Meeting the need for childhood cataract surgical services in Madagascar

Abstract

Background: Cataract has emerged as the most important cause of blindness in children worldwide, and has been one of the priorities of VISION 2020, the global initiative to eliminate avoidable blindness by 2020. More than 2500 children are estimated to be blind from cataract in Madagascar. The aim of this study was to investigate the burden and causes of pediatric cataract in a busy eye clinic in Madagascar and measure service delivery. Materials and Methods: This was a retrospective case series of all children aged 15 and below, receiving cataract surgery at the busiest eye clinic in Southern Madagascar. Data on all children operated on at the eye clinic between September 1999 and July 2009 were retrieved from theatre logs and patient charts. Results: One hundred and fourteen eyes of 86 children were operated on during the study period, with congenital cataract being the diagnosis in 53.5% of the children. For the catchment area of 5.8 million inhabitants 2.7% of incident cases of non-traumatic pediatric cataracts had surgery, with a mean CCSR per year for the entire catchment area of 1.1/million population. Conclusions: The Southern part of Madagascar is underserved for pediatric cataract surgical services, hence the need for a childhood blindness program.

Key words: Africa, childhood cataract, childhood cataract surgical rate, Madagascar