Health literacy of common ocular diseases in Nepal

Background: Poor health literacy is often a key cause of lack of or delayed uptake of health care services. The aim of this study was to assess the health literacy of common ocular diseases, namely cataract, glaucoma, night blindness, trachoma and diabetic retinopathy in Nepal. Methods: A cross sectional study of 1741 participants randomly selected from non-triaged attendants in the outpatient queue at Tilganga Institute of Ophthalmology, a semi urban general population of Bhaktapur district of Kathmandu Valley and patients attending rural outreach clinics. Participants responded to trained enumerators using verbally administered, semi structured questionnaires on their awareness and knowledge of cataract, glaucoma, diabetic retinopathy, night blindness, and trachoma. Results: The awareness of cataract across the entire sample was 49.6%, night blindness was 48.3%, diabetic retinopathy was 29%, glaucoma was 21.3% and trachoma was 6.1%. Patients presenting to rural outreach clinics had poorer awareness of cataract, glaucoma, diabetic retinopathy, night blindness and trachoma compared to those from a semi-urban community and an urban eye hospital (p< 0.05), Old age was directly associated with poorer awareness of cataract, glaucoma, night blindness, trachoma and diabetic retinopathy (p< 0.05). Female gender was associated with lower awareness of cataract, glaucoma, night blindness and trachoma (p< 0.05). Literacy was associated with greater awareness of cataract, glaucoma, diabetic retinopathy, night blindness and trachoma (p< 0.05). Higher education was significantly associated with greater awareness of cataract, night blindness and trachoma (p< 0.05). Multivariate analysis found that the awareness of common ocular diseases was significantly associated with level of education (p< 0.05). Similarly, awareness of cataract, glaucoma, trachoma and night blindness was associated with female gender (p< 0.05) whereas awareness of cataract, night blindness, trachoma and diabetic retinopathy was associated with age (p< 0.05) but the awareness glaucoma and diabetic retinopathy was associated with camps. Conclusions: Low awareness of common ocular conditions is associated with factors such as female gender, old age, lower levels of education and rural habitation. A would be successful health promotion programs should specifically target health determinants to promote health literacy and to ensure timely utilization of eye care services.