Prevalence of Cataract in Rural Indonesia

Abstract

Abstract: : Purpose: To describe the prevalence of cataract in adults in rural Sumatra, Indonesia. Methods: A random sample of all adults aged 21 years or more living in 3 rural villages in central Sumatra was assessed. A one–stage cluster sampling strategy of 190 randomly selected households per village was adopted. 919 of 1089 eligible adults were recruited (participation rate of 84.4%). A team of 7 ophthalmologists examined the anterior segment of both eyes using a portable slit–lamp (Kowa) after pupillary dilatation. Lens opacity was graded according to the LOCS III, using standard color photographs. Nuclear cataract was defined as a LOCS III score of ≥4.0 in either eye, cortical ≥4.0 and posterior subcapsular cataract (PSC) ≥2.0. Results: Overall 201/919 (21.9%) subjects were found to have cataract. The age–adjusted prevalence rate of cataract (including cataract surgery) was 23.0% (95% CI 20.8 – 25.2). The most common type of cataract for both sexes (adjusted for age) was mixed (13%) followed by nuclear only (5.7%), and cortical only (4%). The prevalence rate of any cataract for adults aged 21–29 years was 1.1% increasing to 82.8% for those aged over 60 years. Similar trends with age were noted for nuclear, cortical, and PSC cataract. Women had higher prevalence rates than men for all types of cataract except cortical. There was a significant trend of increasing prevalence with lower level of education for all types of cataract (all p's < 0.001) Conclusion: Cataract prevalence in rural Indonesia is amongst the highest reported in South–east Asia. Despite this, there are inadequate resources availabe to manage this treatable disease. Allocation of resources to tackle the present burden of cataract would likely have large personal, social and economic benefits.

Keywords: cataract • clinical (human) or epidemiologic studies: prevalence/incidence