The Ministry of Health and Population (MoHP) has disseminated a new report on the Nepal Rapid Assessment of Avoidable Blindness (RAAB) Survey 2021. The report reveals that the prevalence of blindness in 2021 has decreased to 1.05% from 2.5% among the population aged 50 and older, compared to the nationwide RAAB survey conducted in 2010.
Nepal is one of the countries where blindness surveys are conducted on regular basis. The first national blindness survey conducted in 1981 was the milestone for eye care services in Nepal, which revealed that the prevalence of blindness as 0.84%.
Another series of blindness and visual impairment survey carried out in Nepal from 2006 to 2010 using Rapid Assessment of Avoidable Blindness (RAAB) Survey methodology estimated that the prevalence of blindness among the age 50 years and older as 2.5% and all age extrapolation of it was estimated as 0.35%. That estimate shows that there was an approximately 60% reduction on the prevalence of blindness compared to 1981 blindness survey estimation.
Similarly, the recent population based RAAB survey was conducted in all the seven provinces in Nepal from 2018 to 2021. Main aim of this survey was to determine the prevalence and causes of blindness and vision impairment, coverage and barriers of cataract surgery among people 50 years and older in Nepal.
The survey designing and technical support was provided by the International Agency for Prevention of Blindness (IAPB), and International Centre of Eye Health (ICEH)/London School of Hygiene and tropical Medicine (LSHTM).
Provincial prevalence estimates were weighted to give nationally representative estimates. Sampling, enumeration, and examination of the population 50 years and older were done at the province level following standard RAAB protocol.
The total sample size required for all seven provinces were 33414 people distributed across 956 clusters of 35 people 50 years or older in each study cluster. Along with causes of blindness and visual impairment, cataract surgical coverage (CSC), effective cataract surgical coverage (eCSC) and visual outcomes of cataract surgery were also documented along with demographic and clinical factors responsible for it. Cataract surgery outcomes were classified as good (vision >6/18), borderline (6/24-6/60) and poor (<6/60). The survey protocol was reviewed and approved by Nepal Health Research Council (NHRC), Government of Nepal.
Across seven surveys 33,228 individuals were enrolled, of whom 32,565 were examined (response rate 98%). Females (n=17,935) made up 55% of the sample. The age-sexprovince weighted national prevalence of blindness (better eye PVA <3/60) was 1.1% (95% CI: 1.0-1.2%), and any vision impairment <6/12 was 20.7% (95% CI: 19.9-21.5%).
The prevalence of blindness and any vision impairment were both higher in women than men (1.3% 95% CI: 1.1-1.5%) vs 0.9% (95% CI: 0.7-1.0%). Age-sex weighted blindness prevalence was highest in Lumbini Province (1.8% 95% CI: 1.3-2.2%) and lowest in Bagmati Province (0.7% 95% CI: 0.4-0.9%) and Sudurpashchim Province (0.7% 95% CI:0.4-0.9%). Cataract (65.2%) was the leading cause of blindness in the sample, followed by corneal opacity (6.4%), glaucoma (5.8%) and age-related macular degeneration (ARMD) (5.3%).
Other posterior segment diseases accounted for 8.4% of cases. The CSC in Nepal for the total population 50 years and older was 82.7% (95% CI: 80.8 – 84.4%) among the VA cut off <6/60 due to cataract, similar in both genders, Sudurpashchim (92.2%) had the highest CSC followed by Bagmati (90.7%), while densely populated Madhesh (77.6%) and Lumbini (75.4%) had least. Need not felt (33%), cost (30.4%), inability to access treatment (13%), and fear (12.3%) were the main barriers to accessing cataract surgical services.
The prevalence of blindness in 2021 has decreased to 1.05% from 2.5% among the 50 and older population of Nepal compared to the nationwide RAAB survey in 2010.The extrapolated prevalence for all ages was estimated as 0.35% in 2010 and 0.28% in 2021.
The Lumbini and Madesh Provinces had a higher prevalence of blindness compared to the other provinces.
Cataract was the still leading cause of blindness and severe vision impairment (SVI) and moderate vision impairment (MVI) while refractive error was the leading cause of mild vision impairment.
Based on the World Health Assembly (WHA) endorsed indicator and set global target for 2030 (visual acuity cut off 6/12), the eCSC was found to be 35.4%.
Public Health Update is a popular public health portal in Nepal. It was initiated in 2011. The main purpose of this platform is to share public health updates, information & opportunities for public health professionals all around the world. Thousands of health professionals have trusted Public Health Update as the right website to find the latest public health opportunities, information & resources for health updates in Nepal. It is expected that this initiation will help public health professionals to have access to the right information & opportunities at the right time to develop their professional careers. Public Health Update is committed & dedicated to deliver accurately, trusted, up-to-date health information & opportunities to all health professionals. The most popular information in this blog are jobs, scholarships, conferences, fellowships, awards, internships, grants, national & international plan policy, guidelines, reports, and health news. If you have any complaints, information, or suggestions about the content published on Public Health Update, please feel free to contact at [email protected]. Thanks for visiting us. Public Health Update: Inform | Advocate | Promote | Motivate | We are globally connected.
Public Health Update (Sagun’s Blog) is a popular public health portal in Nepal. Thousands of health professionals are connected with Public Health Update to get up-to-date public health updates, search for jobs, and explore opportunities. #1 Public Health Blog for sharing Job opportunities and updates in Nepal
”Public Health Information For All” – – Sagun Paudel, Founder
