Abstract
High prevalence of blindness coupled with low public awareness of eye diseases is a severe problem in Pakistan. The objective of this study was to evaluate the awareness, attitude and practices related to common ocular problems and eye care use among general population of Punjab, Pakistan. Data were collected cross-sectionally, using random selection of participants from five districts of Punjab, Pakistan. A pre-tested questionnaire was used to collect the data from January to March 2017. The ordinal data were converted to interval--based data by Rasch analysis, which is termed as “knowledge score” and ranges from −3 to +3. Descriptive statistics, linear regression, binary logistic regression and chi square analysis were performed to evaluate the data. Of the 2073 people contacted, 96.4% (2019) responded the interviewer. The mean (SD) age was 39.9 (11.4) years, majority were males (64.8%) and only 3.1% were illiterate. The majority (68.1%) of respondents were aware that blindness can be prevented and are least aware of age-related macular degradation (31.4%). Multivariate analysis to knowledge scores demonstrated that male gender (β = 0.53 95%CI = 0.39, 0.66, p < 0.001), higher education (β = 0.31 95%CI = 0.25, 0.37, p < 0.001) were significantly associated with knowledge score. Eighty-two percent of our respondents had a positive attitude towards health-seeking behavior and those who had adequate income on most of occasions were 1.82 (AOR = 1.82 95%CI = 1.26, 2.62 p = 0.001) times more prone towards health-seeking behavior than those who had insufficient income. Out of all respondents, 21.5% had an eye examination at least once a year and this frequency was significantly higher in lower age, females, high education and high Socio Economic Status level (p < 0.05). Among the general population of Pakistan, awareness about prevention of blindness and refractive error was optimum, while awareness of blindness causing eye conditions, like age-related macular degradation was low. Intensive improvements in the health literacy and public interventions—specifically in old age people, males and respondents with lower education—are urgently needed.
Highlights
Global estimates report that 191 million population have moderate to extreme vision impairment (MEVI), and among them 32.4 million are blind, with a high proportion of females (60%) [1]
The positive responses to the knowledge questions had significant variations and varied from lowest 31.4%, i.e., “have you ever heard of age-related macular degradation (ARMD)?” to highest
68.1%, i.e., “do you know that blindness can be prevented?” Among all respondents, 61.0% had heard of red eye, 56.6% were aware of cataract, 55% were aware of trachoma and 51.6% heard of the diabetic retinopathy (DR)
Summary
Global estimates report that 191 million population have moderate to extreme vision impairment (MEVI), and among them 32.4 million are blind, with a high proportion of females (60%) [1]. South Asian countries encounter a high burden of age-related blindness, this is still lower than. Sub Saharan countries (4.4% vs 6.0%), whereas prevalence of the MEVI is slightly higher in South. Uncontrolled refractive errors (43%) are the foremost reason for visual impairment (VI) and are trailed by cataracts (33%), diabetic retinopathy (DR), glaucoma and age-related macular degradation (ARMD) [2]. A study in Iran revealed that almost 32 out of 44 persons with blinding issues had cataracts, 10 out of 44 had diabetic retinopathy and more than two out of 44 had glaucoma [3]. The large-scale population-based survey in Pakistan in 2006 reported that prevalence of blindness was 2.7% and was highest in Punjab and Baluchistan and was severe in the rural areas, while it was lowest in North
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