Abstract:
Purpose
To determine the prevalence and causes of blindness and visual impairment among adults
in Kogi, Nigeria.
Methods
A Rapid assessment of avoidable blindness (RAAB) protocol was used with additional tools
measuring disability and household wealth to measure the prevalence of blindness and
visual impairment (VI) and associations with sex, disability, wealth, cataract surgical coverage
and its effectiveness.
Results
Age- and sex-adjusted all-cause prevalence of bilateral blindness was 3.6% (95%CI 3.0–
4.2%), prevalence of blindness among people living with additional, non-visual disabilities
was 38.3% (95% CI 29.0–48.6%) compared to 1.6% (95%CI 1.2–2.1%; w2 = 771.9,
p<0.001) among people without additional disabilities. Cataract was the principal cause
of bilateral blindness (55.3%). Cataract surgical coverage (CSC) at visual acuity (VA) 3/
60 was 48.0%, higher among men than women (53.7% vs 40.3%); 12.0% among people
with non-visual disabilities; 66.9% among people without non-visual disabilities, being
higher among people in the wealthiest two quintiles (41.1%) compared to the lowest three
(24.3%). Effective Cataract Surgical Coverage at Visual Acuity 6/60 was 31.0%, higher
among males (34.9%) than females (25.5%), low among people with additional, nonvisual
disabilities (1.9%) compared to people with no additional disabilities (46.2%).
Effective CDC was higher among people in the wealthiest two quintiles (411%) compared
to the poorest three (24.3%). Good surgical outcome (VA>6/18) was seen in 61 eyes(52.6%) increasing to 71 (61.2%) eyes with best correction. Cost was identified as the
main barrier to surgery.
Conclusion
Findings suggest there exists inequalities in eye care with women, poorer people and people
with disabilities having a lower Cataract Surgical Coverage, thereby, underscoring the
importance of eye care programs to address these inequalities
