Prevalence of visual impairment in El Salvador: Inequalities in educational level and occupational status

  • Anna Rius
  • , Laura Guisasola
  • , Meritxell Sabidó
  • , Janet L. Leasher
  • , David Moriña
  • , Astrid Villalobos
  • , Van C. Lansingh
  • , Oscar J. Mujica
  • , José Eduardo Rivera-Handal
  • , Juan Carlos Silva

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. 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. Methods. 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. Results. 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. Conclusions. 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.

Original languageEnglish
Pages (from-to)290-299
Number of pages10
JournalRevista Panamericana de Salud Publica/Pan American Journal of Public Health
Volume36
Issue number5
StatePublished - Nov 2014

ASJC Scopus Subject Areas

  • Public Health, Environmental and Occupational Health

Keywords

  • Blindness
  • Cataract
  • El Salvador
  • Eye health
  • Health inequalities
  • Ophthalmology
  • Refractive errors

Disciplines

  • Public Health

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