Risk Factors for Couching Practices in Plateau State, Nigeria: Results from a population-based survey

Abstract

Aim: To assess the trend and risk factors for couching practices among individuals aged 50 years or more in Plateau State, Nigeria.
Method: A population-based, cross-sectional survey. Multistaged stratified random sampling, with probability proportional to size was used to select a representative sample of the state. The study instrument was the
standardized Rapid Assessment of Cataract Surgical Services (RACSS) pro-forma. Records of participants who had their eye(s) couched were analysed for age at time of couching, duration of involvement in couching
practice prior to the survey, senatorial district of residence, visual outcome in the couched eyes and use of glasses.
Results: Four thousand, one hundred and fifteen persons were examined (coverage: 98%). One hundred and nineteen (2.9%) persons had had cataract surgery before the survey. Of these, 27 (22.7%) persons had couched eyes. Eight (6.7%) persons had both eyes couched. Couching practice increased significantly with age from 7.4% at the age of 50-54 years to 29.6% at the age of 65-69 years, (p<0.01). Couching practice was lowest in Plateau North Senatorial District with 2 (4.2%) couched eyes, and highest in Plateau Central Senatorial District with 28 (58.3%) couched eyes (p<0.01).
Conclusions: The elderly and those who live far from the state capital are more at risk of being involved in couching practices. The findings from this study have revealed an urgent need for ophthalmologists in Plateau
State to increase practical, effective and safe surgery to underserved communities in the state.

Key words: cataract, couching, risk factors