Blindness, cataract surgery and mortality in Ethiopia.
OBJECTIVE
To examine the relationships between blindness, the intervention of cataract surgery and all-cause mortality in a rural Ethiopian population.


METHODS
Population-based, interventional prospective study.


METHODS
Community-based detection methods identified blind Ethiopian persons from two selected kebeles in Amhara region, Ethiopia. Data from 1201 blind patients were collected-628 cataract-blind and 573 blind from other conditions. Free cataract surgery was provided for consenting, cataract-blind patients. Follow-up surveys were conducted after 12 months (±1 month)-the main outcome measure for this report is all-cause mortality at 1 year.


RESULTS
During the follow-up period, 110 persons died from the selected population (mortality 9.2%), which consisted of those cataract-blind patients who received cataract surgery (N=461), cataract-blind patients who did not receive surgery (N=167) and all non-cataract-blind patients (N=573). Of the 461 patients who received cataract surgery, 44 patients died (9.5%). Of the 740 patients who did not receive surgery, 66 died (8.9%)-28 patients from the cohort of cataract-blind patients who did not receive surgery (16.8%) and 38 patients from the cohort of non-cataract blind (6.6%). Subgroup analysis revealed significantly increased odds of mortality for cataract-blind patients over 75 years of age who did not receive surgery and for unmarried patients of all age groups.


CONCLUSIONS
In this population, mortality risk was significantly elevated for older cataract-blind patients when compared with non-cataract-blind patients-an elevation of risk that was not noted in an age-matched cohort of cataract-blind patients who underwent cataract surgery as early as 1-year follow-up.
Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA Himalayan Cataract Project, Waterbury, Vermont, USA.
Benjamin J
BJ
Thomas
Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.
David S
DS
Sanders
Himalayan Cataract Project, Waterbury, Vermont, USA Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.
Matthew S
MS
Oliva
Department of Political Science, Lehigh University, Bethlehem, Pennsylvania, USA School of International and Public Affairs, Columbia University, New York, New York, USA.
Mark S
MS
Orrs
RAND Corporation, Arlington, Virginia, USA.
Peter
P
Glick
Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
Sanduk
S
Ruit
Department of Epidemiology, University of Utah Medical Center, Salt Lake City, Utah, USA.
Wei
W
Chen
RAND Corporation, Arlington, Virginia, USA.
Jill
J
Luoto
Himalayan Cataract Project, Waterbury, Vermont, USA.
Alemu Kerie
AK
Tasfaw
Division of International Ophthalmology, Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA Himalayan Cataract Project, Waterbury, Vermont, USA.
Geoffrey C
GC
Tabin
D017677:Age Distribution; D000368:Aged; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D014792:Visual Acuity
Lens and zonules; Public health; Treatment Surgery; Vision