Prevalence of Childhood Cataract and Associated Factors Among a Pediatric Population at A Tertiary Hospital in Ghana

Abstract

Background: Childhood cataract unlike adult-related cataract has received a little attention despite the devastating consequences on the early development of the visual system and the overall impact on the quality of life of children. The existence of accurate epidemiological data is a primary step towards management strategies, however, there remains a paucity of data in sub-Saharan Africa including Ghana. Therefore, the study sought to investigate the prevalence of childhood cataract and its associated factors among a pediatric population at a tertiary health facility in Ghana. Methods: The study employed a retrospective electronic medical-record review on 263 pediatric cataract cases examined (from January 2019 to December 2020) at the pediatric ophthalmology department of the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Patient clinical data including sociodemographic, signs and symptoms, primary diagnosis and associated ocular complications were gathered and analyzed using Statistical package and Service Solution (SPSS). Chi-square and regression statistics were used to summarize data at a significance of p< 0.05. Results: The prevalence of childhood cataract was 4.25% (263/6,188). The proportionate distribution of cataracts was congenital (39.5%), traumatic (33.1%) and developmental (26.6%). Over half (51.7%) of the subjects had unilateral cataract. The major complications of childhood cataracts were strabismus (5.70%), nystagmus (3.0%) and retinal detachment (1.90%). Older age (2-12 years, OR = 0.27, p<0.001; > 12 years, OR = 0.12, p<0.001) was significantly associated with reduced odds of congenital cataract. Similarly, increasing age (2-12 years, OR = 12.59, p<0.001; > 12 years, OR = 7.57, p = 0.004) and female sex (OR = 0.58, p = 0.038) was significantly associated with decreased odds of traumatic cataracts. Conversely, older age (2-12 years, OR = 11.02, p<0.001; > 12 years, OR = 26.57, p<0.001) and female sex (OR = 2.27, p = 0.008) were significantly associated with increased odds of developmental cataracts. Conclusion: Our results suggest a higher burden of childhood cataract (approximately four in every hundred children had childhood cataract). This evidence warrants the implementation of pre-school vision screening and eye health education programmes to promote early detection and prevention of avoidable vision impairment and/or blindness within the pediatric population.