Abstract
Objective: To determine the prevalence of Primary Open-Angle Glaucoma (POAG) among patients attending
eye clinic at University Teaching Hospital (UTH).
Design: A cross sectional survey.
Methods: The POAG survey was carried out at the eye clinic of the University Teaching Hospital (UTH), Lusaka
from January to December 2013. The clients (n = 1,625) had a full ocular examination and their demographic
information (specifically age, sex, residence and ethnicity) was captured. The ocular examination included
visual acuity and intraocular pressure (IOP) among others. Multivariate logistic regression, stratified by age
group and gender, was used to determine the association between demographic factors and POAG.
Results: Of the 1,714 patients randomly sampled for the study, 89 (5.2%) declined to participate in the study;
hence the response rate of 94.8%. The ages ranged from 20 to 98 years, with a median age of 51 years (IQR
45, 59). The prevalence of POAG was 19.0% (95% CI, 14.6%, 23.8%), distributed as 5.7% (95% CI 3.2, 9.1) in
males and 13.3% (95% CI 11.7, 21.3) for females. Females were more likely to have POAG than males (72.9%
vs. 27.1%; OR 2.78, 95% CI 2.1, 5.8). Surprisingly, age groups younger than 40 years had higher proportion of
POAG compared to the older population (61.6% vs. 38.4%, P<0.001). The main determinants of POAG were
age, sex and Diabetic Retinopathy (DR). There was a significant negative correlation between POAG and HIV
infection (r2 = 0.0269; p<0.001).
Conclusion: The prevalence of POAG in this population of 19.0% was higher and certainly not comparable
to those in black populations in Barbados, St. Lucia, Nigeria, Ghana and South Africa. The striking finding
of this study was that 40.7% of all the identified POAG cases were below the age of 40 years. There was no
association between POAG and HIV infection
References
Thylefors B. A global initiative for the elimination of
avoidable blindness. Comm Eye Health. 1998; 11: 1.
Resnikoff S, Pascolini D, Etya’ale D, Kocur I,
Pararajasegaram R, Pokharel GP, Mariotti SP.
Global data on visual impairment in the year 2002.
Bull World Health Org. 2004; 82: 844-851.
Muma I, Michelo C, Bailey R. Determinants of
Primary Open Angle Glaucoma: Review of records
of patients attending University Teaching Hospital,
Lusaka, Zambia. Med J Zambia. 2015; 42: 16-24.
Egbert PR. Glaucoma in west Africa: a neglected
problem. Br J Ophthalmol. 2002; 86: 131-132.
Klein BE, Klein R, Sponsel WE, Franke T,
Cantor LB, Martone J, Menage MJ. Prevalence
of glaucoma: the Beaver Dam eye study.
Ophthalmology. 1992; 99: 1499-1504.
Leibowitz HM, Krueger D, Maunder L,
Milton R, Kini M, et al. The Framingham Eye
Study monograph: an ophthalmological and
epidemiological study of cataract, glaucoma,
diabetic retinopathy, macular degeneration, and
visual acuity in a general population of 2631
adults, 1973-1975. Survey Ophthalmol. 1979; 24:
-610.
Leske MC, Connell A, Schachat AP, Hyman L.
The Barbados Eye Study: prevalence of open angle
glaucoma. Archives Ophthalmol. 1994; 112: 821-829.
Ntim-Amponsah C, Amoaku W, Ofosu-Amaah S,
Ewusi R, Idirisuriya-Khair R, et al. Prevalence of
glaucoma in an African population. Eye. 2004; 18:
-497.
Tielsch JM, Sommer A, Katz J, Royall RM, Quigley
HA, Javitt J. Racial variations in the prevalence of
primary open-angle glaucoma: the Baltimore Eye
Survey. JAMA. 1991; 266: 369-374.
Friedman D, Wolf R, O’colman B. Prevalence of
open-angle glaucoma among adults in the United
States. Archives Ophthalmol. 2004; 122: 532.
Ashaye A, Ashaolu O, Komolafe O, Ajayi BGK,
Olawoye O, et al. Prevalence and types of
glaucoma among an indigenous African population
in southwestern Nigeria. Invest Ophthalmol Vis Sci.
; 54:7410–7416. DOI:10.1167/ iovs.13-12698
Rotchford AP, Johnson GJ. Glaucoma in Zulus: a
population-based cross-sectional survey in a rural
district in South Africa. Archives Ophthalmol.
; 120: 471-478.
Rudnicka AR, Mt-Isa S, Owen CG, Cook DG,
Ashby D. Variations in primary open-angle
glaucoma prevalence by age, gender, and race: a
Bayesian meta-analysis. Inves Ophthalmol Vis Sci.
; 47: 4254-4261.
Buhrmann RR, Quigley HA, Barron Y, West SK,
Oliva MS, Mmbaga BB. Prevalence of glaucoma in
a rural east African population. Invest Ophthalmol
Vis Sci. 2000; 41:40–48.
Quigley HA, Broman AT. The number of people
with glaucoma worldwide in 2010 and 2020. Br J
Ophthalmol. 2006; 90: 262-267.