biostudies-literatureJolley ESightsavers and CBMForeign, Commonwealth & Development OfficeIrish Aidi30-i41https://www.ebi.ac.uk/biostudies/studies/S-EPMC12709043biostudies-literatureUnknown17(Supplement_1)<h4>Background</h4>Individuals who do not perceive they have a health problem will not seek care, risking a deterioration of health status. We sought to understand how visually impaired individuals aged ≥50 y from 12 studies across sub-Saharan Africa self-reported their difficulties seeing, and to identify the factors associated with under-reporting.<h4>Methods</h4>We used R software to assess overall agreement between self-report and clinical assessment with a weighted kappa, and described the proportion of individuals accurately reporting, over-reporting and under-reporting their difficulties seeing. We used logistic regression to explore factors associated with under-reporting.<h4>Results</h4>In total, 5777/32 548 participants had moderate vision impairment (VI) or worse. Overall, agreeInternational healthUnder-reporting difficulties in seeing among older people with clinically assessed vision impairment: an exploration of 12 surveys from sub-Saharan Africa.PMC12709043205210-265821910-2017Owoeye JKerkula JMustapha JKashadakawo MRamyil AJolley EBechange SSchmidt ETraore LPye SBoniface JJeyam ABadiane MMdala SfalseUnder-reporting difficulties in seeing among older people with clinically assessed vision impairment: an exploration of 12 surveys from sub-Saharan Africa.<h4>Background</h4>Individuals who do not perceive they have a health problem will not seek care, risking a deterioration of health status. We sought to understand how visually impaired individuals aged ≥50 y from 12 studies across sub-Saharan Africa self-reported their difficulties seeing, and to identify the factors associated with under-reporting.<h4>Methods</h4>We used R software to assess overall agreement between self-report and clinical assessment with a weighted kappa, and described the proportion of individuals accurately reporting, over-reporting and under-reporting their difficulties seeing. We used logistic regression to explore factors associated with under-reporting.<h4>Results</h4>In total, 5777/32 548 participants had moderate vision impairment (VI) or worse. Overall, agree2025-01-01T00:00:00Z2025 Dec2026-06-07T05:07:19.957Z2026-06-07T03:07:10.903ZS-EPMC127090434140316810.1093/inthealth/ihaf095