Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh
Does Cataract Surgery Alleviate Poverty? Evidence from a Multi-Centre Intervention Study Conducted in Kenya, the Philippines and Bangladesh
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DOI：
10.1371/journal.pone.0015431
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发表时间：
2010-11-09
期刊：
影响因子：
3.7
通讯作者：
Foster, Allen
中科院分区：
文献类型：
--
作者：
Kuper, Hannah;Polack, Sarah;Foster, Allen
贫穷和失明被认为是密切相关的，但支持这种关系的经验数据很少。本研究的目的是评估视力受损患者白内障手术后是否会减少贫困。方法/主要发现：在三个国家（肯尼亚、菲律宾、孟加拉国）进行了一项多中心干预研究。贫困数据（家庭人均支出-PCE，资产所有权和自评财富）来自年龄为bb0 = 50岁的因白内障而视力受损的病例（视力较好眼为6/24）和年龄性别匹配的正常视力对照组。为个案提供免费/资助白内障手术。大约一年后，参与者再次就贫困问题接受采访。基线和随访检查466例和436例对照（随访率：病例78%，对照组81%），其中263例接受了白内障手术（“手术病例”）。在基线时，手术病例在PCE（肯尼亚：22美元对35英镑p = 0.02，孟加拉国：16美元对24美元p = 0.004，菲律宾：24美元对32美元p = 0.0007）、资产和自评财富方面比对照组差。通过随访，三种情况下手术病例的PCE均显著增加至对照组水平（肯尼亚：30美元对36英镑p = 0.49，孟加拉国：23美元对23美元p = 0.20，菲律宾：45美元对36美元p = 0.68）。自评财富增加幅度较小，资产没有变化。PCE的变化在不同的社会人口和眼部群体中都很明显。在基线时最贫穷的病例中，PCE增幅最大。结论/意义：本研究表明白内障手术有助于减轻贫困，特别是对社会最弱势群体。这项研究强调需要向穷人提供更多的白内障手术，并表明关注失明可能有助于减轻贫困和实现千年发展目标。
Poverty and blindness are believed to be intimately linked, but empirical data supporting this purported relationship are sparse. The objective of this study is to assess whether there is a reduction in poverty after cataract surgery among visually impaired cases.Methodology/Principal Findings: A multi-centre intervention study was conducted in three countries (Kenya, Philippines, Bangladesh). Poverty data (household per capita expenditure -PCE, asset ownership and self-rated wealth) were collected from cases aged >= 50 years who were visually impaired due to cataract (visual acuity, 6/24 in the better eye) and age-sex matched controls with normal vision. Cases were offered free/subsidised cataract surgery. Approximately one year later participants were re-interviewed about poverty. 466 cases and 436 controls were examined at both baseline and follow-up (Follow up rate: 78% for cases, 81% for controls), of which 263 cases had undergone cataract surgery ("operated cases''). At baseline, operated cases were poorer compared to controls in terms of PCE (Kenya: $22 versus 35 pound p = 0.02, Bangladesh: $16 vs $24 p = 0.004, Philippines: $24 vs 32 p = 0.0007), assets and self-rated wealth. By follow-up PCE had increased significantly among operated cases in each of the three settings to the level of controls (Kenya: $30 versus 36 pound p = 0.49, Bangladesh: $23 vs $23 p = 0.20, Philippines: $45 vs $36 p = 0.68). There were smaller increases in self-rated wealth and no changes in assets. Changes in PCE were apparent in different socio-demographic and ocular groups. The largest PCE increases were apparent among the cases that were poorest at baseline.Conclusions/Significance: This study showed that cataract surgery can contribute to poverty alleviation, particularly among the most vulnerable members of society. This study highlights the need for increased provision of cataract surgery to poor people and shows that a focus on blindness may help to alleviate poverty and achieve the Millennium Development Goals.