Garap Jambi N, Sheeladevi Sethu, Shamanna B R, Nirmalan Praveen K, Brian Garry, Williams Carmel
The Fred Hollows Foundation - Papua New Guinea Eye Care Program, University of Papua New Guinea, Port Moresby.
Clin Exp Ophthalmol. 2006 May-Jun;34(4):335-41. doi: 10.1111/j.1442-9071.2006.01219.x.
To estimate the magnitude and causes of blindness and vision impairment in Papua New Guinea for service delivery planning and ophthalmic education development.
Using the World Health Organization standardized Rapid Assessment of Cataract Surgical Services protocol, a population-based cross-sectional survey was conducted in 2005. By systematic, two-stage cluster random sampling, 39 clusters each of 30 people aged 50 years and over were selected from urban and rural locations. A cause of vision loss was determined for each eye with a presenting visual acuity worse than 6/18.
Of the 1191 people enumerated, 1174 were examined (98.6%). The 50 years and older age-gender adjusted prevalence of vision impairment (presenting visual acuity less than 6/18 in the better eye) was 29.2% (95% Confidence Interval [CI]: 27.6, 35.1, Design Effect [deff] = 2.3). That of functional blindness (presenting visual acuity less than 6/60 in the better eye) was 8.9% (95% CI: 8.4, 12.0, deff = 1.2), and of World Health Organization blindness (but presenting, rather than best corrected, visual acuity of less than 3/60 in the better eye) was 3.9% (95% CI: 3.4, 6.1, deff = 1.0). Uncorrected refractive error (13.1%, 95% CI: 11.3, 15.1, deff = 1.2) and cataract (7.4%, 95% CI: 6.4, 10.2, deff = 1.3) were leading causes of vision impairment, age-gender adjusted. Cataract was the most common (age-gender adjusted 6.4%, 95% CI: 5.1, 7.3, deff = 1.1) cause of functional blindness. On bivariate analysis, increasing age (P < 0.001), illiteracy (P < 0.001) and unemployment (P < 0.001) were associated with functional blindness. Gender was not.
The identification and treatment of refractive error and cataract need to be priorities for eye health services in Papua New Guinea if the burden of vision impairment and blindness is to be diminished. The education of community and hospital eye care providers, whether medical, nursing or other cadres, must emphasize these. Eye care services must be structured and provided to allow and encourage accessibility and uptake, with satisfactory treatment outcomes for these conditions.
为了规划服务提供和开展眼科教育，评估巴布亚新几内亚失明和视力损害的程度及原因。
采用世界卫生组织标准化的白内障手术服务快速评估方案，于2005年开展了一项基于人群的横断面调查。通过系统的两阶段整群随机抽样，从城市和农村地区选取了39个群组，每组30名50岁及以上的人。对每只视力低于6/18的眼睛确定视力丧失的原因。
在清点的1191人中，1174人接受了检查（98.6%）。50岁及以上年龄性别调整后的视力损害患病率（较好眼的视力低于6/18）为29.2%（95%置信区间[CI]：27.6，35.1，设计效应[deff]=2.3）。功能性失明（较好眼的视力低于6/60）的患病率为8.9%（95%CI：8.4，12.0，deff=1.2），世界卫生组织定义的失明（但为当前视力，而非最佳矫正视力，较好眼低于3/60）的患病率为3.9%（95%CI：3.4，6.1，deff=1.0）。年龄性别调整后，未矫正屈光不正（13.1%，95%CI：11.3，15.1，deff=1.2）和白内障（7.4%，95%CI：6.4，10.2，deff=1.3）是视力损害的主要原因。白内障是功能性失明最常见的原因（年龄性别调整后为6.4%，95%CI：5.1，7.3，deff=1.1）。在双变量分析中，年龄增加（P<0.0
