Rapid Assessment of Cataract Blindness Among Ughelli Clan in an Urban/Rural District of Delta State, Nigeria

Background: A population based, rapid assessment for cataract blindness was conducted in Ughelli North local government area of DeltaState, an urban/rural area of Nigeria between June and July 2001 with the aim of establishing baseline data for developing cataract intervention services for the area. Method: A cluster random sampling method was used based on the guidelines for the Rapid Assessment for Cataract Surgery. A total of 8 clusters of 90 persons were randomly selected from the 8 communities that make up the Ughelli clan. Only people of 50 years and above who had been resident in the area for up to six months were included. A total of 684 persons were examined (91.2% coverage) using a designed survey form. The barriers to the uptake of cataract surgery were also identified during the survey. The WHO definitions of blindness and visual impairment according to visual acuity were used as criteria for classification of visual blindness and visual impairment. Results: The prevalence of bilateral cataract blindness (cataract causing visual acuity of less than 3/60 in the better eye) for people of 50 years and above was 4.1% (95% CI: 2.96 to 5.24%) with cataract accounting for 41.2% of all the blindness in this age group. Prevalence of cataract blindness was higher in females than in males (5.0% versus 3.6%) About 80% of the cataract blindness occurs in people of 70 years and above. The cataract surgical coverage for eyes was 4.5%; cataract surgical coverage for couching was 18.2%. The major barriers to the uptake of cataract surgical services were lack of awareness of eye care services in nearby district (71.0%), the imagined high cost of the services (17.9%) the perception of women that their health problems are not of immediate importance (7.1%). Conclusion:At the time of study about 2000 person required immediate cataract surgery in the area. With an estimated incidence of 400 new cases per year, there is a need to set up cataract surgical services in the Ughelli North local government area. Special attention should be given to reduction of cataract blindness in females.Introduction : Evaluation rapide, bas\ue9e sur une population de la c\ue9cit\ue9 provoqu\ue9e par une cataracte a \ue9t\ue9 effectu\ue9e dans l'administration locale du nord d'Ughelli de l'\uc9tat de Delta, une zone urbaine/rurale du Nig\ue9ria entre juin et juillet 2001 dans le but d'\ue9tablir des donn\ue9es de base pour le d\ue9veloppement du service d'intervention chirurgicale de la cataracte pour la r\ue9gion. M\ue9thode : Une m\ue9thode d'un groupe d'\ue9chantillonage au hasard a \ue9t\ue9 utilis\ue9e bas\ue9e sur des directives pour l'Evaluation Rapide pour l'intervention chirurgicale de la Cataracte. Un nombre total de 8 groupes compos\ue9s de 90 personnes ont \ue9t\ue9 s\ue9lectionn\ue9s au hasard parmi les 8 communaut\ue9s dont le clan d'Ughelli est compos\ue9. Un nombre total de 684 personnes ont \ue9t\ue9 examin\ue9es soit 91,2% traitement \ue0 travers l'utilisation d'un formulaire con\ue7u pour faire un sondage. R\ue9sultats : La fr\ue9quence de la c\ue9cit\ue9 de la cataracte bilat\ue9rale (la cataracte qui provoque une acuit\ue9 visuelle de moins de 3/60 dans le meilleur oeil) pour des peuples de 50 ans et plus \ue9tait 4,1% soit 95% CL : 2,96 au 5,24%) dont la cataracte constitue 41,2% de toute les c\ue9cit\ue9s dans cette tranche d'\ue2ge. La fr\ue9quence de la c\ue9cit\ue9 de la cataracte \ue9tait \ue9lev\ue9e chez le sexe f\ue9minin plus que chez le sexe masculin (5,0% contre 3,6%) Environ 80% de la c\ue9cit\ue9 de la cataracte arrivent chez des gens \ue2g\ue9s de 70 ans et plus. Les traitements \ue0 travers l'intervention chirurgicale de la cataracte pour des yeux \ue9tait 4,5%. Les traitements pour l'intervention chirurgicale pour le couching contitue 18,2%. Les barri\ue8res principales contre les services d'intervention chirurgicale de la cataracte \ue9taient manque de l'opinion publique sur la conscience de services de soins des yeux dans la r\ue9gion d'\ue0 c\uf4t\ue9 (71,0%), le soi-disant services \ue0 grands frais, (17,9%), la conception des femmes que les probl\ue8mes r\ue9latifs \ue0 leurs sant\ue9 n'est pas d'urgence (7,1%). Conclusion : Pendant cette \ue9tude, environ 2000 personnes avaient besoin de l'intervention chirurgicale de la cataracte d'urgence dans cette r\ue9gion. Avec une fr\ue9quence d'environ 400 nouveaux cas chaque ann\ue9e, c'est n\ue9cessaire de cr\ue9er un service d'Intervention Chirurgicale de la Cataracte dans l'administration locale du nord d'Ughelli. Une attention particuli\ue8re devrait \ueatre port\ue9e sur la reduction de la c\ue9cit\ue9 de la cataracte chez des femmes

Blindness and low vision in adults in Ozoro, a rural community in Delta State, Nigeria

No Abstract. Nigerian Journal of Medicine Vol. 14(4) December 2005: 390-39

Rapid assessment of cataract blindness among ughelli clan in an urban/rural district of Delta state, Nigeria

Background: A population based, rapid assessment for cataract blindness was conducted in Ughelli North local government area of DeltaState, an urban/rural area of Nigeria between June and July 2001 with the aim of establishing baseline data for developing cataract intervention services for the area. Method: A cluster random sampling method was used based on the guidelines for the Rapid Assessment for Cataract Surgery. A total of 8 clusters of 90 persons were randomly selected from the 8 communities that make up the Ughelli clan. Only people of 50 years and above who had been resident in the area for up to six months were included. A total of 684 persons were examined (91.2% coverage) using a designed survey form. The barriers to the uptake of cataract surgery were also identified during the survey. The WHO definitions of blindness and visual impairment according to visual acuity were used as criteria for classification of visual blindness and visual impairment. Results: The prevalence of bilateral cataract blindness (cataract causing visual acuity of less than 3/60 in the better eye) for people of 50 years and above was 4.1% (95% CI: 2.96 to 5.24%) with cataract accounting for 41.2% of all the blindness in this age group. Prevalence of cataract blindness was higher in females than in males (5.0% versus 3.6%) About 80% of the cataract blindness occurs in people of 70 years and above. The cataract surgical coverage for eyes was 4.5%; cataract surgical coverage for couching was 18.2%. The major barriers to the uptake of cataract surgical services were lack of awareness of eye care services in nearby district (71.0%), the imagined high cost of the services (17.9%) the perception of women that their health problems are not of immediate importance (7.1%). Conclusion:At the time of study about 2000 person required immediate cataract surgery in the area. With an estimated incidence of 400 new cases per year, there is a need to set up cataract surgical services in the Ughelli North local government area. Special attention should be given to reduction of cataract blindness in females

The Nigerian national blindness and visual impairment survey: Rationale, objectives and detailed methodology.

BACKGROUND: Despite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken to estimate the prevalence and determine the major causes of blindness and low vision. This paper presents the detailed methodology used during the survey. METHODS: A nationally representative sample of persons aged 40 years and above was selected. Children aged 10-15 years and individuals aged <10 or 16-39 years with visual impairment were also included if they lived in households with an eligible adult. All participants had their height, weight, and blood pressure measured followed by assessment of presenting visual acuity, refractokeratomery, A-scan ultrasonography, visual fields and best corrected visual acuity. Anterior and posterior segments of each eye were examined with a torch and direct ophthalmoscope. Participants with visual acuity of < = 6/12 in one or both eyes underwent detailed examination including applanation tonometry, dilated slit lamp biomicroscopy, lens grading and fundus photography. All those who had undergone cataract surgery were refracted and best corrected vision recorded. Causes of visual impairment by eye and for the individual were determined using a clinical algorithm recommended by the World Health Organization. In addition, 1 in 7 adults also underwent a complete work up as described for those with vision < = 6/12 for constructing a normative data base for Nigerians. DISCUSSION: The field work for the study was completed in 30 months over the period 2005-2007 and covered 305 clusters across the entire country. Concurrently persons 40+ years were examined to form a normative data base. Analysis of the data is currently underway. CONCLUSION: The methodology used was robust and adequate to provide estimates on the prevalence and causes of blindness in Nigeria. The survey would also provide information on barriers to accessing services, quality of life of visually impaired individuals and also provide normative data for Nigerian eyes