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      Establishing the profile of eye diseases among elderly patients attending a tertiary hospital in Northern Malawi

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          Abstract

          Globally, there has been a dramatic increase in the geriatric population. Sadly, this populace is highly prone to develop various ocular morbidities putting pressure on the strained eye care delivery system especially in low-income countries. Hence, the aim of this study was to determine the distribution of ocular morbidities among elderly. The study was a retrospective cross-sectional study conducted at Mzuzu Central Hospital in Malawi. We retrieved data from the hospital’s Ophthalmology out-patient registry from January 2021 to December 2021. We recruited all 970 elderly patients who visited the clinic during the period of study. Data entry and analysis was done employing SPSS (v.26). More males than females had ocular morbidities. Cataract 400 (41.2%) was the most prevalent ocular morbidity followed by glaucoma 189 (19.5%), pinguecula 48 (4.9%) and allergic conjunctivitis 43 (4.4%). Anterior segment eye diseases were common 714 (73.6%) . The prevalence of cataract, glaucoma, refractive error and allergic conjunctivitis was significantly associated with sex ( p < 0.05). Age association was found with the prevalence of cataract, glaucoma, pinguecula, allergic conjunctivitis and corneal scar ( p < 0.05). The pattern of eye diseases is endemic to the country. More resources should be targeting cataract and glaucoma among the age group.

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          Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi

          Background There has been a notable expansion in routine health care in sub-Saharan Africa. While heath care is nominally free in many contexts, the time required to access services reflects an opportunity cost that may be substantial and highly gendered, reflecting the gendered nature of health care guidelines and patterns of use. The time costs of health care use, however, have rarely been systematically assessed at the population-level. Methods Data come from the 2015 wave of a population-based cohort study of young adults in southern Malawi during which 1,453 women and 407 men between the ages of 21 and 31 were interviewed. We calculated the time spent seeking health care over a two-month period, disaggregating findings by men, recently-pregnant women, mothers with children under two years old, and “other women”. We then extrapolated the time required for specific services to estimate the time that would be needed for each subpopulation to meet government recommendations for routine health services over the course of a year. Results Approximately 60% of women and 22% of men attended at least one health care visit during the preceding two months. Women spent six times as long seeking care as did men (t = -4.414, p<0.001), with an average 6.4 hours seeking care over a two-month period compared to 1 hour for men. In order to meet government recommendations for routine health services, HIV-negative women would need to spend between 19 and 63 hours annually seeking health care compared to only three hours for men. An additional 40 hours would be required of HIV-positive individuals initiating antiretroviral care. Conclusions Women in Malawi spend a considerable amount of time seeking routine health care services, while men spend almost none. The substantial time women spend seeking health care exacerbates their time poverty and constrains opportunities for other meaningful activities. At the same time, few health care guidelines pertain to men who thus have little interaction with the health care system. Additional public health strategies such as integration of services for those services frequently used by women and specific guidelines and outreach for men are urgently needed.
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            Lens opacities in a rural population of southern India: the Aravind Comprehensive Eye Study.

            To determine the prevalence of lens opacities in an older population in rural southern India. A cross-sectional study of 5150 persons aged 40 years and more who were selected as part of a representative sample from three southern districts of the state of Tamil Nadu in southern India. All lenses were graded and classified for opacities and other disorders by slit lamp after pupillary dilation, using the Lens Opacification Classification System (LOCS) III and standard photographs. Definite cataract was defined as either LOCS III nuclear opalescence of grade 3.0 or more and/or cortical cataract of grade 3.0 or more and/or posterior subcapsular cataract (PSC) of grade 2.0 or more. Definite cataract was present in one or both eyes in 2499 (47.5%) of 5150 subjects. The age-adjusted prevalence (adjusted to U.S. population estimates for 2000) of definite cataract in this population was 61.9% (95% CI, 60.6-6.3). The prevalence was significantly lower in men (P=0.0002). In those eyes with cataracts, nuclear cataract (59.7%) was most common, and cortical cataract was present in 20.0% and PSC in 24.3%. Cataract surgery had been performed in 9.4% persons, including 3.0% who had bilateral surgery for cataracts. Best corrected visual acuity was less than 6/60 in 3.7% of aphakic eyes and in 0.8% of pseudophakic eyes. The higher age-adjusted prevalence and relatively early onset of age-related cataract in this population suggest that the cataract-centered approach to minimizing preventable blindness, adopted by the National Program for Prevention of Blindness in India, is appropriate.
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              A qualitative study on gender barriers to eye care access in Cambodia

              Background The Fred Hollows Foundation (FHF) Cambodia recently partnered with the Ministry of Women’s Affairs (MoWA) and National Program for Eye Health (NPEH, part of the Ministry of Health) to establish the Gender Equality in Eye Health Project. As part of this project, a qualitative study was carried out to identify barriers affecting women’s access to eye health in Cambodia. Methods A cross-sectional qualitative study was conducted in four provinces in both urban and rural locations between May and June 2015. Purposive sampling was used to identify respondents from a range of age groups, geographical locations, and experiences to explore different perceptions regarding access barriers to eye health care. Thirteen women experiencing eye problems (age range 45–84 years; mean age 63 years) and 25 eye health professionals took part in in-depth interviews. Eleven focus groups discussions were held with 69 participants (50 women, 19 married men) to capture the views and experiences of both younger and older women, as well as household decision makers’ perspectives. Results Gender-based differences in decision-making, access and control over resources and women’s social status all contributed to impeding women’s access to eye health services. Women relied predominantly on informal sources of information about health, and these channels might be utilised to address barriers to information and access. Disparities in perceived costs of eye health treatment were evident between eye healthcare providers and users: costs were not perceived as a barrier by service providers due to health financing support for poor patients, however, many users were not aware of the availability of the scheme. Conclusion Demand-side and supply-side elements interact to reduce women’s ability to seek eye treatment.
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                Author and article information

                Contributors
                Ogbonnagrace19@gmail.com
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                20 March 2024
                20 March 2024
                2024
                : 14
                : 6725
                Affiliations
                [1 ]Department of Optometry, Mzuzu University, ( https://ror.org/008ej3804) Private Bag 201, Mzuzu, Malawi
                [2 ]Department of Ophthalmology, Mzimba North District Hospital, Mzuzu, Malawi
                Article
                55538
                10.1038/s41598-024-55538-z
                10954608
                38509142
                433b7566-cbd1-4555-a0a4-8497656b5f0d
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 3 July 2023
                : 24 February 2024
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                © Springer Nature Limited 2024

                Uncategorized
                anatomy,diseases,health care,medical research
                Uncategorized
                anatomy, diseases, health care, medical research

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