Medico-social aspects of the main diseases causing blindness in West Africa

4f A\rPAII Doc. 79/s WOAID }LIAITI{ OIiGAJI]ZATIOiI Onchocerciasis Coi,tro1 Pro3i.rrrromc ir: tiie t/olta liiver n;rsin lirea llpiderniologica1 .uVafuation Unit \Iiorlcing Document OCP / EPV 79/ 48 DR A. ]iOII,A}IDI I'IIIDICO-SOCIAI ASP,ICTS OI TIIII 1[A]l[ DISJAS]S Cl,UStr[G BI]}ID]VJJSS IN IVJJSI AT'RICA Ouagadougou, October 1979 xophthalmologist ? IYI-IO Consultant ) JTo establ-ish zi long-tern programme for sociai relntegration of the bl-ind on a national scale ccrtain iledical ciata are incli-spensable: The basic elcrncnt is obviously thc est:-:lablon or'the total number of blind. Brea.lrclown of the cases of lt'lindness accorirrng to'blle age of appearance, sex, er:.virorurient and causes iirust also be tvel-l imovvn. In fact: - -bhe metirocls anc.l tirc costs of social reintegration of tire blind may be very d.iffercnt a"ccordlng to whether thc ss;\jects live in.:n'"u'bln or c razal enviroru*oent, thc latter t:eing often ritore i]olrogeneous anci wclconing. - capacities for adaptation also vary vrid.ely ]:etween y'ounger people for whom they are consid.eriLble arrd ol-der neople; - the medico-social importamce of the main diseases causing blinclness can change vrith time in conjunction with progranmes foi' prevention aJrd care" Thus, we c.ln already state th.rt at present nevr cases of blindness from onchocerciasi-s are very rare in tire area covered by tire Onchocerciasis Control Progranme in the i/ol-ta River Basin area. fhis will certainJ-y Iig]rten the overall- load of blindness ti:rougirout the country. . The main benefits will be realized in the areas bord,ering the rlvers, vuhere the insect vectors of the diseases were uost coilrmon, by the group of mal-e vsorkers rnost affected by tiris infection. Oir the other hancl , tLris Prografiune will- not influcricc nevr clrsesblindness in the urban envirorurrent where onctlocerciasls, in general , not sevr:re. of !D /il-so, the importa"nce of trachoma coul-d dimini-sh lvith general econoi:ric ancl socj-aI developl'rent and v,rith the establ-ishmen-b of a i:red-ical control prOgra.ume. This innrovemerrt vlill cot cern, above all , vloinen, v'rho are moreheavily affected. tha"n nen, the nain reservoi.r of the virus belng infants and young childrcn ',dro are in close contact lvith their motirer. On the other Lrand, the general devel_opnent of a. corni:unity, by increasing the life expectancy of adL,;fts, rvi-ll tend to incrcase the number of cases of blindness froro ci:.taracts, glaucoma, c.rrclio-ve.scu.lar cLiseascs and diabetes. lkrese clisorclers affect nainly older person$. Their treatmentis possible but their prever:.tion is irnpossible or very difficul-t" -2 - iiloreovc;r',,nresstirere cxist p--:cise regulatlons, incrustrlar_d'evelopncnt can increase cases of l:linilness r6sutti-ng f:.o:u traulratismand polsonfurg in ilre urban envirorx*ir.ert. ft was .brror-i6^b usefultherefore, to si.immavize i:nd to vlsuallze these f.rcts in tlro tableswhickr shoyr: - rletiiods of prevention ancl of treatrnent of i;iie principal causesof bl-indness 1n \iest .A.frica; - breakdot.rn of these cases accordln3,'to ctiuse, age and envirol:rent. ;,(_t cr F]O ti Ba 5 a O l]-iH fA flg O O O O O OH Et Ha tfB + + + O E{ Ec ts F A rcH 7a Ff # l=.1 & +OO O+ + >i E F{zH o)H F,i(} H e7 fl 2oia trL-itr El 42 t-l -,.' 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