Ghana

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With over 75% of the cases avoidable, over 200,000 individuals in Ghana are blind.[1] The most common types of blindness in Ghana are: Cataract (100,000), Glaucoma (30,000), Trachoma (6,000), Childhood Blindness (8,000), Refractive Errors and Low Vision (10,000), Diabetic and Sickle Cell Retinopathy (6,000).[1] In Ghana, as opposed to other countries in West Africa, disease prevalence is spotty and concentrated in two of the country’s 10 administrative regions: the Northern and Upper West Regions.[2] The different types of blindness affects different ages of people in Ghana, with glaucoma commonly affecting those who are 65 years of age and older, and refractive errors and low vision commonly affecting school-aged children, with the regions most affected by blindness are the North and Upper West areas of the country.[1] Among the most common forms of blindness affecting males and females in Ghana, the top three types of blindness are: cataracts, adult onset blindness and refractive errors.[4] When looking at the genetic causes of blindness, the most common causes are noted to be vitamin A deficiency, measles and infections to the cornea, with corneal blindness as a common cause among children.[5]

Being that eye care is currently largely institution based and run by specialists in big cities and towns, eye care services are readily accessible only to about 60% of the people.[1] Eye care providers in Ghana are relatively few compared to the need for eye care providers in the country. In order to address this gap, Ghana continues to train and deploy more eye care workers. In addition, financing for eye health remains a big problem in Ghana, with a continued lack of sufficient funding for eye equipment, consumables, supplies or research.[1] Each form of blindness is treated very differently in Ghana. Trachoma, for example, is currently a public health problem in focal communities in the northern and upper west regions in Ghana. The country has established a program with a number of NGOs working together in a partnership with the health sector to eliminate blindness due to trachoma in the country and to reduce the rate and risk for infection so that it will no longer be considered a problem.[1] The Trachoma Control Program began in 2000, when an estimated 2.8 million people were at risk of trachoma, and over 12,000 cases existed of trachoma related blindness.[2] The country put into place a two-year strategic plan to address the issue of trachoma in the five districts, with NGOs and the government agencies playing a role in the control of trachoma.[2] 


Number of Blind

There are an estimated 200,000 blind in Ghana, with over 600,000 who are visually impaired.[1] 

Number of Curable Blind

Seventy five percent of causes of blindness are avoidable.[1]

Prevalence of Curable Blind

In Ghana, as opposed to other countries in West Africa, disease prevalence is spotty and concentrated in two of the country’s 10 administrative regions: the Northern and Upper West Regions.[2]

Most Common Types of Curable Blindness

Cataract (100,000); Glaucoma (30,000); Trachoma (6,000); Childhood Blindness (8,000); Refractive errors and low vision (10,000); Diabetic and sickle cell retinopathy (6,000) [1]

Age Range of Affected Population

 

Glaucoma is most commonly seen in people 65 years or older. Refractive errors and low vision are most common in school-aged children. Vitamin A deficiency is a common cause of childhood blindness, 70% of which is curable.[1] 

The regions that are the most affected are the north and west regions of Ghana.[1]

Gender Breakdown of Affected Population

Girls have less access to medical and surgical services (diagnosis of correctable cataract, treatment of eye infections and provision of corrective glasses); the gender equity continues to adulthood with women accounting for 2/3 of the blind population and ¾ of  the population with trachoma related blindness.[3]     

Males (per 100,000): Glaucoma (223); Cataracts (795); Refractive errors (313); Macular degeneration and others (182) [4] 

Females (per 100,000): Glaucoma (264); Cataracts (920); Refractive errors (327); Macular degeneration and others (222) [4]

Racial/Ethnic Breakdown of Affected Population

Information Unavailable  

Income Range of Affected Population

Information Unavailable

City/Rural Breakdown of Affected Population

Trachoma is endemic in the North and West regions in Ghana.[2]

Single/Married Breakdown of Population

Information Unavailable

Cases of family history/genetic factors

Common causes of blindness are vitamin A deficiency, measles, corneal conditions and infection.[5]

Causes of Blindness

Cataract is most commonly seen among older population.[1] 

Trachoma is associated with poverty, lack of water, poor personal hygiene and environmental sanitation.[1] 

Childhood Blindness is associated with nutritional deficiencies, especially vitamin A, measles, infection of the cornea and the use of harmful traditional medicines and injuries.[1]

Awareness of curable blindness/different types of treatment

Eye care is largely institution based and run by specialists in big cities and towns; only readily available to 60% percent of the people.[1] 

Treatment: 

Cataracts are treated by optical correction and operations.[1] 

To treat glaucoma, there is an importance in creating awareness, detection and treatment in order to monitor the progress of the disease.[1] 

There is a trachoma control program in place and there are a number of NGOs working to eliminate blindness due to trachoma and reduce infection.[1]

 

Percent of individuals with access to clean water   

April 2002: Treated water was available to 62-70 percent in urban areas and 35-40 percent in rural areas; in urban areas only 40 percent have working tap water and 78 percent of the poor in the urban areas do not have piped water; CESR's report found that inadequate water and sanitation contributes to 70 percent of diseases in Ghana.[5]

Level of government intervention

Information Unavailable

Amount of economic burden/economic productivity

Blindness and low vision may lead to a reduction of 0.5 percent of GDP in parts of Africa and Asia by 2020.[3]

Level of access to eye doctors per 1000 individuals

Number of eye care services are small compared to the service need.[1] 

Eye health financing remains a big problem; never having sufficient funding for equipment, consumables, supplies or research.[1]

Success of eye surgeries

Five mission hospitals with resident ophthalmologists and a few eye clinics.[1] 

Key activities for trichiasis surgery include: creating awareness; case identification and registration during systematic active case searching and passive case identification; community- and facility-based surgery; and follow-up on operated persons.[2]

1. Stephenson, J (2009) River Blindness Trial. JAMA 302(7): 732 (doi:10.1001/jama.2009.1158). <http://jama.ama-assn.org/cgi/content/extract/302/7/732-a>

2. Gyasi, M.E., Amoaku, W.M.K, and Asamany, D.K. (2007) Barriers to Cataract Surgical Uptake in the Upper East Region of Ghana. Ghana Medical Journal Vol. 41, No.4. <http://www.ncbi.nlm.nih.gov/pubmed/18464906>

3. Ntim-Amponsah, C.T., and Amoaku, W.M.K.. (2008) Causes of childhood visual impairment and unmet low-vision care in blind school students in Ghana. International Ophthalmology Journal. <http://www.ncbi.nlm.nih.gov/pubmed/17898940>  

1. Ghana Eye Foundation. January 19, 2010. <http://www.ghanaeyefoundation.org/index1.php?linkid=20>

2. International Trachoma Initiative. January 21, 2010. <http://www.trachoma.org/media/press_releases_ghana.html>

3. The USAID Childhood Blindness Program. USAID. January 19, 2010. <http://www.a2zproject.org/pdf/Blindness_Brochure_111407.pdf>

4. Excel spreadsheets – WHO Health Statistics – DALY estimates for 2004. January 20, 2010<http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html>.

5. Gogate P, Kalua K, Courtright P (2009) Blindness in Childhood in Developing Countries: Time for a Reassessment? PLoS Med 6(12): e1000177. doi:10.1371/journal.pmed.1000177