Prevalence and associated factors of visual impairment in two rural communities in Ghana

Abstract

Background: Limited information on the burden of visual impairment (VI) impedes decision-making in terms of eye health provision.
Aim: This study assessed the prevalence, causes and associated factors of VI in rural communities in Ghana.
Setting: The study site included two rural communities of the Birim Central Municipality (BCM) in the Eastern Region of Ghana.
Methods: A cross-sectional study was conducted using a multi-stage sampling technique in two randomly selected villages within the Birim Central Municipality (BCM). Participants were recruited through systematic household sampling. Socio-demographic data were collected using interviewer-administered questionnaires. Comprehensive eye examinations included visual acuity testing, anterior and posterior segment evaluation, auto-refraction and tonometry. Visual impairment was classified according to the International Classification of Diseases (ICD-11).
Results: The overall prevalence of VI was 30.1% (95% confidence interval [CI]: 25.80–34.70). Cataracts were the leading cause, accounting for 39–40.28% of VI per eye, 52.46% of bilateral VI and 68.75% of blindness. Uncorrected refractive error was the primary cause of unilateral VI (48.57%). Significant risk factors for VI included age (P < 0.001), marital status (P = 0.02) and occupation (P = 0.01). Participants aged 36–59 years (adjusted odds ratio [AOR] 4.93, 95% CI 1.14–21.31) and 60+ years (AOR 11.29, 95% CI 2.41–52.85) had higher odds of VI. Civil servants and traders had 20% and 28% lower odds of VI compared to students.
Conclusion: Visual impairment prevalence in rural Ghana is high, with cataracts and uncorrected refractive error as the primary causes, both of which are preventable or treatable. Establishing community vision centres could enhance early detection and management, reducing the VI burden in underserved areas.
Contribution: This study has shed light on the burden of VI in rural communities in Ghana; the main drivers of the VI and risk factors. Additionally, the study has called attention to making eye care accessible and affordable for rural dwellers in Ghana.