Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh

A H M Enayet Hussain; Munir Ahmed; Jerry E Vincent; Johurul Islam; Yuddha D Sapkota; Taraprasad Das; Nathan Congdon; Lutful Husain; Gulam Khandaker; Mohammad Muhit; Mohammad Awlad Hossain; Danny Haddad

doi:10.1371/journal.pone.0243005

Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh

A H M Enayet Hussain, Munir Ahmed, Jerry E Vincent, Johurul Islam, Yuddha D Sapkota, Taraprasad Das, Nathan Congdon, Lutful Husain, Gulam Khandaker, Mohammad Muhit, Mohammad Awlad Hossain, Danny Haddad

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Abstract

AIM: To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh.

METHODS: We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis.

RESULTS: We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction.

CONCLUSION: The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.

Original language	English
Article number	e0243005
Number of pages	12
Journal	PLoS ONE
Volume	15
Issue number	12
DOIs	https://doi.org/10.1371/journal.pone.0243005
Publication status	Published - 01 Dec 2020
Externally published	Yes

Keywords

Aged
Aged, 80 and over
Bangladesh
Blindness/epidemiology
Cataract Extraction/statistics & numerical data
Female
Humans
Male
Middle Aged
Myanmar/epidemiology
Presbyopia/epidemiology
Prevalence
Refractive Errors/epidemiology
Refugees/statistics & numerical data
Treatment Outcome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0243005Licence: CC BY

Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox’s Bazar, Bangladesh
© 2020 The Authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 395 KBLicence: CC BY

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Hussain, A. H. M. E., Ahmed, M., Vincent, J. E., Islam, J., Sapkota, Y. D., Das, T., Congdon, N., Husain, L., Khandaker, G., Muhit, M., Hossain, M. A., & Haddad, D. (2020). Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh. PLoS ONE, 15(12), Article e0243005. https://doi.org/10.1371/journal.pone.0243005

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title = "Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh",

abstract = "AIM: To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh.METHODS: We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis.RESULTS: We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction.CONCLUSION: The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.",

keywords = "Aged, Aged, 80 and over, Bangladesh, Blindness/epidemiology, Cataract Extraction/statistics & numerical data, Female, Humans, Male, Middle Aged, Myanmar/epidemiology, Presbyopia/epidemiology, Prevalence, Refractive Errors/epidemiology, Refugees/statistics & numerical data, Treatment Outcome",

author = "Hussain, {A H M Enayet} and Munir Ahmed and Vincent, {Jerry E} and Johurul Islam and Sapkota, {Yuddha D} and Taraprasad Das and Nathan Congdon and Lutful Husain and Gulam Khandaker and Mohammad Muhit and Hossain, {Mohammad Awlad} and Danny Haddad",

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doi = "10.1371/journal.pone.0243005",

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Hussain, AHME, Ahmed, M, Vincent, JE, Islam, J, Sapkota, YD, Das, T, Congdon, N, Husain, L, Khandaker, G, Muhit, M, Hossain, MA & Haddad, D 2020, 'Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh', PLoS ONE, vol. 15, no. 12, e0243005. https://doi.org/10.1371/journal.pone.0243005

TY - JOUR

T1 - Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh

AU - Hussain, A H M Enayet

AU - Ahmed, Munir

AU - Vincent, Jerry E

AU - Islam, Johurul

AU - Sapkota, Yuddha D

AU - Das, Taraprasad

AU - Congdon, Nathan

AU - Husain, Lutful

AU - Khandaker, Gulam

AU - Muhit, Mohammad

AU - Hossain, Mohammad Awlad

AU - Haddad, Danny

PY - 2020/12/1

Y1 - 2020/12/1

N2 - AIM: To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh.METHODS: We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis.RESULTS: We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction.CONCLUSION: The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.

AB - AIM: To determine the prevalence and causes of blindness, vision impairment and cataract surgery coverage among Rohingya refugees aged ≥ 50 years residing in camps in Cox's Bazar, Bangladesh.METHODS: We used the Rapid Assessment of Avoidable Blindness (RAAB) methodology to select 76 clusters of 50 participants aged ≥ 50 years with probability proportionate to size. Demographic and cataract surgery data were collected using questionnaires, visual acuity was assessed per World Health Organization criteria and examinations were conducted by torch, and with direct ophthalmoscopy in eyes with pinhole-corrected vision <6/12. RAAB software was used for data entry and analysis.RESULTS: We examined 3,629 of 3800 selected persons (95.5%). Age and sex adjusted prevalence of blindness (<3/60), severe visual impairment (SVI; >3/60 to ≤6/60), moderate visual impairment (MVI; >6/60 to ≤6/18), and early visual impairment (EVI; >6/18 to ≤6/12) were 2.14%, 2.35%, 9.68% and 14.7% respectively. Cataract was responsible for 75.0% of blindness and 75.8% of SVI, while refractive error caused 47.9% and 90.9% of MVI and EVI respectively. Most vision loss (95.9%) was avoidable. Cataract surgical coverage among the blind was 81.2%. Refractive error was detected in 17.1% (n = 622) of participants and 95.2% (n = 592) of these did not have spectacles. In the full Rohingya cohort of 76,692, approximately 10,000 surgeries are needed to correct all eyes impaired (<6/18) by cataract, 12,000 need distance glasses and 73,000 require presbyopic correction.CONCLUSION: The prevalence of blindness was lower than expected for a displaced population, in part due to few Rohingya being ≥60 years and the camp's good access to cataract surgery. We suggest the United Nations High Commissioner for Refugees include eye care among recommended health services for all refugees with long-term displacement.

KW - Aged

KW - Aged, 80 and over

KW - Bangladesh

KW - Blindness/epidemiology

KW - Cataract Extraction/statistics & numerical data

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Myanmar/epidemiology

KW - Presbyopia/epidemiology

KW - Prevalence

KW - Refractive Errors/epidemiology

KW - Refugees/statistics & numerical data

KW - Treatment Outcome

U2 - 10.1371/journal.pone.0243005

DO - 10.1371/journal.pone.0243005

M3 - Article

C2 - 33259555

SN - 1932-6203

VL - 15

JO - PLoS ONE

JF - PLoS ONE

IS - 12

M1 - e0243005

ER -

Rapid assessment of avoidable blindness and cataract surgery coverage among forcibly displaced Myanmar Nationals (Rohingya refugees) in Cox's Bazar, Bangladesh

Abstract

Keywords

UN SDGs

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