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