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Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo

PURPOSE: The purpose of this study is to describe the methodology and to assess the effectiveness of a community-based rehabilitation (CBR) program to identify and refer children with blinding cataract for the management and surgery to reduce the burden of childhood blindness due to cataract in Kins...

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Autores principales: Kilangalanga, Janvier Ngoy, Stahnke, Thomas, Moanda, Astrid, Makwanga, Emile, Hopkins, Adrian, Guthoff, Rudolf Friedrich
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737789/
https://www.ncbi.nlm.nih.gov/pubmed/31543665
http://dx.doi.org/10.4103/meajo.MEAJO_273_18
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author Kilangalanga, Janvier Ngoy
Stahnke, Thomas
Moanda, Astrid
Makwanga, Emile
Hopkins, Adrian
Guthoff, Rudolf Friedrich
author_facet Kilangalanga, Janvier Ngoy
Stahnke, Thomas
Moanda, Astrid
Makwanga, Emile
Hopkins, Adrian
Guthoff, Rudolf Friedrich
author_sort Kilangalanga, Janvier Ngoy
collection PubMed
description PURPOSE: The purpose of this study is to describe the methodology and to assess the effectiveness of a community-based rehabilitation (CBR) program to identify and refer children with blinding cataract for the management and surgery to reduce the burden of childhood blindness due to cataract in Kinshasa. METHODS: Church-based volunteers were trained to identify children with presumed eye disorders in their localities and households and to refer them for cataract identification by an ophthalmic nurse during parishes' visits. Volunteers were parishioners living in the quartiers where identification took place and worked as community workers with the CBR program. Nurses used a lamp-torch to rule out cataract. Selected children were referred to the tertiary eye health facility at St Joseph Hospital for diagnosis and management. RESULTS: Identification took place in 31 out of 165 parishes in the Archdioceses of Kinshasa from 2000 to 2016 and 11,106 children aged <16 years were screened. Among them, 1277 children (11.5%) were presumed to have cataract. Ninety-two children among them died before surgery; 107 children were lost to further follow-up and did not report to the CBR center for referral. Reasons given were change of home address, moving in their lieu of origin, death, and refusal of treatment by the parents. Finally, only 1078 children were referred to the pediatric ophthalmologist and 705 children (65.4%) were definitively diagnosed to have treatable cataract, while in 373 children (34.6%), cataract surgery was not indicated for several reasons. There was a positive history of familial cataract in 36 children (2.8%). CONCLUSION: Using church-based volunteers and ophthalmic nurses during community screening proved efficient in the identification and referral of pediatric cataract. Keeping regular identification activities in the community and maintaining high-quality and accessible pediatric cataract surgery services can help to clear up the backlog of cataract blind children.
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spelling pubmed-67377892019-09-20 Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo Kilangalanga, Janvier Ngoy Stahnke, Thomas Moanda, Astrid Makwanga, Emile Hopkins, Adrian Guthoff, Rudolf Friedrich Middle East Afr J Ophthalmol Original Article PURPOSE: The purpose of this study is to describe the methodology and to assess the effectiveness of a community-based rehabilitation (CBR) program to identify and refer children with blinding cataract for the management and surgery to reduce the burden of childhood blindness due to cataract in Kinshasa. METHODS: Church-based volunteers were trained to identify children with presumed eye disorders in their localities and households and to refer them for cataract identification by an ophthalmic nurse during parishes' visits. Volunteers were parishioners living in the quartiers where identification took place and worked as community workers with the CBR program. Nurses used a lamp-torch to rule out cataract. Selected children were referred to the tertiary eye health facility at St Joseph Hospital for diagnosis and management. RESULTS: Identification took place in 31 out of 165 parishes in the Archdioceses of Kinshasa from 2000 to 2016 and 11,106 children aged <16 years were screened. Among them, 1277 children (11.5%) were presumed to have cataract. Ninety-two children among them died before surgery; 107 children were lost to further follow-up and did not report to the CBR center for referral. Reasons given were change of home address, moving in their lieu of origin, death, and refusal of treatment by the parents. Finally, only 1078 children were referred to the pediatric ophthalmologist and 705 children (65.4%) were definitively diagnosed to have treatable cataract, while in 373 children (34.6%), cataract surgery was not indicated for several reasons. There was a positive history of familial cataract in 36 children (2.8%). CONCLUSION: Using church-based volunteers and ophthalmic nurses during community screening proved efficient in the identification and referral of pediatric cataract. Keeping regular identification activities in the community and maintaining high-quality and accessible pediatric cataract surgery services can help to clear up the backlog of cataract blind children. Wolters Kluwer - Medknow 2019-08-26 /pmc/articles/PMC6737789/ /pubmed/31543665 http://dx.doi.org/10.4103/meajo.MEAJO_273_18 Text en Copyright: © 2019 Middle East African Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kilangalanga, Janvier Ngoy
Stahnke, Thomas
Moanda, Astrid
Makwanga, Emile
Hopkins, Adrian
Guthoff, Rudolf Friedrich
Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo
title Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo
title_full Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo
title_fullStr Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo
title_full_unstemmed Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo
title_short Role of a Community-based Program for Identification and Referral of Pediatric Cataract Patients in Kinshasa, Democratic Republic of the Congo
title_sort role of a community-based program for identification and referral of pediatric cataract patients in kinshasa, democratic republic of the congo
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737789/
https://www.ncbi.nlm.nih.gov/pubmed/31543665
http://dx.doi.org/10.4103/meajo.MEAJO_273_18
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