ABSTRACT
The leading global factor contributing to irreversible blindness in black people is primary open-angle glaucoma (POAG). Blindness, a glaucoma side effect, can be prevented with early detection and treatment. For early detection and diagnosis of glaucoma, people must be aware of the disease and routinely seek evaluation. There has never before been research on medical students’ knowledge of glaucoma.
The purpose of this study is to evaluate the pre-clinical medical students at LAUTECH’s understanding of glaucoma risk factors.
The study used a cross-sectional, quantitative approach. Data on demographics, visual and health histories, knowledge of eye problems, attitudes regarding glaucoma, and awareness of risk factors were collected using a self-administered questionnaire with guidance from chosen prior studies. 403 pre-clinical medical students from all four colleges of the university were chosen using a stratified sample approach, which excluded all eye care professionals such ophthalmologists, optometrists, ophthalmic nurses, and opticians. In order to determine the numbers from schools under each institution, a proportionate sampling was utilized. In each of the schools under the various colleges, every third pre-clinical medical student who gave their assent was enrolled.
The average age of the study’s 237 male participants (58.8%) and 166 female participants (41.2%) was 30.6 6.4 years. The majority of 224 pre-clinical medical students (55,6%) were between the ages of 20 and 29. The highest rate of glaucoma awareness was 88.09%, followed by cataract (62.03%) and refractive error (40.45). Only 4% of people have never heard of any of the eye diseases. Knowledge has a mean score of 7.33 4.26 total. The average score for glaucoma attitude was 25.55 + 2.59. According to the study, only 77.17% of people had a general understanding of eye diseases. However, 82.88% of people had a positive attitude regarding glaucoma blindness, and 39.7% of people got their information on glaucoma blindness from TV or radio advertisements. 334 of the 403 participants have ever checked their eyes, whereas 69 have never done so. 213 of 403 (52.9%) people had their eyes tested regularly in the past two years or less. Good knowledge and a positive attitude are significantly related to good practice, according to a multivariate analysis.
The results of this study showed that while attitudes concerning glaucoma blindness were positive, knowledge levels were low. However, attitude has a considerable impact on knowledge of risk factors for blindness. In order to ensure early identification of eye disorders and management, pre-clinical medical students need to receive more glaucoma education. This will boost knowledge and practice.
LIST OF ABBREVIATIONS
- DALYS Disability Adjusted Life Years
- IAPB International Agency for the Prevention of Blindness
- MDG Millennium Development Goals
- OAG Open Angle Glaucoma
- SDG Sustainable Development Goals
- URE Uncorrected refractive error
- WHO World Health Organization
CHAPTER ONE
INTRODUCTION
1.1 Background
In today’s world, visual impairment, regardless of the source, is a serious impediment. Blindness or vision impairment can have a wide range of reasons, including illness and other eye diseases. Glaucoma is one of the diseases caused by genetic defects that account for a sizable fraction of the cases.
Glaucoma is a common eye disease that results in slow fluid outflow, which raises the eye’s fluid pressure. It can affect the eye’s optic nerve and other tissues if left untreated, which could result in vision loss or even blindness. Glaucoma is an extremely serious eye disease that impairs peripheral vision and frequently progresses without obvious symptoms (Medical Dictionary, 2008).
Glaucoma is an eye condition that causes a significant amount of permanent blindness worldwide (Pokharel & Maiotti, 2004). Sadly, there is no cure for the illness. Early and moderate disease is typically asymptomatic; when symptoms do appear, the disease is frequently progressed and frequently incurable.
Primary open-angle glaucoma and secondary glaucoma are the two kinds of glaucoma. Primary angle-closure glaucoma can lead to secondary glaucoma, which can be brought on by an eye injury, surgery, the development of an eye tumor, or as a side effect of a condition like diabetes or medicine (Yves & Walid, 2007). However, age-related primary open-angle glaucoma is by far the most prevalent (POAG).
Despite the availability of diagnostic tools, glaucoma remains a serious public health issue. Glaucoma is thought to be the second most common cause of blindness in the world, accounting for 4.5 million cases (12.0%), after cataracts, which affect 50 million people (47.9%). According to projections, 3.9 million primary-angle closure glaucoma patients and an additional 4.5 million POAG sufferers will lose their vision in 2010. (Bourne, 2006; Quigley & Broman, 2006; Giangiacomo & Coleman, 2009). Furthermore, according to these authors, by 2020, there would be 79.6 million persons worldwide with POAG and angle closure glaucoma (ACG), 74% of whom will have POAG. In 2010, 59% of all glaucoma cases and 55% of POAG cases will be in women. These numbers unmistakably imply that glaucoma is a condition of considerable public health importance. Independent of their underlying causes, blindness and impaired vision are serious worldwide health problems because they significantly reduce economic productivity, increase morbidity and death, and lower quality of life (Vu, Keefe, McCathy & Taylor, 2005).
There is no evidence of trustworthy epidemiological data on either glaucoma visual impairments or visual impairments from other sources since epidemiological data on the scope of visual impairments in Nigeria is lacking. The World Health Organization (WHO) projects that cataract, glaucoma, and corneal abnormalities would cause at least 1.00% of the population to be blind in the nation. It is estimated that cataracts alone are responsible for at least 50% of all blindness, with glaucoma accounting for 4% of cases among people aged 40 and beyond. The WHO also forecasts an annual incidence rate of 0.2% for glaucoma in the majority of Southern African nations. According to WHO projections, at least 10,920 (4%) persons in Nigeria are anticipated to have glaucoma (World Health Organization [WHO], 2008).
Therefore, effective therapies are needed to stop eye illnesses, postpone or stop vision loss, and prevent blindness. At all levels of health care delivery, primary and comprehensive glaucoma interventions are to be implemented in order to attain the aims. incorporating comprehensive glaucoma care into current health systems to increase access to these services.
Therefore, including glaucoma in the current healthcare system will encourage the delivery of comprehensive healthcare and is important for achieving visual health. It has been found that roughly 5% of causes of blindness are linked to diabetic retinopathies and hypertension, thus eye exams should be a regular component of medical checkups for everyone, especially those with a history of diabetes and hypertension (Boutayeb, 2016). Preventing blindness and visual impairment among pre-clinical medical students depends on appropriate eye education and community involvement in glaucoma blindness in Nigeria (Ilechie, Otchere, Darko-takyi, & Halladay, 2013).
According to research, when early causes of blindness are identified, 75–80% of them can be reversed or prevented (WHO, 2019). According to the American Academy of Ophthalmology (2015), comprehensive glaucoma care, which includes regular eye and vision exams, is a crucial component of preventative healthcare. This is because many eye and vision disorders have no outward symptoms, making it possible for someone to go without realizing they have a problem unless they check.
1.2 Problem Statement
At the IHO eye clinic, 60% of patients who received a glaucoma diagnosis for the first time had the disease in an advanced stage, making it difficult to salvage their vision. Patients who neglect to undergo regular eye exams and who subsequently appear with the disease in its advanced state are a concern not only at IHO because this unsettling trend has also been noted in other African nations. For instance, a 2005 study by Mafwira, Bowman, Wood, and Kabiru discovered that an audit in a hospital for the disabled included 29% of glaucoma patients from Lagos state and 53% of patients with eye disorders who were already blind. In Lagos State, 70% of patients had a cup/disc ratio greater than 0.8 in the better eye. How can we make this better? Because there is no appropriate screening test now available and it is impractical, population-based glaucoma screening is not recommended (Bowman & Kirupananthan, 2006). Patients who visit the IHO eye clinic may already be blind due to a lack of knowledge or awareness about glaucoma.
There is no proof that a published epidemiological research on glaucoma awareness was conducted in Nigeria. Another conclusion that could be drawn is that low glaucoma awareness is a nationwide problem.
Graduate programs in Nigerian universities are created to train people and professionals from all backgrounds in the development of abilities to tackle challenges in their daily lives. This is anticipated to enable these experts, among others, to realize the health requirements of communities and advocate a healthy lifestyle. The most productive top group is also meant to be trained in graduate programs.
Pre-clinical medical students, the bulk of whom are young, make up any nation’s labor force. To continue being extremely effective at work and in other facets of their lives, they need, among other things, healthy vision. Consequently, it will be wise to get more understanding regarding glaucoma.
So, in this study, LAUTECH pre-clinical medical students were evaluated on their degree of knowledge on risk factors for glaucoma blindness.
1.3 Research Questions
- What is the knowledge of LAUTECH medical students risk factors glaucoma blindness?
- What is the attitude of LAUTECH pre-clinical medical students towards Glaucoma blindness?
- How do health history of medical students, knowledge and attitude influence knowledge of risk factors of blindness?
1.4 General Objective
To assess the knowledge of risk factors of glaucoma blindness among LAUTECH Pre-clinical medical students.
Specific Objectives
- To determine the knowledge of LAUTECH pre-clinical medical students of glaucoma blindness.
- To assess the attitude of LAUTECH pre-clinical medical students towards glaucoma blindness.
- To determine the influence of knowledge and attitude on knowledge of risk factors of blindness among LAUTECH pre-clinical medical students.
1.5 Significance of the Study
30% of individuals in Africa have glaucoma blindness, and different countries and regions have different distributions of glaucoma services (Murthy & Raman, 2009). Nigeria’s population has been increasing since the 1960s, and as a result of the demographic shift from a young to an older population, age-related conditions including cataract and presbyopia are expected to become more prevalent and might develop earlier in life (GDP, 2018; Yorston, 1998).
Studies on community understanding of glaucoma in Nigeria have been conducted, however not many have focused on medical students’ knowledge.
Data on public awareness and glaucoma risk factors are necessary to properly target programs for community involvement and glaucoma education. Most people believe that adults are essential to the family, community, and society (Murray, 1996). Graduates are most suited to champion health education and the accompanying shift in health-seeking behavior because they possess the abilities necessary to devise tactics needed to enhance health, such as encouraging families to better their own and the community’s health. A more efficient procedure for creating awareness interventions will be developed with the use of an assessment of knowledge, attitude, and practice levels. If implemented through community outreach and visual rehabilitation projects, this will enable vision-related programs to be more effectively customized to the requirements of the community.
1.6 Definition of Concepts
Glaucoma: The term glaucoma refers to a group of diseases that have in common a characteristic optic neuropathy with associated visual function loss (American academy of ophthalmology, 2009-20010).
Awareness: The state or level of consciousness where sense data can be confirmed by an observer. The awareness of one type of idea naturally fosters an awareness of another idea (English Dictionary, 2010).
Knowledge: Expertise, and skills acquired by a person through experience or education, the theoretical or practical understanding of a subject (Oxford English Dictionary, 2010).
Information, education and communication (IEC): It combines strategies, approaches and methods that enable individuals, families, groups, organisations and communities to play an active role in achieving, protecting and sustaining their own health. In this study IEC materials mean graphics which could be included in brochures or posters on glaucoma (The communication Initiative site, 2008).
Normal vision: The WHO defines normal vision as a visual acuity of 6/6-6/18 in a better eye with available best correction (WHO, 2008).
Visual impairment: The WHO defines visual impairment as a visual acuity of 6/36- 6/60 in a better eye (WHO, 2008).
Severe visual impairment: The WHO defines severe visual impairment as a visual acuity of 6/60-3/60 in a better eye or a visual field constriction of less than 20 degrees in the better eye with best possible correction (WHO, 2008).
Blindness: The WHO defines blindness as a visual acuity worse than 3/60 meter or visual field of less than 10 degrees in the better eye with best possible correction (WHO, 2008).
Best possible correction: This refers to the best visual acuity achieved with spectacles, contact lenses, or surgery (WHO, 2008).
1.7 Organization of the study
The backdrop to the problem, the problem’s statement, the study’s aim, goals, and relevance, as well as definitions of essential concepts, are all outlined in Chapter 1. The literature review that was done for the study is covered in Chapter 2. The research design and technique are covered in Chapter 3. The data analysis and study results are discussed in Chapter 4 of the book. The study’s recommendations, limits, and findings are presented in Chapter 5.
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