Prevalence and causes of vision loss in sub-Saharan Africa in 2015: magnitude, temporal trends and projections

Br J Ophthalmol. 2020 Dec;104(12):1658-1668. doi: 10.1136/bjophthalmol-2019-315217. Epub 2020 Mar 30.

Abstract

Background: This study aimed to assess the prevalence and causes of vision loss in sub-Saharan Africa (SSA) in 2015, compared with prior years, and to estimate expected values for 2020.

Methods: A systematic review and meta-analysis assessed the prevalence of blindness (presenting distance visual acuity <3/60 in the better eye), moderate and severe vision impairment (MSVI; presenting distance visual acuity <6/18 but ≥3/60) and mild vision impairment (MVI; presenting distance visual acuity <6/12 and ≥6/18), and also near vision impairment (<N6 or N8 in the presence of ≥6/12 best-corrected distance visual acuity) in SSA for 1990, 2010, 2015 and 2020.In SSA, age-standardised prevalence of blindness, MSVI and MVI in 2015 were 1.03% (80% uncertainty interval (UI) 0.39-1.81), 3.64% (80% UI 1.71-5.94) and 2.94% (80% UI 1.05-5.34), respectively, for male and 1.08% (80% UI 0.40-1.93), 3.84% (80% UI 1.72-6.37) and 3.06% (80% UI 1.07-5.61) for females, constituting a significant decrease since 2010 for both genders. There were an estimated 4.28 million blind individuals and 17.36 million individuals with MSVI; 101.08 million individuals were estimated to have near vision loss due to presbyopia. Cataract was the most common cause of blindness (40.1%), whereas undercorrected refractive error (URE) (48.5%) was the most common cause of MSVI. Sub-Saharan West Africa had the highest proportion of blindness compared with the other SSA subregions.

Conclusions: Cataract and URE, two of the major causes of blindness and vision impairment, are reversible with treatment and thus promising targets to alleviate vision impairment in SSA.

Keywords: epidemiology; public health.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Blindness / epidemiology*
  • Blindness / etiology
  • Blindness / rehabilitation
  • Cataract / complications*
  • Forecasting*
  • Glaucoma / complications*
  • Humans
  • Macular Degeneration / complications*
  • Prevalence
  • Refractive Errors / complications*
  • Visual Acuity
  • Visually Impaired Persons / statistics & numerical data*