Visual impairment and associated factors in adults from three suburban communities in Nampula, Mozambique.

CLINICAL RELEVANCE: Scientific evidence on the burden of visual impairment, its causes, and associated factors are essential to monitor progress in eye health, identify priorities and develop strategies and policies that meet the needs of the population, towards the eradication of preventable blindness. BACKGROUND: The aim of this study was to determine the prevalence of visual impairment, its causes and associated factors in adults living in suburban communities in Nampula. METHODS: This is a cross-sectional study conducted from November 2019 to February 2020. Eye examinations were performed on adults aged ≥18 years covered by the Lúrio University program, 'one student, one family'. The odds ratio (OR) and adjusted odds ratio (aOR) were calculated to study the association between the dependent variable (presenting visual impairment) and independent variables (gender, age, school level, residence, family income and systemic diseases), with a 95% confidence interval. RESULTS: Distance and near presenting visual impairment had a prevalence of 16.3% and 21.1%, respectively, and were statistically associated with the age groups between 45-65 (OR:4.9) and >65 years (OR: 29.1), illiterate (OR:13.8), primary (OR:4.8) and secondary (aOR:37.5) school level, farmer (OR:32.8) and retired (OR:14.3) occupation, and presence of systemic diseases (OR :3.3). The main causes of presenting visual impairment were uncorrected refractive error and cataract. CONCLUSION: The prevalence of presenting visual impairment is relatively high, given the enormous effort undertaken within the framework of VISION 2020: The Right to Sight global initiative. There is a need to develop intervention plans targeted at the highest risk groups, with a view to achieving the 'one student, one family' program goals with respect to eye health.

Assessment of the distribution of human and material resources for eye health in the public sector in Nampula, Mozambique.

BACKGROUND: The unavailability of human and material resources can affect access to eye health services, constituting an obstacle in the fight against avoidable visual impairment. This study aimed to assess the availability and distribution of human and material resources for eye health in the public sector in Nampula province. METHODS: A mixed method approach was used, which included document reviews (to extract information regarding the number of professionals and inhabitants in each district) and application of a questionnaire to heads of the ophthalmology department in each health facility (to obtain the list of available equipment). The ratios of eye health professionals per population in Nampula province and each of its districts were calculated and evaluated taking into account the recommendations of the World Health Organization (WHO). Based on the level of care of each health facility, the availability of equipment was evaluated. RESULTS: Nampula Province has not reached the recommended ratio of eye health professionals per population in the different categories (ophthalmic technicians with 0.8 per 100 thousand inhabitants; optometrists and ophthalmologists with 0.4 and 0.2 per 250 thousand inhabitants, respectively). Most districts of Nampula did not reach the recommended ratio in the three categories of professionals, except Nampula City (provincial capital). However, there was a greater concentration of professionals and facilities with eye health services in the provincial capital. Primary and secondary level health facilities lacked some equipment to provide eye health services within their scope. CONCLUSIONS: There is an unequal distribution of the workforce in Nampula and the centralization of surgical services at the Central Hospital of Nampula level. Therefore, there is a need to review resource distribution strategies and decentralization policy of eye health services in Nampula.

Assessment of cataract surgery outcomes in Nampula (Mozambique): visual acuity, visual function and quality of life.

BACKGROUND: Despite advances in surgical techniques, cataract remains the leading cause of preventable blindness, and massive surgeries have been adopted as a strategy to change this situation. Monitoring the results of cataract surgeries has become imperative to ensure their quality. Therefore, this study aims to assess the cataract surgery outcomes performed at the Central Hospital of Nampula Mozambique. METHODS: This is a prospective and longitudinal study in which translation, cultural adaptation and validation of the visual function (VF) and quality of life (QoL) questionnaire were performed. The appearance, content, construct, criterion, internal consistency and responsiveness were validated using the most common methods and indicators. Visual acuity (VA), VF and QoL were evaluated on 447 patients before and after surgery by t-test and effect sizes. RESULTS: VF and QoL questionnaires showed one-dimension, good values of TLI (0.973, 0.951) and SRMR (0.057, 0.054), and for each item, weights > 0.7, H2 > 0.5, ranges > 5.8 and the RMSEA < 0.08. Correlations for criterion validity were high and for responsiveness were high for QoL and moderate for VF one and the ordinal Cronbach's alpha coefficients were greater than 0.97. Difference between VA, VF and QoL before and after surgery was statistically significant (p < 0.001). After surgery, 74.3% of patients had good, 23.5% had borderline and 2.2% had poor VA. CONCLUSIONS: The cataract surgery outcomes are outside the WHO recommendations regarding VA, but they have had a great impact on improving VF and QoL. The questionnaires showed excellent psychometric properties and should be used in daily clinical practice to evaluate the results of cataract surgeries.

Acceptability of the Vaccine against COVID-19 in Spanish Health Sciences Students: A Cross-Sectional Study.

Healthcare professionals must play an exemplary role in the field of vaccinology. It is convenient that they are trained during their time at university. The objective of this study was to determine the acceptability of the vaccines against COVID-19 in health sciences students in Spanish universities. A cross-sectional study was performed regarding the acceptance of the vaccines against COVID-19 in students in the Health Sciences Degrees in Spanish universities was performed on a sample of students of nursing, medicine, and pharmacy during the spring of 2021, via an online questionnaire with 36 questions designed ad hoc, self-administered, anonymized, and standardized. There were 1222 students participating, of Spanish nationality (97.4%), women (80.5%) and with an average age of 22.0 ± 4.8 years old. Of those, 12.3% had had the disease, 44.0% had to quarantine, 70.8% had undergone diagnostic tests, out of which 14.1% were positive. In total, 97.5% of those surveyed indicated their desire of being vaccinated, if possible, with Comirnaty® (74.9%). At the time of the study, 49.6% were already vaccinated. The reasons for vaccination differed according to the degree and the doubts about vaccine safety was the largest reason for reluctance. Some 37.7% suspected that there are unknown adverse effects and 85.6% of those vaccinated experienced some mild effects after injection. Vaccine acceptance and confidence in the recommendations given by health authorities is high in health sciences students.