Influence of socio-economic status and educational achievement on cataract formation in a rural community in Imo State, South-Eastern Nigeria

Abstract

Purpose: Cataract is a leading cause of visual impairment globally. This study explored medical, behavioral, and socioeconomic factors associated with cataract development in a rural community in Imo State, Nigeria. Methods: A case-control study was done on 61 patients above 40 years old from a medical outreach program to determine the presence of cataract and its risk factors. Results: Of 54 complete records, 52% had cataracts (while 48% had no cataracts). There were no significant differences in co-morbidities such as ocular allergy (OR 0.98, 95% CI: 0.36–2.69), refractive error (OR 1.46, 95% CI: 0.61–3.50), hypertension (OR 0.66, 95% CI: 0.24–1.89), or arthritis (OR 0.90, 95% CI: 0.33–2.43) between people with or without cataract. The no cataract group had a higher educational level (p = 0.01) and socio-economic score (SES, 20.9 ± 2.9 vs. 18.8 ± 3.0, p = 0.01). Both groups obtained medications without a prescription (OR 0.95, 95% CI: 0.40–2.28), and had equivalent sun exposure (3.4 ± 2.9 vs. 3.9 ± 2.2 hours, p = 0.31), use of multivitamins (p = 0.80), sunglasses (p = 0.32), and hats (p = 0.83). Conclusion: Poor knowledge and use of cataract risk reducers in the community contributed to development of cataracts, regardless of socioeconomic status.

Keywords:

• global health
• blindness
• international vision care
• medical mission
• cataracts
• socio-economic status
• educational achievement
• rural Nigeria

Public Interest Statement

Cataract is a disease that causes decreased vision due to progressive opacification of the lens of the eye. For those who have access to modern medicine, cataracts can be treated with a short, outpatient surgery. However, in developing regions of the world, surgery to remove cataracts is available to relatively few. In these places, cataracts devastate the personal and socioeconomic wellbeing of millions. Imo State is a rural, developing region of Nigeria that has an unusually high number of adults with cataracts. This study aimed to identify causes of the high rate of cataracts in this area. To do so, we compared the lifestyle, education, and health care habits of adults with cataracts to those without cataracts in Imo state. This comparison demonstrated that having a higher level of education or a higher socioeconomic standing correlated with a lower risk of cataract. Understanding the interaction between social class, education and cataract will help guide future initiatives to reduce the burden of cataracts in this region.

Competing Interests

The authors declare no competing interest.

Additional information

Notes on contributors

Kevin Rolnick

Researchers from the University of Wisconsin School of Medicine and Public Health (UWSMPH) in coordination with the Mezu International Foundation (MIF), and the support of researchers from the Department of Optometry, Federal University of Technology, Owerri (FUTO) implemented this study. MIF is a non-profit, organization that conducts philanthropic, humanitarian services in US and internationally, including an annual Medical Outreach Program to Imo State, Nigeria. The goals of MIF, as well as the involved researchers from UWSMPH, include identifying general healthcare needs in developing regions of the world, with a particular focus on visual health. This study is one of multiple studies that have been conducted in conjunction with the annual MIF Medical Outreach Program in Imo State. Findings from this study will help guide further research into the visual health of those living in Imo State, as well as interventions to decrease the rate of cataract in the region.