title: The Sokoto blind beggars: causes of blindness and barriers to rehabilitation services.
abstract: OBJECTIVE
  To determine the causes of blindness and the barriers to accessing rehabilitation services (RS) among blind street beggars (bsb) in Sokoto, Nigeria.
  
  
  METHODS
  A cross-sectional survey of 202 bsb (VA < 3/60) using interviewer administered questionnaire. The causes of blindness were diagnosed by clinical ophthalmic examination.
  
  
  RESULTS
  There were 107 (53%) males and 95 (47%) females with a mean age of 49 years (SD 12.2). Most bsb 191 (94.6%) had non-formal education. Of 190 (94.1%) irreversibly bsb, 180/190 (94.7%) had no light perception (NPL) bilaterally. The major causes of blindness were non-trachomatous corneal opacity (60.8%) and trachoma corneal opacity (12.8%). There were 166 (82%) blind from avoidable causes and 190 (94.1%) were irreversibly blind with 76.1% due to avoidable causes. The available sub-standard RS were educational, vocational and financial support. The barriers to RS in the past included non-availability 151 (87.8%), inability to afford 2 (1.2%), unfelt need 4 (2.3%), family refusal 1 (0.6), ignorance 6 (3.5%) and being not linked 8 (4.7%). The barriers to RS during the study period included inability of 72 subjects (35.6%) to access RS and 59 (81.9%) were due to lack of linkage to the existing services.
  
  
  CONCLUSIONS
  Corneal opacification was the major cause of blindness among bsb. The main challenges to RS include the inadequate services available, societal and users factors. Renewed efforts are warranted toward the prevention of avoidable causes of blindness especially corneal opacities. The quality of life of the blind street beggar should be improved through available, accessible and affordable well-maintained and sustained rehabilitation services.
authors.affiliation: Department of Ophthalmology, Federal Medical Centre, Birnin-kebbi, Nigeria.
authors.forename: Aliyu Hamza
authors.initials: AH
authors.lastname: Balarabe
authors.affiliation: Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Abdulraheem O
authors.initials: AO
authors.lastname: Mahmoud
authors.affiliation: Department of Ophthalmology, University of Abuja, Abuja, Nigeria.
authors.forename: Abdulkabir Ayansiji
authors.initials: AA
authors.lastname: Ayanniyi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000453:epidemiology* / Q000534:rehabilitation*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D012046:Rehabilitation; D019987:Persons with Visual Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Blind Street Beggars; Corneal Opacity; Irreversible Blindness; Nigeria; Quality of Life; Rehabilitation Services; Sokoto