Coverage of hospital-based cataract surgery and barriers to the uptake of surgery among cataract blind persons in Nigeria

the Nigeria National Blindness and Visual Impairment Survey

The Nigeria National Blindness and Visual Impairment Study Group

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To determine cataract surgical coverage, and barriers to modern cataract surgery in Nigeria.

Methods: Multistage stratified cluster random sampling was used to identify a nationally representative sample of 15,027 persons aged 40+ years. All underwent visual acuity testing, frequency doubling technology visual field testing, autorefraction, and measurement of best corrected vision if <6/12 in one or both eyes. An ophthalmologist examined the anterior segment and fundus through an undilated pupil for all participants. Participants were examined by a second ophthalmologist using a slit lamp and dilated fundus examination using a 90 diopter condensing lens if vision was <6/12 in one or both eyes, there were optic disc changes suggestive of glaucoma, and 1 in 7 participants regardless of findings. All those who had undergone cataract surgery were asked where and when this had taken place. Individuals who were severely visually impaired or blind from unoperated cataract were asked to explain why they had not undergone surgery.

Results: A total of 13,591 participants were examined (response rate 89.9%). Prevalence of cataract surgery was 1.6% (95% confidence interval 1.4–1.8), significantly higher among those aged ≥70 years. Cataract surgical coverage (persons) in Nigeria was 38.3%. Coverage was 1.7 times higher among males than females. Coverage was only 9.1% among women in the South-South geopolitical zone. Over one third of those who were cataract blind said they could not afford surgery (36%).

Conclusions: Cataract surgical coverage in Nigeria was among the lowest in the world. Urgent initiatives are necessary to improve surgical output and access to surgery.
Original languageEnglish
Pages (from-to)58-66
Number of pages9
JournalOphthalmic Epidemiology
Volume19
Issue number2
DOIs
Publication statusPublished - Apr 2012

Fingerprint

Visually Impaired Persons
Vision Disorders
Blindness
Nigeria
Cataract
Surveys and Questionnaires
Optic Disk
Pupil
Visual Fields
Glaucoma
Lenses
Visual Acuity
Confidence Intervals
Technology

Keywords

  • adult
  • aged
  • blindness
  • cataract
  • cataract extraction
  • cross-sectional studies
  • female
  • health services accessibility
  • health surveys
  • humans
  • male
  • middle aged
  • Nigeria
  • prevalence
  • rural population
  • urban population
  • visual acuity
  • visual fields
  • visually impaired persons

Cite this

Coverage of hospital-based cataract surgery and barriers to the uptake of surgery among cataract blind persons in Nigeria : the Nigeria National Blindness and Visual Impairment Survey. / The Nigeria National Blindness and Visual Impairment Study Group.

In: Ophthalmic Epidemiology, Vol. 19, No. 2, 04.2012, p. 58-66.

Research output: Contribution to journalArticle

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title = "Coverage of hospital-based cataract surgery and barriers to the uptake of surgery among cataract blind persons in Nigeria: the Nigeria National Blindness and Visual Impairment Survey",
abstract = "Purpose: To determine cataract surgical coverage, and barriers to modern cataract surgery in Nigeria.Methods: Multistage stratified cluster random sampling was used to identify a nationally representative sample of 15,027 persons aged 40+ years. All underwent visual acuity testing, frequency doubling technology visual field testing, autorefraction, and measurement of best corrected vision if <6/12 in one or both eyes. An ophthalmologist examined the anterior segment and fundus through an undilated pupil for all participants. Participants were examined by a second ophthalmologist using a slit lamp and dilated fundus examination using a 90 diopter condensing lens if vision was <6/12 in one or both eyes, there were optic disc changes suggestive of glaucoma, and 1 in 7 participants regardless of findings. All those who had undergone cataract surgery were asked where and when this had taken place. Individuals who were severely visually impaired or blind from unoperated cataract were asked to explain why they had not undergone surgery.Results: A total of 13,591 participants were examined (response rate 89.9{\%}). Prevalence of cataract surgery was 1.6{\%} (95{\%} confidence interval 1.4–1.8), significantly higher among those aged ≥70 years. Cataract surgical coverage (persons) in Nigeria was 38.3{\%}. Coverage was 1.7 times higher among males than females. Coverage was only 9.1{\%} among women in the South-South geopolitical zone. Over one third of those who were cataract blind said they could not afford surgery (36{\%}).Conclusions: Cataract surgical coverage in Nigeria was among the lowest in the world. Urgent initiatives are necessary to improve surgical output and access to surgery.",
keywords = "adult, aged, blindness, cataract, cataract extraction, cross-sectional studies, female, health services accessibility, health surveys, humans, male, middle aged, Nigeria, prevalence, rural population, urban population, visual acuity, visual fields, visually impaired persons",
author = "Tafida Abubakar and Gudlavalleti, {Murthy V S} and Selvaraj Sivasubramaniam and Gilbert, {Clare E} and Abdull, {Mohammed M} and Imam, {Abdullahi U} and {The Nigeria National Blindness and Visual Impairment Study Group}",
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T1 - Coverage of hospital-based cataract surgery and barriers to the uptake of surgery among cataract blind persons in Nigeria

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AU - Abubakar, Tafida

AU - Gudlavalleti, Murthy V S

AU - Sivasubramaniam, Selvaraj

AU - Gilbert, Clare E

AU - Abdull, Mohammed M

AU - Imam, Abdullahi U

AU - The Nigeria National Blindness and Visual Impairment Study Group

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N2 - Purpose: To determine cataract surgical coverage, and barriers to modern cataract surgery in Nigeria.Methods: Multistage stratified cluster random sampling was used to identify a nationally representative sample of 15,027 persons aged 40+ years. All underwent visual acuity testing, frequency doubling technology visual field testing, autorefraction, and measurement of best corrected vision if <6/12 in one or both eyes. An ophthalmologist examined the anterior segment and fundus through an undilated pupil for all participants. Participants were examined by a second ophthalmologist using a slit lamp and dilated fundus examination using a 90 diopter condensing lens if vision was <6/12 in one or both eyes, there were optic disc changes suggestive of glaucoma, and 1 in 7 participants regardless of findings. All those who had undergone cataract surgery were asked where and when this had taken place. Individuals who were severely visually impaired or blind from unoperated cataract were asked to explain why they had not undergone surgery.Results: A total of 13,591 participants were examined (response rate 89.9%). Prevalence of cataract surgery was 1.6% (95% confidence interval 1.4–1.8), significantly higher among those aged ≥70 years. Cataract surgical coverage (persons) in Nigeria was 38.3%. Coverage was 1.7 times higher among males than females. Coverage was only 9.1% among women in the South-South geopolitical zone. Over one third of those who were cataract blind said they could not afford surgery (36%).Conclusions: Cataract surgical coverage in Nigeria was among the lowest in the world. Urgent initiatives are necessary to improve surgical output and access to surgery.

AB - Purpose: To determine cataract surgical coverage, and barriers to modern cataract surgery in Nigeria.Methods: Multistage stratified cluster random sampling was used to identify a nationally representative sample of 15,027 persons aged 40+ years. All underwent visual acuity testing, frequency doubling technology visual field testing, autorefraction, and measurement of best corrected vision if <6/12 in one or both eyes. An ophthalmologist examined the anterior segment and fundus through an undilated pupil for all participants. Participants were examined by a second ophthalmologist using a slit lamp and dilated fundus examination using a 90 diopter condensing lens if vision was <6/12 in one or both eyes, there were optic disc changes suggestive of glaucoma, and 1 in 7 participants regardless of findings. All those who had undergone cataract surgery were asked where and when this had taken place. Individuals who were severely visually impaired or blind from unoperated cataract were asked to explain why they had not undergone surgery.Results: A total of 13,591 participants were examined (response rate 89.9%). Prevalence of cataract surgery was 1.6% (95% confidence interval 1.4–1.8), significantly higher among those aged ≥70 years. Cataract surgical coverage (persons) in Nigeria was 38.3%. Coverage was 1.7 times higher among males than females. Coverage was only 9.1% among women in the South-South geopolitical zone. Over one third of those who were cataract blind said they could not afford surgery (36%).Conclusions: Cataract surgical coverage in Nigeria was among the lowest in the world. Urgent initiatives are necessary to improve surgical output and access to surgery.

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KW - blindness

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KW - cataract extraction

KW - cross-sectional studies

KW - female

KW - health services accessibility

KW - health surveys

KW - humans

KW - male

KW - middle aged

KW - Nigeria

KW - prevalence

KW - rural population

KW - urban population

KW - visual acuity

KW - visual fields

KW - visually impaired persons

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DO - 10.3109/09286586.2011.643271

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EP - 66

JO - Ophthalmic Epidemiology

JF - Ophthalmic Epidemiology

SN - 0928-6586

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ER -