National Survey on Blindness, Low Vision and Trachoma in Ethiopia: Methods and Study Clusters Profile

Abstract

Background: The magnitude and causes of eye diseases in Ethiopia has been derived from small scale studies. This information became no longer useful in tracking the success of intensified efforts in preventing and controlling avoidable causes of blindness and eye diseases in line with the goals of Vision 2020: The Right to Sight.
Objective: The national household survey was conducted primarily to provide national and regional state level estimates of low vision, blindness and trachoma. The secondary aims include describing the major causes of low vision and blindness.
Methods: The national survey utilized cross sectional epidemiological study design with multistage sampling strategy. All nine regional states and two city administrations of the country were involved in the survey. Sample size and sampling strategies were developed taking into account population size of the regional states. Visual acuity was tested
using the LogMar chart and trachoma grading was done following the WHO grading system. The cause of low vision and blindness were determined by ophthalmologists.
Results: A total of 174 clusters, 6056 households and 30022 individuals were involved in the survey. Of the total 30022 individuals 25650 (85.4%) were present and examined by the survey team. Implementing quality control supervision in the very remote clusters was a major challenge. About 55% of the survey clusters were within 10 Km of health facility that stock tetracycline; 18.3% within 10 Km of health facility that provides Trachomatous Trichiasis (TT) surgery and 18.6% were within 10Km of health facility that provides cataract surgery. Only 29.4% of the survey clusters were fully accessible by car. The majority of survey household head were farmers (70.8%) and illiterate (64.5%). About 48% of the households obtain their water from either a protected well/spring or piped distribution.
Only 40.4% of the households reported that no animal is kept around the living quarter. Most households dispose garbage in open field (84.6%) and have no latrine (60.3%).
Conclusion: The survey was conducted on a representative sample and provides reliable estimates at the national and regional levels. However, careful interpretations of results from remote and inaccessible areas are warranted. Access to eye care facilities are limited and need expansion in order to reduce the blindness and low vision load. Sanitation
conditions favoring fly breeding are rampant and trachoma control program need to emphasize a more integrated approach.

Ethiopian Journal of Health Development Vol. 21 (3) 2007: pp. 185-203