Prevalence of Cataract Blindness in Rural Ethiopia
AbstractBackground: Over three-quarter of all blindness worldwide are preventable and usually caused by cataract and trachoma.
Objective: To assess the prevalence of cataract blindness in rural Ethiopia in order to facilitate further health care planning.
Methods: A Cross-sectional, community-based study of inhabitants over 40 years of age from villages in the Abeshge and Kebena Districts, south of Addis Ababa. A total of 1100 eligible participants were identified in the study. Visual acuity (VA) was measured using a Snellen’s E chart at 6 metres and eye examinations were performed using torch light, 2.5 X magnifying glasses and an ophthalmoscope. Cataract was defined as lens opacity identified as the cause of blindness and low vision after ruling out other causes. Unfortunately, there was no access to a refraction set and slit lamp to conduct thorough examinations.
Results: The adjusted prevalence of bilateral cataract blindness (VA<3/60) was 2.4%, 95% confidence interval [CI], 1.8%–3.0%. Cataract is the major cause of bilateral blindness (66.7%) among the participants. The cataract surgical coverage was 28.9% for men and 18.1% for women. The adjusted prevalence of bilateral cataract and VA<6/60 was 3.6% (95% CI, 1.4%–5.8%). In this last group, the surgical coverage was 41.2% (persons) and 38.5% (eyes). Of all operated eyes, 30% could not see at 6/60. Inability to afford the procedure (64.5%) and poor knowledge of cataract (29.8%) were the reasons why surgery had not been performed.
Conclusions: Cataract blindness is a major health problem in the study area with low surgical uptake. There is backlog of cataract blindness in the study area that will increase with ageing. This backlog was also reflected in other developing countries. Awareness campaigns, reducing cost, and expansion of surgical services may help to increase the cataract surgical rate, and women should be offered more cataract surgery. These results will enable health managers to plan effective interventions in line with Vision 2020. [Ethiop. J. Health Dev. 2011;25(2):156-160]