Burden of eye disease and demand for care in the Bangladesh Rohingya displaced population and host community: A cohort study


Autoři: Munir Ahmed aff001;  Noelle Whitestone aff002;  Jennifer L. Patnaik aff003;  Mohammad Awlad Hossain aff001;  Lutful Husain aff001;  Mohammed Alauddin aff001;  Mushfiqur Rahaman aff005;  David Hunter Cherwek aff003;  Nathan Congdon aff003;  Danny Haddad aff003
Působiště autorů: Orbis Bangladesh, Dhaka, Bangladesh aff001;  Independent consultant, Orbis International, New York, New York, United States of America aff002;  Orbis International, New York, New York, United States of America aff003;  Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, United States of America aff004;  Cox’s Bazar Baitush Sharaf Hospital, Cox’s Bazar, Bangladesh aff005
Vyšlo v časopise: Burden of eye disease and demand for care in the Bangladesh Rohingya displaced population and host community: A cohort study. PLoS Med 17(3): e32767. doi:10.1371/journal.pmed.1003096
Kategorie: Research Article
doi: 10.1371/journal.pmed.1003096

Souhrn

Background

There is a growing awareness that addressing chronic as well as acute health conditions may contribute importantly to the well-being of displaced populations, but eye care service has generally not been prioritized in crisis situations. We describe a replicable model of eye care provision as delivered by Orbis International and local partners to the Rohingya and host population in Cox’s Bazar, Bangladesh, and characterize the burden of vision impairment and demand for sight-restoring services in this setting.

Methods and findings

Orbis International and local secondary facility Cox’s Bazar Baitush Sharaf Hospital (CBBSH) provide eye care support to the Rohingya population and the host community of all ages in Cox’s Bazar, Bangladesh, with fixed vision screening locations established in Camps 4 and 11 of the Kutupalong refugee settlement. Structured outreach targets these camps and four surrounding local subdistricts, with referrals made as needed for refraction (glasses measurement) and cataract surgery to CBBSH. Between February 2018 and March 2019, 48,105 displaced Rohingya (70.3%, among whom 71.6% were children and 46.5% women) and 20,357 local residents (29.7%, 88.5% children, 54.4% women) underwent vision screening. Displaced Rohingya sought services from a total of 12 surrounding camps, within which coverage was 17.3%, including 43.3% (27,027/62,424) of children aged 5–11 years and 60.0% (5,315/8,857) of adults ≥ 60 years old. The prevalence of blindness (presenting acuity < 3/60) among Rohingya patients exceeded that among local residents by 3- to 6-fold in each 10-year age group between 18 and 59 years (P < 0.001 comparing vision between the two groups in this age range), and the prevalence of cataract requiring surgery was also higher in Rohingya patients (18–29 years: 4.67% versus 1.80%, P = 0.0019; 30–39: 7.61% versus 2.39%, P < 0.001; and 40–49 years: 7.91% versus 3.77%, P = 0.0014). A limitation of the study is lack of data on population prevalence of eye disease.

Conclusions

The burden of untreated eye disease is very high among the Rohingya, particularly those in their peak working years who could contribute most to the resiliency of their community. Demand for eye care service is also great among children and adults in this population with many competing healthcare priorities. Research is needed, building on strong evidence of benefit in settled populations, to explore the specific impact of vision care on the well-being of displaced populations.

Klíčová slova:

Bangladesh – Cataract surgery – Cataracts – Eye diseases – Eyes – Vision – Visual acuity – Visual impairments


Zdroje

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Interní lékařství

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PLOS Medicine


2020 Číslo 3

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