Factors influencing the decision-making of carers of children with bilateral cataract in Nepal

BMJ Open Ophthalmology
Suzannah J BellAllen Foster

Abstract

Two hundred thousand children worldwide are blind from cataract. Late presentation for surgery resulting in poor visual outcomes is a problem globally. We aimed to explore the reasons why children are not brought earlier for surgery in Nepal. Mixed-method study of carers of children with bilateral cataract attending a large non-government eye hospital were administered a proforma. A random sample took part in semistructured interviews and focus group discussions. Carers of 102 children completed proformas; 10 interviews and 2 focus group discussions were held. 80.4% were Indian, 35.3% of children were female, and their mean age was 58 months (range 4 months to 10 years). Median delay in time between the carer first noticing a problem to presentation was 182 days IQR (60.8-364.8). This was significantly longer for girls (median 304 IQR (91.2-1094.4)) than boys (median 121.6 IQR (30.4-364.8); p=0.02). Cost to access care was a problem for 42 (41.2%) carers. 13 (12.8%) participants were not aware of treatment and 12 (11.8%) were aware but did not seek treatment. The community influenced carer's health-seeking behaviour. Cataract was sometimes described as 'phula', meaning something white seen on the eye. Fewer girls presented for ...Continue Reading

References

Oct 20, 2005·The British Journal of Ophthalmology·J MwendeP Courtright
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Jan 27, 2010·Ophthalmic Epidemiology·Parikshit GogateMadan Deshpande
Sep 30, 2010·Journal of Pediatric Ophthalmology and Strabismus·M Edward WilsonSanjay Kumar Singh
Nov 10, 2011·Arquivos brasileiros de oftalmologia·Claudia Leite, Andrea Zin
Apr 10, 2013·Journal of Pediatric Ophthalmology and Strabismus·Albrecht HennigClare Gilbert
Aug 22, 2015·Alcohol and Alcoholism : International Journal of the Medical Council on Alcoholism·Anamitra BarikAbhijit Chowdhury
Aug 1, 2018·Eye·Sethu SheeladeviCatherine Suttle

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