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Original articles
Blindness and eye disease in a Tibetan region of China: findings from a Rapid Assessment of Avoidable Blindness survey
  1. Danba Jiachu1,
  2. Feng Jiang1,
  3. Li Luo1,
  4. Hong Zheng1,
  5. Ji Duo1,
  6. Jing Yang1,
  7. Yongcuo Nima1,
  8. Jin Ling2,
  9. Baixiang Xiao2,
  10. Ken Bassett3,4
  1. 1 Kham Eye Centre, Kandze Prefecture People`s Hospital, Dartsedo, China
  2. 2 Department of Preventive Ophthalmology, Zhongshan Ophthalmic Center of Sun Yat-sen University, Guangzhou, China
  3. 3 British Columbia Center for Epidemiology & International Ophthalmology and Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
  4. 4 Seva Canada, Vancouver, Canada
  1. Correspondence to Dr Ken Bassett; bassett{at}mail.ubc.ca

Abstract

Introduction The only population-based survey of blindness and visual impairment of a Tibetan population was conducted in the Tibet Autonomous Region in 1999.

Methods and analysis The Rapid Assessment of Avoidable Blindness methodology was used to conduct a survey of Kandze Tibetan Autonomous Prefecture, Sichuan Province of China in the Fall 2017. Using the 2010 census, 100 clusters of 50 participants aged 50 years or older were randomly sampled using probability proportionate to size.

Results Among the 5000 people enumerated, 4763 were examined (95.3% response). The age-adjusted and sex-adjusted prevalence of blindness, severe visual impairment, moderate visual impairment and early visual impairment (EVI) were 1.6% (95% CI: 1.08 to 2.38)), 0.9% (95% CI:0.7 to 1.5), 5.1% (95% CI:4.4 to 5.7), and 7.45% (95% CI:6.67 to 8.2), respectively. The prevalence of blindness among Tibetans was significantly higher than that among Han Chinese (2.2% (95% CI:1.8 to 2.6) and 0.6 (95% CI:0.2 to 1.7), respectively, p<0.05). Women bore a significant excess burden of EVI compared with men (8.5% (95% CI:7.5 to 9.6) and 6.1% (95% CI:5.1 to 7.2), respectively, p<0.05). Cataract was the primary cause of blindness (39.4%) followed by macular degeneration (10.6%) and corneal opacity (5.3%).

Conclusion Blindness and visual impairment in Kandze Tibetan Autonomous Prefecture is substantially less than an earlier study of a Tibetan region and now resembles other regions of China. About 58% of blindness and 67% of SVIwere avoidable, primarily by providing cataract services. Eighty-three percent of EVI was avoidable by providing refractice services throughout the region.

  • blindness prevalence survey
  • Tibetan population
  • China
  • epidemiology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

https://doi.org/10.1136/bmjophth-2018-000209

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    Footnotes

    • Contributors DJ, FJ, LL, HZ, DJ, JY and NY all contributed to the planning, conduct and reporting of the work. LJ gathered, analysed and reported the study data. BX provided training, supervision, quality control of the study as well as contributing to manuscript production. KB provided overall supervision and acted as the lead manuscript author.

    • Funding Supported by Sichuan Provincial Health Ministry Research Fund, China (No.150063) and Seva Canada.

    • Disclaimer The funding sources had no influence on study design, conduct, analysis or reporting.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Sichuan Health Research Council as well as from Zhongshan Ophthalmic Center, Sun Yat-sen University.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All the original RAAB data are available to share with interested researchers and for meta-analysis.