Polack Sarah, Kuper Hannah, Eusebio Cristina, Mathenge Wanjiku, Wadud Zakia, Foster Allen
London School of Hygiene and Tropical Medicine, London, United Kingdom.
Ophthalmic Epidemiol. 2008 Nov-Dec;15(6):372-82. doi: 10.1080/09286580802478716.
Cataract is the leading cause of blindness in the world, and is particularly common in low-income countries. Cataract is asserted to increase poverty through reduced productivity; however there is a lack of empirical data supporting this claim. The aim of this study was to examine the relationship between visual impairment from cataract with time-use in adults (aged >or= 50 years) in Kenya, Bangladesh, and The Philippines.
A population-based case-control study was conducted in three countries. Detailed time-use data were collected through interview from 139, 216 and 238 cases with visually impairing cataract and 124, 280 and 163 controls with normal vision in Kenya, Bangladesh and Philippines, respectively during 2005-2006.
Cases were substantially less likely than controls to participate in productive activities, including paid work and non-market activities (odds ratio [OR] across three countries is 0.2 95% confidence interval (CI): 0.1-0.3) and in leisure outside of the household (OR 0.7, 95% CI: 0.5, 0.9). Among cases, those with more severe visual impairment spent significantly less time on productive activities and leisure outside of the home, and more time on "no particular activity" (Kenya and Bangladesh) or leisure in the home (The Philippines). Cases were substantially more likely to require assistance in any activity than controls in Kenya (OR 9.8, 95% CI: 3.3, 29.8), Bangladesh (OR 8.6, 95% CI: 5.1-14.4) and the Philippines (OR 2.7, 95% CI: 1.4-5.1).
Cataract visual impairment restricts engagement in productive and leisure activities in this population of older adults in three different low income settings.
白内障是全球失明的主要原因，在低收入国家尤为常见。有人认为白内障会因生产力下降而加剧贫困；然而，缺乏实证数据支持这一说法。本研究的目的是在肯尼亚、孟加拉国和菲律宾，调查50岁及以上成年人白内障所致视力损害与时间利用之间的关系。
在三个国家开展了一项基于人群的病例对照研究。2005年至2006年期间，分别从肯尼亚、孟加拉国和菲律宾139216例和238例视力受损白内障患者以及124280例和163例视力正常对照者中，通过访谈收集了详细的时间利用数据。
病例参与生产活动（包括有偿工作和非市场活动）（三个国家的优势比[OR]为0.2，95%置信区间[CI]：0.1 - 0.3）以及家庭外休闲活动的可能性显著低于对照者（OR 0.7，95% CI：0.5，0.9）。在病例中，视力损害更严重的患者在生产活动和家庭外休闲活动上花费的时间显著减少，而在“无特定活动”（肯尼亚和孟加拉国）或家庭内休闲活动（菲律宾）上花费的时间更多。在肯尼亚（OR 9.8，95% CI：3.3，29.8）、孟加拉国（OR 8.6，95% CI：5.1 - 14.4）和菲律宾（OR 2.7，95% CI：1.4 - 5.1），病例在任何活动中需要帮助的可能性都显著高于对照者。
在三种不同的低收入环境中，白内障所致视力损害限制了这一老年人群体参与生产和休闲活动。
