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FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

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 ABSTRACT

To achieve the state of complete physical, mental and social well-being of the population there is need to create awareness and stimulate actions from the community to achieve health. However, there seems to be no relationship between health practices and the information available on people’s health in Anambra State.

The central issue of this study is to identify the factors responsible for the spread of glaucoma in Anambra State by studying the records of adult patients in the three general hospitals in Anambra State with functional eye clinics for the period between 2002 and 2006 with appropriate research questions and hypothesis formulated to obtain data for the solution. The literature on past studies on the factors influencing the incidence of glaucoma and its management in Nigeria is reviewed. The Social Learning Theory and the Health Belief Model (HBM) are used as the theoretical framework.

The study is designed as both a descriptive and a Cohort Survey seeking to describe the distribution and incidence of glaucoma within Anambra state of persons who experienced the same life event within 2017 to 2021. The random sampling technique was used with the multi-stage   sampling procedure and the use of tables and percentages in  data  presentation. The increase   in health education and eye examination centers are recommended   and the level of awareness of the glaucoma disease and its control is recommended for more intense studies.

CHAPTER ONE

INTRODUCTION

1.1  Background to the Study

Millions of people living in Nigeria are cut off from the mainstream of economic and social development due to heavy burden of diseases.  Among these diseases is glaucoma which is the result of too much pressure in the eye. It is usually believed to begin after the age of 40 (forty) years and is a common cause of blindness (Mohammed, 2001).

Responsibility for health care in Nigeria is shared among the constitutional tiers of government: federal, state and local. The local governments are supposed to take care of the primary level (emphasizing preventive Medicare), while state governments are responsible for the secondary level (emphasizing curative Medicare), and the federal government is in charge of the tertiary level of care (emphasizing referral Medicare) to which teaching and specialist hospitals belong. This implies that there are basically three health care levels in Nigeria: primary, secondary and tertiary health care levels. (Anyanwu, Oyefusi, Oaikhegn,  & Dimowo 1997:608).

In Nigeria, glaucoma constitutes a medical, public health and socio- economic problem. This is because Nigeria is found to be one of the most endemic countries in the world, accounting for a sizeable proportion of the global cases, with about 6.7 million patients with glaucoma worldwide (WHO, 1992). The damaging and insidious nature of glaucoma make it spread gradually without being noticed but causes serious harm.

The Basic Health Service (BHS) scheme formed an important health programme of the Third Development Plan (1975-1980) and Fourth Development Plan (1981-1985) of the Federal Government. Under the BHS the government intended to significantly improve the modern health care system of the country within the framework of a three-tier national comprehensive health care delivery system mentioned earlier. Record achievement from the implementation of the BHS shows increases in personnel and institutions. For example, the number of registered medical practitioners in Nigeria rose from 10,399 in 1981 to 16,145 in 1987 (Mbanefo, Soyibo & Anyanwu) 1996.

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However, the unsuccessful implementation of the BHS programme made the federal government to embark on a new direction health care delivery which makes Primary Health Care (PHC) the focus. There was need for close involvement of the local governments, local communities, and individuals in the implementation of the PHC in collaboration with the other two tiers of government. Activities that formed part of the PHC include: National Programme on Immunization (NPI), Campaign against River blindness, Oral Rehydration Therapy (ORT), among others (FMH, 1988).

FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

The incidence of glaucoma among adult patients refers to the rate of occurrence of this disease. In epidemiology the interest is in the number of new cases arising in a given period of time in a specified group of people. The American Academy of ophthalmology (1983) notes that an estimated 2 million people have been identified as having glaucoma. Of these 889,000 are visually impaired, 67,150 are legally blind and each year an additional 5,500 people become blind from glaucoma. Equally, in 1997 glaucoma caused 36,000 hospital admission in America, 25 million office visits and more than $440 million spent on direct health cost on glaucoma.

It is from the implication of the data as given above and the fact that glaucoma is one of the avoidable causes of blindness that the need to maintain adequate and effective health care delivery system becomes imperative. Therefore this study examines the factors responsible for the occurrence of glaucoma among adult patients in Anambra state (2002- 2006).

1.2  Statement of the Problem

For Nigeria to achieve the state of complete physical, mental and social well-being of the population there is need to create awareness and stimulate actions from the community to achieve health. This can be accomplished through an effective health education which according to Onukwubiri (1994), bridges the gap between health information and health practices. It is any combination of methods designed to facilitate voluntary change of behaviours of individuals or groups to promote health.

In Anambra state there seems to be no relationship between health practices and the information available on people’s health. The researcher observed during her clinical posting to Eye clinic at the General Hospital Enugwu-ukwu that most adult glaucoma patients reported to the clinic when their eye conditions had deteriorated. Furthermore, the adults suffering from the disease are not aware of the disease occurrence.

The central focus of this study therefore borders on identifying the factors responsible for the spread of glaucoma in Anambra State. In other words what are those constraints to effective primary health care delivery and health education in the state. This is done by studying the records of adult patients in the three General Hospitals in Anambra State with functional eye clinics for the period between 2017 to 2021.

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1.3 Objective of the Study

The broad purpose of the study is to examine the factors influencing the incidence of glaucoma among adult patients (in general hospitals) in Anambra state (2002 – 2006) and to highlight the problems resulting from lack of information on factors influencing the incidence of glaucoma. The specific objectives of the study include:

(i)  To determine the incidence of glaucoma among adult patients in Anambra state between 2017 to 2021.

  1. To verify the incidence of glaucoma in relation to family history in Anambra state between 2017 to 2021.
  2. To identify the incidence of glaucoma in relation to gender in Anambra state between 2002 to2006.
  3. To identify other factors influencing the incidence of glaucoma in adult patients in Anambra state from 2017 to 2021.
  4. To ascertain the number of people affected by glaucoma in relation to age from 2017 to 2021.
  5. To determine the relation between health information and incidence of glaucoma in Anambra State, and
  6. To examine the level of awareness of the glaucoma in Anambra state.

1.4  Significance of the Study

The result of the study will be of immense benefit to health institutions, community members, researchers and government. The study on the factors influencing the incidence of glaucoma will give a preview of the level of incidence for intervention strategic planning.

Furthermore, this research will help to create awareness of the disease to the community members, as well as serve as related literature to other researchers by providing a fore-knowledge of what is obtainable and available on the ground as it concerns the area of study.

1.5  Scope of Study

The study is a determination of the factors influencing the incidence of glaucoma in adult patients in Anambra state between 2002 and 2006. This means that only available data on adult patients who visited the General Hospital in Awka, Enugwu-ukwu and Onitsha are used for the study. Another delimitation is that adults between the ages of  40  years  and above is mostly on open angle glaucoma.

1.6  Research Questions

  1. What is the incidence of glaucoma among adult patients in Anambra state between 2017 to 2021?
  2. What is the incidence of glaucoma in relation to family history in Anambra state from 2017 to 2021?
  3. What is the incidence of glaucoma in relation to gender in Anambra state from 2017 to 2021?
  4. What other factors influence the incidence of glaucoma in adult patients in Anambra state from 2017 to 2021?
  5. What is the number of people affected by glaucoma in relation  to age from 2017 to 2021?
  6. How does health information effect the incidence of glaucoma in Anambra state?
  7. What is the level of awareness of glaucoma in Anambra state?

1.7  Hypotheses of the Study

Ho1: There is no significant relationship between the incidences of glaucoma disease among different age groups of the study from 2017 to 2021.

Ho2: There is no significant difference in the incidence of glaucoma between males and females of the study group from 2017 to 2021.

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Ho3: There is no significant difference in the incidence of glaucoma and hereditary among the study group from 2017 to 2021.

Ho4: There is no significant relationship between health information and the incidence of glaucoma in Anambra state.

1.8 Limitation of the Study

A major constraint during the study is the attitude of the hospital personnel in releasing the records and files for investigation.

1.9  Definition of Terms

Glaucoma: Glaucoma is a condition that damages your eye optic nerve. It gets worse overtime. It’s often linked to a buildup of pressure inside the eye. Glaucoma tends to run in families, you usually don’t get it until later in life.

Optic Neuropathy: Is a damage to the optic nerve from any cause. Damage and death of these nerve cells, or the neurons, leads to characteristic features of optic neuropathy. The main symptom is loss of vision, with colours appearing subtly washed out in the affected eye.

Ocular: the word ocular is a medical meaning “of the eye”. An ocular nerve connects to the eye, and an ocular exam you’ll have your vision tested or your eyes examined. If you get ocular damage from a stray baseball, you’ve got a hurt eyeball. Ocular comes from a latin root, oculus, “an eye”.

Retina: The Retina is a thin layer of tissue that lines the back of the eye on the inside. It is located near the optic nerve. The purpose of the retina is to receive light that the lens has focused, convert the light into neural signals, and send these signals onto the brain for visual recognition.

Choroid: The choroid also known as the choroidea or choroid coat, is the vascular layer of the eye, containing connective tissues, and lying between the retina and the sclera. The human choroid is the thickest at the far extreme rear of the eye (at 0.2mm), while in the outlying areas if narrows to 0.1m.

Cornea: The cornea is the transparent part of the eye that covers the front portion of the eye.

Iris: In humans and most mammals and birds, the iris is a thin annular structure in the eye, responsible for controlling the diameter and size of the pupil and thus the amount of light reaching the retina.

Blood Vessels: Blood vessels flow blood throughout the body, Arteries transport blood away from the heart.

Ciliary Body: The ciliary body is a part of the eye that includes the ciliary muscle, which controls the shape of the lens, and the ciliary epithelium.

Pupil: Pupil in the anatomy of the eye, the opening with the iris through which light passes before reaching the lens and being focused onto the retina.

FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

FACTORS INFLUENCING THE INCIDENCE OF GLAUCOMA AMONG ADULT PATIENTS FROM 2017 TO 2021

Mr. Harrison

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