John M Nesemann1,2,3, Noelia Morocho-Alburqueque4, Alvaro Quincho-Lopez5, Marleny Muñoz6, Sandra Liliana-Talero7, Emma M Harding-Esch8, Martha Idalí Saboyá-Díaz9, Harvy A Honorio-Morales10, Salomón Durand11, Cristiam A Carey-Angeles12, Jeffrey D Klausner13, Andres G Lescano14, Jeremy D Keenan15,16. 1. Francis I. Proctor Foundation, University of California, San Francisco, CA, USA. JNesemann@mednet.ucla.edu. 2. David Geffen School of Medicine, University of California, Los Angeles, CA, USA. JNesemann@mednet.ucla.edu. 3. Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru. JNesemann@mednet.ucla.edu. 4. Universidad Nacional de Piura, Piura, Peru. 5. Universidad Nacional Mayor de San Marcos, Lima, Peru. 6. Área de Epidemiología, Red de Salud Alto Amazonas, Yurimaguas, Peru. 7. Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia. 8. Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK. 9. Department of Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization, Washington, DC, USA. 10. Componente de Salud Ocular y Prevención de la Ceguera, Ministerio de Salud, Lima, Peru. 11. Área de Epidemiología, Dirección Regional de Salud Loreto, Iquitos, Peru. 12. Universidad Nacional de la Amazonia Peruana, Iquitos, Peru. 13. Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 14. Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru. 15. Francis I. Proctor Foundation, University of California, San Francisco, CA, USA. 16. Department of Ophthalmology, University of California, San Francisco, CA, USA.
Abstract
OBJECTIVE: To determine the relationship between socioeconomic status (SES) and visual impairment (VI) or blindness in the rural Peruvian Amazon, hypothesizing that higher SES would have a protective effect on the odds of VI or blindness. METHODS: In this cross-sectional study of 16 rural communities in the Peruvian Amazon, consenting adults aged ≥ 50 years were recruited from ~30 randomly selected households per village. Each household was administered a questionnaire and had a SES score constructed using principal components analysis. Blindness and VI were determined using a ministry of health 3-meter visual acuity card. RESULTS: Overall, 207 adults aged ≥ 50 were eligible; 146 (70.5%) completed visual acuity screening and answered the questionnaire. Of those 146 participants who completed presenting visual acuity screening, 57 (39.0%, 95% CI 30.2-47.1) were classified as visually impaired and 6 (4.1%, 95% CI 0.9-7.3) as blind. Belonging to the highest SES tercile had a protective effect on VI or blindness (OR 0.29, 95% CI 0.09 to 0.91, p = 0.034), with a linear trend across decreasing levels of SES (p = 0.019). This observed effect remained significant regardless of how SES groups were assigned. CONCLUSION: Belonging to a higher SES group resulted in a lower odds of VI or blindness compared to those in the lowest SES group. The observation of a dose response provides confidence in the observed association, but causality remains unclear. Blindness prevention programs could maximize impact by designing activities that specifically target people with lower SES.
OBJECTIVE: To determine the relationship between socioeconomic status (SES) and visual impairment (VI) or blindness in the rural Peruvian Amazon, hypothesizing that higher SES would have a protective effect on the odds of VI or blindness. METHODS: In this cross-sectional study of 16 rural communities in the Peruvian Amazon, consenting adults aged ≥ 50 years were recruited from ~30 randomly selected households per village. Each household was administered a questionnaire and had a SES score constructed using principal components analysis. Blindness and VI were determined using a ministry of health 3-meter visual acuity card. RESULTS: Overall, 207 adults aged ≥ 50 were eligible; 146 (70.5%) completed visual acuity screening and answered the questionnaire. Of those 146 participants who completed presenting visual acuity screening, 57 (39.0%, 95% CI 30.2-47.1) were classified as visually impaired and 6 (4.1%, 95% CI 0.9-7.3) as blind. Belonging to the highest SES tercile had a protective effect on VI or blindness (OR 0.29, 95% CI 0.09 to 0.91, p = 0.034), with a linear trend across decreasing levels of SES (p = 0.019). This observed effect remained significant regardless of how SES groups were assigned. CONCLUSION: Belonging to a higher SES group resulted in a lower odds of VI or blindness compared to those in the lowest SES group. The observation of a dose response provides confidence in the observed association, but causality remains unclear. Blindness prevention programs could maximize impact by designing activities that specifically target people with lower SES.
Authors: Juan Carlos Silva; Oscar J Mújica; Enrique Vega; Alberto Barcelo; Van C Lansingh; Joan McLeod; Hans Limburg Journal: Rev Panam Salud Publica Date: 2015-01
Authors: Anna Rius; Laura Guisasola; Meritxell Sabidó; Janet L Leasher; David Moriña; Astrid Villalobos; Van C Lansingh; Oscar J Mujica; José Eduardo Rivera-Handal; Juan Casrlos Silva Journal: Rev Panam Salud Publica Date: 2014-11
Authors: Jacqueline Ramke; Jennifer Petkovic; Vivian Welch; Ilse Blignault; Clare Gilbert; Karl Blanchet; Robin Christensen; Anthony B Zwi; Peter Tugwell Journal: Cochrane Database Syst Rev Date: 2017-11-09