permanent vision loss, 103 (78.6%) knew glaucoma is often asymptomatic in early stages, 62 (47.3%) identified elevated intraocular pressure as a glaucoma risk factor, and 124 (94.7%) knew glaucoma was treatable. A majority of this subset (126; 96.2%) said they would be willing to use medicated eye drops, and 130 (99.2%) indicated a willingness to undergo surgery if recommended. Education level was independently associated with glaucoma awareness ( p < 0.001) and glaucoma quiz performance ( p = 0.03).

          Conclusion

          In a population sample from an ophthalmology waiting room in Addis Ababa, glaucoma awareness was poor and most strongly associated with education level. Educational interventions at public health and provider-patient levels are warranted. Our results suggest high receptiveness to both medical and surgical treatment.

          Electronic supplementary material

          The online version of this article (10.1007/s40123-020-00314-1) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis.

          Seth R Flaxman, Rupert Bourne, Serge Resnikoff … (2017)
          Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020.
          Article 0 comments Cited 783 times – based on 0 reviews     Review now
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            The number of people with glaucoma worldwide in 2010 and 2020.

            H A Quigley (2006)
            To estimate the number of people with open angle (OAG) and angle closure glaucoma (ACG) in 2010 and 2020. A review of published data with use of prevalence models. Data from population based studies of age specific prevalence of OAG and ACG that satisfied standard definitions were used to construct prevalence models for OAG and ACG by age, sex, and ethnicity, weighting data proportional to sample size of each study. Models were combined with UN world population projections for 2010 and 2020 to derive the estimated number with glaucoma. There will be 60.5 million people with OAG and ACG in 2010, increasing to 79.6 million by 2020, and of these, 74% will have OAG. Women will comprise 55% of OAG, 70% of ACG, and 59% of all glaucoma in 2010. Asians will represent 47% of those with glaucoma and 87% of those with ACG. Bilateral blindness will be present in 4.5 million people with OAG and 3.9 million people with ACG in 2010, rising to 5.9 and 5.3 million people in 2020, respectively. Glaucoma is the second leading cause of blindness worldwide, disproportionately affecting women and Asians.
            Article 0 comments Cited 772 times – based on 0 reviews     Review now
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              Racial variations in the prevalence of primary open-angle glaucoma. The Baltimore Eye Survey.

              J Tielsch, A Sommer, J. Katz … (1991)
              --To compare the prevalence of primary open-angle glaucoma between black and white Americans. --The design was a population-based prevalence survey of a noninstitutionalized black and white population aged 40 years or older from the eastern and southeastern health districts of Baltimore, Md. A multistage random sampling strategy was used to identify 7104 eligible participants, of whom 5308 (2395 blacks, 2913 whites) received an ophthalmologic screening examination. Those with abnormalities were referred for definitive diagnostic evaluation. --Primary open-angle glaucoma was defined based on evidence of glaucomatous optic nerve damage, including abnormal visual fields and/or severe optic disc cupping, and was independent of intraocular pressure. --Age-adjusted prevalence rates for primary open-angle glaucoma were four to five times higher in blacks as compared with whites. Rates among blacks ranged from 1.23% in those aged 40 through 49 years to 11.26% in those 80 years or older, whereas rates for whites ranged from 0.92% to 2.16%, respectively. There was no difference in rates of primary open-angle glaucoma between men and women for either blacks or whites in this population. Based on these data, an estimated 1.6 million persons aged 40 years or older in the United States have primary open-angle glaucoma. --Black Americans are at higher risk of primary open-angle glaucoma than their white neighbors. This may reflect an underlying genetic susceptibility to this disease and indicates that additional efforts are needed to identify and treat this sight-threatening disorder in high-risk communities.
              Article 0 comments Cited 183 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Scott D. Lawrence: scottlaw@med.umich.edu
                Journal
                Journal ID (nlm-ta): Ophthalmol Ther
                Journal ID (iso-abbrev): Ophthalmol Ther
                Title: Ophthalmology and Therapy
                Publisher: Springer Healthcare (Cheshire )
                ISSN (Print): 2193-8245
                ISSN (Electronic): 2193-6528
                Publication date (Electronic): 29 October 2020
                Publication date PMC-release: 29 October 2020
                Publication date (Print): March 2021
                Volume: 10
                Issue: 1
                Pages: 39-50
                Affiliations
                [1 ]GRID grid.214458.e, ISNI 0000000086837370, University of Michigan Medical School, ; Ann Arbor, MI USA
                [2 ]GRID grid.460724.3, St. Paul’s Hospital Millennium Medical College, ; Addis Ababa, Ethiopia
                [3 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Ophthalmology and Visual Sciences, , University of Michigan Medical School, ; Ann Arbor, MI USA
                Article
                Publisher ID: 314
                DOI: 10.1007/s40123-020-00314-1
                PMC ID: 7886940
                PubMed ID: 33123989
                SO-VID: 34a21da6-c5a1-4d2a-9832-72124e3cd6ce
                Copyright © © The Author(s) 2020
                License:

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 2 September 2020
                Date accepted : 8 October 2020
                Categories
                Subject: Original Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                Keywords: awareness,education,ethiopia,glaucoma,knowledge
                Data availability:
                Keywords: awareness, education, ethiopia, glaucoma, knowledge

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