Rius Anna, Guisasola Laura, Sabidó Meritxell, Leasher Janet L, Moriña David, Villalobos Astrid, Lansingh Van C, Mujica Oscar J, Rivera-Handal José Eduardo, Silva Juan Casrlos
UNESCO Chair in Visual Health and Development, Universitat Politècnica de Catalunya, Terrassa, Spain,
TransLab Research Group, Department of Medical Sciences, Universitat de Girona, Girona, Spain.
Rev Panam Salud Publica. 2014 Nov;36(5):290-9.
To examine the prevalence of blindness, visual impairment, and related eye diseases and conditions among adults in El Salvador, and to explore socioeconomic inequalities in their prevalence by education level and occupational status, stratified by sex.
Based upon the Rapid Assessment of Avoidable Blindness (RAAB) methodology, this nationwide sample comprised 3 800 participants (3 399 examined) ≥ 50 years old from 76 randomly selected clusters of 50 persons each. The prevalence of blindness, visual impairment and related eye diseases and conditions, including uncorrected refractive error (URE), was calculated for categories of education level and occupational status. Multiple logistic regression models were fitted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) and stratified by sex.
Age-adjusted prevalence was 2.4% (95% CI: 2.2-2.6) for blindness (men: 2.8% (95% CI: 2.5-3.1); women: 2.2% (95% CI: 1.9-2.5)) and 11.8% (95% CI: 11.6-12.0) for moderate visual impairment (men: 10.8% (95% CI: 10.5-11.1); women: 12.6% (95% CI: 12.4-12.8)). The proportion of visual impairment due to cataract was 43.8% in men and 33.5% in women. Inverse gradients of socioeconomic inequalities were observed in the prevalence of visual impairment. For example, the age-adjusted OR (AOR) was 3.4 (95% CI: 2.0-6.4) for visual impairment and 4.3 (95% CI: 2.1-10.4) for related URE in illiterate women compared to those with secondary education, and 1.9 (95% CI: 1.1-3.1) in cataract in unemployed men.
Blindness and visual impairment prevalence is high in the El Salvador adult population. The main associated conditions are cataract and URE, two treatable conditions. As socioeconomic and gender inequalities in ocular health may herald discrimination and important barriers to accessing affordable, good-quality, and timely health care services, prioritization of public eye health care and disability policies should be put in place, particularly among women, the unemployed, and uneducated people.
调查萨尔瓦多成年人失明、视力损害及相关眼病和眼部状况的患病率，并按性别分层，探讨教育水平和职业状况在患病率方面的社会经济不平等情况。
基于可避免失明快速评估（RAAB）方法，该全国性样本包括来自76个随机选取的、每组50人的群组中3800名年龄≥50岁的参与者（3399人接受了检查）。计算了教育水平和职业状况类别中失明、视力损害及相关眼病和眼部状况（包括未矫正屈光不正（URE））的患病率。拟合多元逻辑回归模型以计算优势比（OR）和95%置信区间（CI），并按性别分层。
年龄调整后的失明患病率为2.4%（95%CI：2.2 - 2.6）（男性：2.8%（95%CI：2.5 - 3.1）；女性：2.2%（95%CI：1.9 - 2.5）），中度视力损害患病率为11.8%（95%CI：11.6 - 12.0）（男性：10.8%（95%CI：10.5 - 11.1）；女性：12.6%（95%CI：12.4 - 12.8））。男性因白内障导致的视力损害比例为43.8%，女性为33.5%。在视力损害患病率方面观察到社会经济不平等的反向梯度。例如，与接受中等教育的女性相比，文盲女性视力损害的年龄调整后OR（AOR）为3.4（95%CI：2.0 - 6.4），相关URE的AOR为4.3（95%CI：2.1 - 10.4），失业男性白内障的AOR为1.9（95%CI：1.1 - 3.1）。
萨尔瓦多成年人群中失明和视力损害患病率较高。主要相关状况是白内障和URE，这两种状况均可治疗。由于眼部健康方面的社会经济和性别不平等可能预示着歧视以及获得负担得起、高质量和及时的医疗服务的重要障碍，应制定公共眼部保健和残疾政策的优先事项，特别是在女性、失业者和未受过教育的人群中。
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