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Meeting the need for childhood cataract surgical services in Madagascar
Henry E Nkumbe1, Herinjanahary C L Randrianotahina
1Department of Ophthalmology, Salfa Eye Project, Antananarivo, Republic of Madagascar. nkumbe@gmx.net
Insights
Pediatric cataract surgery is insufficient in Southern Madagascar, with only 2.7% of cases treated. This highlights a critical need for a childhood blindness program to address the significant burden of childhood cataract.
Area of Science:
- Ophthalmology
- Public Health
- Pediatric Medicine
Background:
- Childhood cataract is a leading cause of preventable blindness globally.
- An estimated 2500 children in Madagascar are blind due to cataracts.
- VISION 2020 aimed to eliminate avoidable blindness by 2020.
Purpose of the Study:
- To determine the prevalence and causes of pediatric cataracts in Southern Madagascar.
- To assess the surgical service delivery for childhood cataracts.
- To identify gaps in care for pediatric cataract patients.
Main Methods:
- Retrospective case series analysis.
- Inclusion criteria: children aged 15 and below undergoing cataract surgery.
- Data collected from September 1999 to July 2009 at a major eye clinic in Southern Madagascar.
Main Results:
- 114 eyes of 86 children were operated on.
- Congenital cataracts accounted for 53.5% of cases.
- Surgical coverage was low at 2.7% of incident non-traumatic pediatric cataracts for a catchment area of 5.8 million.
Conclusions:
- Southern Madagascar has inadequate pediatric cataract surgical services.
- A dedicated childhood blindness program is essential.
- Urgent intervention is needed to improve access to care for children with cataracts.
Background:
Cataract has emerged as the most important cause of blindness in children worldwide, and has been one of the priorities of VISION 2020, the global initiative to eliminate avoidable blindness by 2020. More than 2500 children are estimated to be blind from cataract in Madagascar. The aim of this study was to investigate the burden and causes of pediatric cataract in a busy eye clinic in Madagascar and measure service delivery.
Materials And Methods:
This was a retrospective case series of all children aged 15 and below, receiving cataract surgery at the busiest eye clinic in Southern Madagascar. Data on all children operated on at the eye clinic between September 1999 and July 2009 were retrieved from theatre logs and patient charts.
Results:
One hundred and fourteen eyes of 86 children were operated on during the study period, with congenital cataract being the diagnosis in 53.5% of the children. For the catchment area of 5.8 million inhabitants 2.7% of incident cases of non-traumatic pediatric cataracts had surgery, with a mean CCSR per year for the entire catchment area of 1.1/million population.
Conclusions:
The Southern part of Madagascar is underserved for pediatric cataract surgical services, hence the need for a childhood blindness program.
