Rapid Assessment of Cataract Surgical Services in Birnin-Kebbi Local Government Area of Kebbi State, Nigeria

Purpose: To provide baseline data for cataract surgical services in Birnin-Kebbi Local Government Area (LGA) of Kebbi state, Nigeria for effective planning of services in the LGA and the state. Methods: People aged 50 years and above were enrolled in the study using stratified cluster sampling with probability proportional to size procedures. Subjects were assessed based on the WHO (World Health Organization) RACSS (Rapid Assessment of Cataract Surgical Services) methodology. Results: Out of the 2,589 enumerated subjects, 2,424 (93.6%) were examined 51.7% of whom were male. The overall prevalence of bilateral blindness was 4.5% (confidence interval (CI) 95% 3.7%-5.3%). The prevalence of bilateral cataract blindness was 2.1% (CI 95% 1.5%-2.7%). The prevalence of operable cataract in the study was 9.5% (CI95% 8.3%-10.7%). The cataract surgical coverage was 28.9%, but couching coverage was 32.9%. The presenting vision was poor in 100% of non-intraocular lens (IOL) operated eyes, 90.6% of couched eyes and only 6.9% of pseudophakic eyes. The major barriers to services were 'old age and no need for surgery' (29.6%), 'cannot afford operation' (16.9%), 'waiting for cataract surgery' (12.7%). Conclusion: Despite the recently introduced free cataract surgical services the prevalence of operable cataract is high. Accessibility of existing services needs to be improved and other barriers should be overcome by appropriate health education on cataract services.