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. 2010 Jun 1;5(6):e10913.
doi: 10.1371/journal.pone.0010913.

The impact of cataract surgery on activities and time-use: results from a longitudinal study in Kenya, Bangladesh and the Philippines

Sarah Polack  1 , Christina Eusebio, Wanjiku Mathenge, Zazkia Wadud, Mamunur Rashid, Allen Foster, Hannah Kuper
Affiliations

The impact of cataract surgery on activities and time-use: results from a longitudinal study in Kenya, Bangladesh and the Philippines

Sarah Polack et al. PLoS One. .

Abstract

Background: Cataract is the leading cause of blindness in the world, and blindness from cataract is particularly common in low-income countries. The aim of this study is to explore the impact of cataract surgery on daily activities and time-use in Kenya, Bangladesh and the Philippines.

Methods/principal findings: A multi-centre intervention study was conducted in three countries. Time-use data were collected through interview from cases aged >or=50 years with visually impairing cataract (VA <6/24) and age- and gender-matched controls with normal vision (VA>or=6/18). Cases were offered free/subsidized cataract surgery. Approximately one year later participants were re-interviewed about time-use. At baseline across the three countries there were 651 cases and 571 controls. Fifty-five percent of cases accepted surgery. Response rate at follow up was 84% (303 out of 361) for operated cases, and 80% (459 out of 571) for controls. At baseline, cases were less likely to carry out and spent less time on productive activities (paid and non-paid work) and spent more time in "inactivity" compared to controls. Approximately one year after cataract surgery, operated cases were more likely to undertake productive activities compared to baseline (Kenya from 55% to 88%; Bangladesh 60% to 95% and Philippines 81% to 94%, p<0.001) and mean time spent on productive activities increased by one-two hours in each setting (p<0.001). Time spent in "inactivity" in Kenya and Bangladesh decreased by approximately two hours (p<0.001). Frequency of reported assistance with activities was more than halved in each setting (p<0.001).

Conclusions/significance: The empirical evidence provided by this study of increased time spent on productive activities, reduced time in inactivity and reduced assistance following cataract surgery among older adults in low-income settings has positive implications for well-being and inclusion, and supports arguments of economic benefit at the household level from cataract surgery.

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Conflict of interest statement

Competing Interests: Professor Allen Foster (one of the co-authors) was involved in this study in his position as Director of the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine. At the time of the study Professor Foster was also the Medical Advisor to CBM, one of the international development organizations that co-funded this study. In January 2006, two years into the study, Professor Foster was appointed President of CBM. He contributed to the conception of the study question, study design and critically reviewed the draft of the article. He was not involved in the data collection, data analysis or interpretation of results. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Change in time spent on productive activities and inactivity between baseline and follow up.
See this image and copyright information in PMC

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