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Gender differences in blindness, cataract blindness and cataract surgical coverage in India: a systematic review and meta-analysis
  1. Manya Prasad1,
  2. Sumit Malhotra1,
  3. Mani Kalaivani2,
  4. Praveen Vashist3,
  5. Sanjeev K Gupta4
  1. 1 Community Medicine, All India Institute of Medical Sciences, Delhi, India
  2. 2 Biostatistics, All India Institute of Medical Sciences, Delhi, India
  3. 3 Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
  4. 4 Community Medicine, All India Institute of Medical Sciences, Delhi, India
  1. Correspondence to Dr Sumit Malhotra, Community Medicine, All India Institute of Medical Sciences, Delhi 110029, India; drsumitaiims{at}gmail.com

Abstract

Background The magnitude of blindness is unevenly distributed worldwide. This systematic review aimed to study gender differences in the prevalence of blindness, cataract blindness and cataract surgical coverage in India among persons aged 50 years and above.

Methods Literature search was carried out in the Medline, Web of Science, Google Scholar, EMBASE and Trip databases. Data were abstracted and risk of bias was assessed for the selected full-text articles. Pooled prevalence, ORs and risk differences were synthesised by meta-analyses.

Results 22 studies were included in the systematic review. The pooled prevalence of blindness obtained for men was 4.17% and that for women was 5.68%. Women had 35% higher odds of being blind (OR 1.35, 95% CI 1.08 to 1.62) and 69% higher odds of being cataract blind (OR 1.69, 95% CI 1.44 to 1.95). Women had a 27% lower odds of getting cataract surgery (OR 0.73, 95% CI 0.45 to 1.01). In women, around 35% of the prevalence of blindness and 33% of the prevalence of cataract blindness are attributable to their gender.

Conclusion Marked gender differences in blindness, cataract blindness and cataract surgical coverage were seen in India, with the odds being unfavourable for women. Interventions implemented for reduction of blindness, including cataract blindness, need to consider these gender differentials in the Indian context. Further research is needed to ascertain the reasons for these differences and devise interventions to reduce these differences in order to tackle the magnitude of avoidable blindness in India.

  • public health
  • epidemiology
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Footnotes

  • MP and SM contributed equally.

  • Contributors SM, MP and MK had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: SM, PV and SKG. Acquisition, analysis or interpretation of data: SM, MP, MK and SKG. Drafting of the manuscript: MP and SM. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: MK, MP and SM. Study supervision: PV and SKG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.

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