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Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda

Background: The Rapid Assessment of Avoidable Blindness (RAAB) survey methodology is a cost-effective tool for assessing the burden of blindness and cataract surgical services in a population. This study analyses the 2015 Rwanda National RAAB data to ascertain whether there are gender differences in...

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Main Author: Owusu, Kyei Michael
Other Authors: Mathenge, Wanjiku
Format: Thesis
Language:English
Published: Division of General Surgery 2020
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access_status_str Open Access
author Owusu, Kyei Michael
author2 Mathenge, Wanjiku
author_browse Mathenge, Wanjiku
Owusu, Kyei Michael
author_facet Mathenge, Wanjiku
Owusu, Kyei Michael
author_sort Owusu, Kyei Michael
collection Thesis
description Background: The Rapid Assessment of Avoidable Blindness (RAAB) survey methodology is a cost-effective tool for assessing the burden of blindness and cataract surgical services in a population. This study analyses the 2015 Rwanda National RAAB data to ascertain whether there are gender differences in access to cataract surgical services and also assess whether there is an association between measured distances travelled to access cataract surgical services and the cataract surgical coverage (CSC) in the country. Methods: Secondary data non automated analysis was performed on the 2015 Rwanda RAAB data, which had a sample of 5,275 persons who underwent ophthalmic examinations as per RAAB protocols to elicit the prevalence and causes of blindness and answered a standard questionnaire on barriers to cataract surgery. Cataract blindness prevalence and cataract surgical coverage were estimated for males and females and assessed for significant differences. Distances from clustered patients' locations to the nearest eye surgical facility ere calculated using Google Maps and analyses performed to identify if a relationship exists between distances travelled and the CSC for the area. Results: The prevalence of bilateral cataract blindness for males was 0.4% (n=8; 95% CI=0.1-0.7) and females 0.5% (n=17; 95% CI=0.3-0.8) and the CSC for males and females were 69.2% and 68.5% respectively. The difference in CSC was not statistically significant. Females aged ≥70 years reported more barriers to cataract surgical services compared to men. At a VA <3/60 in the better eye, 1km increase in the distance to the nearest eye surgicalcentre was associated with a reduction in the CSC for the area of 4.8% (Linear regression: F (1,95) = 16.06, p = 0.0001, R-Squared = 0.1446, Adjusted R-Squared = 0.1356). Conclusions: Older women (≥70 years) were the most vulnerable to untreated cataract blindness in Rwanda and therefore special programs need to target them for cataract surgical services. Distance to surgical facilities with ophthalmologists is related to the cataract surgical coverage even in a small country like Rwanda.
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institution University of Cape Town (South Africa)
language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2020
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spelling oai:open.uct.ac.za:11427/32320 Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda Owusu, Kyei Michael Mathenge, Wanjiku Geneau, Robert general surgery Background: The Rapid Assessment of Avoidable Blindness (RAAB) survey methodology is a cost-effective tool for assessing the burden of blindness and cataract surgical services in a population. This study analyses the 2015 Rwanda National RAAB data to ascertain whether there are gender differences in access to cataract surgical services and also assess whether there is an association between measured distances travelled to access cataract surgical services and the cataract surgical coverage (CSC) in the country. Methods: Secondary data non automated analysis was performed on the 2015 Rwanda RAAB data, which had a sample of 5,275 persons who underwent ophthalmic examinations as per RAAB protocols to elicit the prevalence and causes of blindness and answered a standard questionnaire on barriers to cataract surgery. Cataract blindness prevalence and cataract surgical coverage were estimated for males and females and assessed for significant differences. Distances from clustered patients' locations to the nearest eye surgical facility ere calculated using Google Maps and analyses performed to identify if a relationship exists between distances travelled and the CSC for the area. Results: The prevalence of bilateral cataract blindness for males was 0.4% (n=8; 95% CI=0.1-0.7) and females 0.5% (n=17; 95% CI=0.3-0.8) and the CSC for males and females were 69.2% and 68.5% respectively. The difference in CSC was not statistically significant. Females aged ≥70 years reported more barriers to cataract surgical services compared to men. At a VA <3/60 in the better eye, 1km increase in the distance to the nearest eye surgicalcentre was associated with a reduction in the CSC for the area of 4.8% (Linear regression: F (1,95) = 16.06, p = 0.0001, R-Squared = 0.1446, Adjusted R-Squared = 0.1356). Conclusions: Older women (≥70 years) were the most vulnerable to untreated cataract blindness in Rwanda and therefore special programs need to target them for cataract surgical services. Distance to surgical facilities with ophthalmologists is related to the cataract surgical coverage even in a small country like Rwanda. 2020-10-22T09:23:10Z 2020-10-22T09:23:10Z 2020 2020-10-22T07:33:32Z Master Thesis Masters MPH http://hdl.handle.net/11427/32320 eng application/pdf Division of General Surgery Faculty of Health Sciences
spellingShingle general surgery
Owusu, Kyei Michael
Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda
thesis_degree_str Master's
title Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda
title_full Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda
title_fullStr Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda
title_full_unstemmed Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda
title_short Assessment of cataract blindness prevalence and factors associated with surgical coverage in Rwanda
title_sort assessment of cataract blindness prevalence and factors associated with surgical coverage in rwanda
topic general surgery
url http://hdl.handle.net/11427/32320
work_keys_str_mv AT owusukyeimichael assessmentofcataractblindnessprevalenceandfactorsassociatedwithsurgicalcoverageinrwanda