International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel St, London, United Kingdom.
International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel St, London, United Kingdom.
PLoS One. 2020 Feb 13;15(2):e0229008. doi: 10.1371/journal.pone.0229008. eCollection 2020.
This study has two main objectives: 1) to assess the value of combining the rapid assessment of avoidable blindness (RAAB) and the recently developed rapid assessment of hearing loss (RAHL) based on existing population-based data from Cameroon andIndia; 2) to test the feasibility of a combined RAAB-RAHL protocol.
A secondary data analysis of population-based disability surveys in India and Cameroon (in 2013-2014) was conducted, focussing on people aged 50+. Hearing impairment (HI) was defined as pure tone average of ≥41dB (better ear).Visual impairment (VI) was defined as presenting visual acuity of <6/18 (better eye). The relationship between HI and VI was examined. The feasibility of a combined RAAB-RAHL survey was assessed within a RAHL conducted among adults aged 50+ in Malawi in 2018. Outcomes included: time taken, costs, number of people examined in a day, and qualitative feedback from participants and field teams.
The prevalence of combined VI and HI among people aged 50+ was 4.4% (95% confidence interval (CI) 3.0, 6.4) in India and 4.8% (95%CI 3.0, 8.0) in Cameroon. Among participants with VI, approximately a third in India (29.3%) and Cameroon (35.1%) also had HI. A quarter of participants in India (25.4%) and Cameroon (26.9%) who had HI also had VI. In Malawi, the total time taken to complete both RAAB and RAHL assessments was approximately 27 minutes per participant. It was feasible to complete 30 participants per day for a team of four people. The estimated cost of a combined RAAB-RAHL approach in comparison to two separate impairment surveys is up to 37% less depending on the method of combination.
The substantial overlap between VI and HI supports a combined rapid survey of the two impairments. The pilot study of a combined RAAB-RAHL survey demonstrates feasibility and lower cost compared to conducting two standalone impairment surveys. A combined RAAB-RAHL approach could maximize limited resources to increase prevalence data for both vision and hearing impairment.
本研究有两个主要目标：1）评估结合快速可避免盲（RAAB）评估和最近基于喀麦隆和印度人群的基础数据开发的快速听力损失（RAHL）评估的价值；2）测试联合 RAAB-RAHL 方案的可行性。
对印度和喀麦隆（2013-2014 年）基于人群的残疾调查的二次数据分析进行了研究，重点关注 50 岁以上的人群。听力损伤（HI）定义为纯音平均听力≥41dB（好耳）。视力损伤（VI）定义为视力低于 6/18（好眼）。研究了 HI 和 VI 之间的关系。在 2018 年马拉维对 50 岁以上成年人进行的 RAHL 中，评估了联合 RAAB-RAHL 调查的可行性。结果包括：所花费的时间、成本、每天检查的人数以及参与者和现场团队的定性反馈。
在印度和喀麦隆，50 岁以上人群中 VI 和 HI 联合的患病率分别为 4.4%（95%置信区间（CI）为 3.0-6.4）和 4.8%（95%CI 为 3.0-8.0）。在 VI 患者中，印度约有三分之一（29.3%）和喀麦隆（35.1%）也有 HI。印度（25.4%）和喀麦隆（26.9%）四分之一 HI 患者也有 VI。在马拉维，完成 RAAB 和 RAHL 评估的总时间约为每位参与者 27 分钟。四人团队每天可完成 30 名参与者的评估。与两项独立的损伤调查相比，联合 RAAB-RAHL 方法的估计成本最多可降低 37%，具体取决于组合方法。
VI 和 HI 之间存在很大的重叠，支持对这两种损伤进行联合快速调查。联合 RAAB-RAHL 调查的试点研究表明，与进行两项独立的损伤调查相比，具有可行性和更低的成本。联合 RAAB-RAHL 方法可以最大限度地利用有限的资源，增加视力和听力损伤的患病率数据。
