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The cataract situation in Suriname: an effective intervention programme to increase the cataract surgical rate in a developing country
  1. Jerrel C Pawiroredjo1,
  2. Janna Minderhoud1,2,
  3. Dennis R A Mans3,
  4. Herman C I Themen1,
  5. Anne-Marie T Bueno de Mesquita-Voigt1,
  6. Michael R Siban1,
  7. Cindy M Forster-Pawiroredjo1,
  8. Annette C Moll2,
  9. Ruth M A van Nispen2,
  10. Hans Limburg4
  1. 1Suriname Eye Centre, Academic Hospital Paramaribo, Paramaribo, Suriname
  2. 2Department of Ophthalmology and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
  3. 3Department of Pharmacology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
  4. 4Health Information Services, Grootebroek, The Netherlands
  1. Correspondence to Dr Jerrel C Pawiroredjo, Suriname Eye Center, Academic Hospital Paramaribo, Flustraat 2, Paramaribo, Suriname; jcpawi{at}yahoo.com

Abstract

Aims To provide an overview of cataract data in Suriname and to describe and evaluate a programme to control cataract blindness in a developing country.

Design Evaluation of hospital data and findings from a population-based cross-sectional survey.

Methods The implementation of a new cataract surgical intervention programme was described and retrospectively evaluated by analysing the number of cataract operations and other related indicators at the Suriname Eye Centre (SEC) in the period 2006–2014. Findings of the recent Rapid Assessment of Avoidable Blindness (2013–2014) survey were used to evaluate the national cataract situation in Suriname in people aged ≥50 years (n=2998), including prevalence of cataract blindness, outcome and cataract surgical rate (CSR).

Results Since the implementation of a new cataract intervention programme, the number of cataract operations at the SEC has increased from 1150 in 2006 to 4538 in 2014, leading to an estimated national CSR of 9103 per one million inhabitants. The prevalence of bilateral cataract blindness in Suriname was 0.8% (95% CI 0.2% to 1.3%) in individuals aged ≥50 years. The proportion of eyes with a postoperative visual acuity <6/60 (poor outcome) was lowest in eyes operated at the SEC (8.5%) and highest in surgeries performed by foreign humanitarian ophthalmic missions.

Conclusions The cataract situation in Suriname is well under control since the implementation of the new intervention programme. Important factors contributing to this success were the introduction of phacoemulsification, intensive training, and improvement in the affordability and accessibility of cataract surgery. The proportion of poor outcomes was still >5%.

  • Epidemiology
  • Low vision aid
  • Public health
  • Vision
  • Treatment Surgery

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Footnotes

  • JCP and JM contributed equally.

  • Contributors Each author and coauthor meet the requirements for authorship. JCP, JM and HL contributed to all aspects of the study (research design, data acquisition, data analysis and manuscript preparation). DRAM, ACM and RMAvN contributed to the research design, data analysis and manuscript preparation. A-MTBdM-V, MRS, CMF-P and HCIT contributed to the data acquisition and research execution.

  • Funding The authors thank the Academic Hospital Paramaribo, Paramaribo; Worldwide Access to Medical Advances Foundation, Amsterdam; Nelly Reef Fund, Amsterdam; Stichting Blindenhulp, Den Haag; Stichting tot Verbetering van het Lot der Blinden, Huizen; Rudolph en Barbara Hoppenbrouwers fonds, Amsterdam; Stichting Nederlands Oogheelkundig Onderzoek, Nijmegen, Rotterdamse Blindenbelangen, Rotterdam and Katholieke Stichting voor Blinden en Slechtzienden, Grave for providing financial support. Although the Academic Hospital Paramaribo partly funded the research by providing transport, materials and survey staff (ophthalmologists pro deo), the Academic Hospital Paramaribo or other funding organisations had no role in the design or conduct of this research.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ministry of Health Suriname.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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