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Blindness, cataract surgery and mortality in Ethiopia
  1. Benjamin J Thomas1,2,
  2. David S Sanders3,
  3. Matthew S Oliva2,3,
  4. Mark S Orrs4,5,
  5. Peter Glick6,
  6. Sanduk Ruit1,7,
  7. Wei Chen8,
  8. Jill Luoto6,
  9. Alemu Kerie Tasfaw2,
  10. Geoffrey C Tabin1,2
  1. 1Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
  2. 2Himalayan Cataract Project, Waterbury, Vermont, USA
  3. 3Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
  4. 4Department of Political Science, Lehigh University, Bethlehem, Pennsylvania, USA
  5. 5School of International and Public Affairs, Columbia University, New York, New York, USA
  6. 6RAND Corporation, Arlington, Virginia, USA
  7. 7Tilganga Institute of Ophthalmology, Kathmandu, Nepal
  8. 8Department of Epidemiology, University of Utah Medical Center, Salt Lake City, Utah, USA
  1. Correspondence to Dr Geoffrey C Tabin, University of Utah, 65 N Mario Capecchi Drive, Salt Lake City, UT 84132, USA; gtabin{at}cureblindness.org

Abstract

Purpose To examine the relationships between blindness, the intervention of cataract surgery and all-cause mortality in a rural Ethiopian population.

Design Population-based, interventional prospective study.

Methods Community-based detection methods identified blind Ethiopian persons from two selected kebeles in Amhara region, Ethiopia. Data from 1201 blind patients were collected—628 cataract-blind and 573 blind from other conditions. Free cataract surgery was provided for consenting, cataract-blind patients. Follow-up surveys were conducted after 12 months (±1 month)—the main outcome measure for this report is all-cause mortality at 1 year.

Results During the follow-up period, 110 persons died from the selected population (mortality 9.2%), which consisted of those cataract-blind patients who received cataract surgery (N=461), cataract-blind patients who did not receive surgery (N=167) and all non-cataract-blind patients (N=573). Of the 461 patients who received cataract surgery, 44 patients died (9.5%). Of the 740 patients who did not receive surgery, 66 died (8.9%)—28 patients from the cohort of cataract-blind patients who did not receive surgery (16.8%) and 38 patients from the cohort of non-cataract blind (6.6%). Subgroup analysis revealed significantly increased odds of mortality for cataract-blind patients over 75 years of age who did not receive surgery and for unmarried patients of all age groups.

Conclusions In this population, mortality risk was significantly elevated for older cataract-blind patients when compared with non-cataract-blind patients—an elevation of risk that was not noted in an age-matched cohort of cataract-blind patients who underwent cataract surgery as early as 1-year follow-up.

  • Lens and zonules
  • Treatment Surgery
  • Vision
  • Public health

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