Duration 5min, Q&A 3min
Addressing the Cataract Challenge in Sub-Saharan Africa
The first challenge, when discussing cataract in Africa is that there is not just one Africa but several. Geographic, environmental, linguistic (having to do with the colonial history), genetic and cultural differences all contribute to differences in the epidemiology of cataract blindness as well as service delivery.
Review of publications on cataract blindness in Africa as well as a meeting of experts during WOC 2010 in Berlin.
A review of the summary of the round table of discussion entitled "Africa: can we succeed in the greatest challenge to blindness prevention?". This was a special meeting of experts on the fight against blindness in Africa, which was organised during the World Ophthalmology Congress 2010 in Berlin. The conclusions of this milestone meeting are backed by available published data on cataract blindess in Africa.
Results and Conclusion
There is increasing evidence on eye disease profiles across Africa, which confirms cataract as the number one cause of blindness. The same evidence suggests that when cataract surgical services are provided, the outcomes are often r poor. Besides, very few surgeons audit their cataract surgical outcome. However, the ethical dilemma of research on cataract blindness is that well researched communities often remain blind with no follow up action.
Couching is still practiced in many countries in West and Central Africa, accounting for close to 50% of operated cataracts in Nigeria, the country with the highest population of black Africans worldwide.
Several terms are encountered when discussing the fight against cataract blindness, such as community participation, primary eye care, comprehensive eye care, cataract surgical rate (CSR) etc. However, the understanding and scope of these approaches varies from place to place, making it difficult to make comparisons.
Therefore, context-specific tailored approaches are usually necessary, since one size does not fit all. For instance, a standard target cataract surgical rate may not be applicable across Africa to eliminate cataract blindness. Each country, and in some cases, district may need to calculate their own target cataract surgical rate.
Particular support is needed to develop human resources and eye care delivery systems in francophone and lusophone countries, which have the lowest cataract surgical rates in Africa.
Much has been achieved in meeting VISION 2020 objectives in Africa. During the next 6 years leading to the year 2020, however, there is need for better coordination of activities among stakeholders, with a focus on underserved districts and countries.
[ Keyword ]
Africa / Cataract blindness / Service delivery / Epidemiology / Couching
[ Conflict of Interest ]