Table 1

Reported causes of delay of presentation for cataract surgery from four different studies located in India, Nigeria, Brazil and Tanzania

Author (date)Sheeladevi et al (2018)7Ugalahi et al (2019)6Leite et al (2011)5Mwende et al (2005)20
CountryIndiaNigeriaBrazilTanzania
Number of children75116470178
Bilateral/unilateralBilateral/unilateralBilateral/unilateralBilateral/unilateralBilateral/unilateral
Definition of delayChildren presenting >12 months from birth.Carer defaulting from or deferring surgery.Children presenting ≥4 months from cataract identification.Children presenting >12 months from cataract identification.
Factors associated with a statistically significant cause for delay (p≤0.05)Only children presented later (in congenital cataract group)NR

  •  Number of siblings (only children presented earlier)

  •  Lack of insurance

  •  Professional first sought for help

  •  Developmental cataract

  •  Living far from the hospital

  •  Low socioeconomic status of the mother

  •  Only children presented later (in congenital cataract group)

Factors recorded but not associated with statistically significant delay (p≥0.05)

  •  Gender of child

  •  Birth place

  •  Location(rural/urban)

  •  Paying versus non-paying

  •  Bilateral/unilateral cataract

  •  Family history of congenital cataract

  •  Consanguinity

  •  Maternal/paternal age/education/occupation

  •  Family's reported income

NR

  •  Gender of child

  •  Maternal age

  •  Bilateral/unilateral cataract

  •  Family history of cataract

  •  Marital status of parents

  •  Who first noticed problem (relative or healthcare workers)

  •  Maternal/paternal education

  •  Economic category

  •  Household income

 

  •  Gender of child

  •  Age of child at presentation to hospital

  •  Travelling costs (>/< $5)

  •  Reported self-treatment

  •  Religion

  •  Who first noticed problem (caregivers or others)

  •  Socioeducational status of father

  •  Age of mother (<30 or>30 years)

  •  Bilateral/unilateral cataract

  •  Family history of cataract

  •  Marital status of parents

Carer reported cause for delay (in ascending order of most to least reported)NR

  •  Cost of surgery

  •  Fear of surgery

  •  Illness in caregiver

  •  Lack of awareness about surgery booking

  •  Child died before surgery

  •  Parents did not know who to look for/where to go

  •  Waited for treatment in a public hospital

  •  Had difficulties making appointment

  •  Paediatricians neither diagnosed nor referred

NR
CommentsMultivariate analysis OR (95% CI) 4.69 (1.84 to 9.85) p=<0.001.Carer reported reasons for defaulting from surgery.Having insurance (adjusted OR 0.17; 95% CI 0.04 to 0.82) and being the only child (adjusted OR 0.16; 95% CI 0.04 to 0.69) decreased likelihood of late presentation. First professional sought for help ophthalmologist versus paediatrician.Congenital cataract defined as recognised since birth or within the first year. Developmental cataract defined as leading to reduction in vision after 1 year of age. Congenital versus developmental cataract OR 2.67 (1.38 to 5.28) p=0.002. Distance to hospital OR 1.97 (1.02 to 3.79). Mothers socioeducational status (illiterate farmer versus educated farmer versus educated business) χ2(trend)=3.83 p=0.05.

  • NR, not reported.