Changes in the prevalence and causes of vision impairment and coverage of services between 2008 and 2024 in Koulikoro, Mali: results from two cross-sectional studies.

BACKGROUND

While no national vision impairment (VI) data exist for Mali, population-based eye health surveys among people aged ≥50 y were conducted in several regions over the last two decades, including in the Koulikoro region in 2008. In 2024, a similar survey was repeated. This paper describes the changes in VI prevalence, causes and service coverage during the 16-y period.

METHODS

The standard Rapid Assessment of Avoidable Blindness methodology was used with two-stage sampling to select a representative sample of 2600 adults (aged ≥50 y) in 2008 and 2040 in 2024. Ophthalmologists conducted a rapid vision examination on participants, assessing their presenting and best corrected visual acuity (VA), cause of any VI and cataract surgical status. Data were analysed using Stata.

RESULTS

The age- and sex-adjusted prevalence of blindness decreased from 9.0% in 2008 to 4.4% in 2024, a -51.1% (p<0.001) decrease. Cataract surgical coverage at all levels of VA increased significantly from 2008 to 2024. The absolute increases were 29.3% (95% CI 26.5 to 32.1%; p<0.001), 28.5% (95% CI 25.6 to 31.4%; p<0.001) and 27.9% (95% CI 25.1 to 30.7%; p<0.001) for VA<3/60, VA<6/60 and VA<6/18, respectively.

CONCLUSION

The significant reduction in blindness and VI in Koulikoro from 2008 to 2024 was associated with improved cataract surgical services, which need to be further expanded.