Abstract:Background: Visual impairment is one of the most common non-communicable causes of disability worldwide. 94 million people suffer from cataracts, disproportionately in resource-poor settings with barriers to eye health services. Untreated cataracts can lead to social isolation, decreased economic productivity, increased risk of injury, and overall decrease in quality of life. Objectives: This study examines the extent that cataract surgery delivered at a field hospital affects vision-related quality of life (VRQOL) in Djibouti, and determinants of improvement. Materials and methods: Serial cross-sectional surveys were administered to cataract patients assessing VRQOL at baseline and 2-months post-op. Patients completed face-to-face surveys using a translated “World Health Organization Prevention of Blindness and Deafness 20″item Visual Functioning Questionnaire”, containing subscales (overall vision, visual function, general function, and psychosocial impact). Results: 542 patients completed the surveys, with 73.4% (n=398) exhibiting improvement in visual acuity. On average, the overall score improved by 18.21 (SD=18.78, p=0.000), representing 22.76% of total possible score improvement. Of the subscales, overall activity improved by 1.55 (SD=2.04, p=0.000), 19.38% of total possible improvement. General function improved by 11.53 (SD=12.42, p=0.000, 24% of total possible improvement. Visual function improved by 1.70 (SD=263, p=0.000), 21.25% of total possible improvement. Psychosocial impact improved by 3.42 (SD=4.08, p=0.000), 21.38% of total possible improvement. Multivariable regression identified significant predictors of VRQOL change as visual improvement (B=-1.870, p=0.027), and baseline score (B=-1.014, p=0.000). Sex and age were not significant variables in the regression model across all subscales. Conclusion: Cataract surgery delivered in a field setting leads to significant improvement in field hospital setting, as it would be expected in a regular health service, notably in the general function subscale. The intervention significantly improves outcomes regardless of age and sex in socially inequitable, resource-poor society like Djibouti. Improvement in women’s health can lead to broader, equitable impact in household and community outcomes.
Keywords: Non-Communicable Diseases (NCDs), non-communicable disease, quality of life, visual health, health equity, sex, Africa
