Abstract
In sub-Saharan Africa, cataract surgical services are highly inadequate and surgical uptake for cataract is low. This paper describes cataract surgical uptake among older adults in Ghana. This work was based on World Health Organization's multi-country Study on global Ageing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and Department of Community Health, University of Ghana Medical School. A nationally representative sample of 5571 older adults (≥50 years) and a small sample of persons 18-49 years were interviewed. Data was obtained on uptake of cataract surgery in older adults and analyzed using descriptive measures and chi square for associations in categorical outcome measures. Overall surgical uptake was 48.9% among older adults and was slightly higher among older men (49.1%) than women (48%). Cataract surgical uptake was relatively higher in the 60-69 years group (55%), urban residents (52.6%) and those living without partners (50%). Educational and income levels of older persons did not affect cataract surgical uptake. Regional differences in cataract surgical uptake existed; was less than 60% in all ten regions (except one), and the two regions with most self-reported cataracts (Ashanti and Greater Accra) had less than 50% uptake. Intensive public education, engagement of community groups and increased access to cataract surgery at health facilities and outreach services need consideration at national/sub-national levels. Further investigations to garner equity in national eye care efforts are recommended.
Highlights
Cataract remains the major cause of blindness and low vision worldwide.[1]
Among 122 older women who have been diagnosed with cataract, 59 (48.4%) have had cataract surgery; while a slightly greater number 63 (51.6%)
In terms of proportions of those diagnosed with cataract who have had surgery, older men had an uptake of 49.5% while the uptake was marginally lesser for the older women, 48.4%
Summary
Cataract remains the major cause of blindness and low vision worldwide.[1] In Ghana, regional surveys conducted in Wenchi[2] and the Volta region[3] indicate that cataract contributed to 62.5% (in persons 30 years and above) and 53.9% (in those 40 years and above) respectively. Cataract surgery remains the mainstay treatment of cataract blindness. Surgical intervention has been found to have greater cost benefits (including intangible benefits like increased sight) compared to no surgical intervention for those with cataract.[5, 6] Despite these obvious benefits of cataract surgery, cataract remains the leading cause of blindness in Ghana as a result of a number of barriers between patients and the available services
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