Prevalence and causes of blindness and visual impairment in Kogi state, Nigeria–Findings from a Rapid assessment of avoidable blindness survey

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