Epidemioclinic Cataract in Children 0 to 15 Years: Case of the Saint Yvonne Ophthalmic Clinic in Lubumbashi / DRC
Mwamba Ngoy B1, Nday Banza Kalumba F1, Tambwe Ndumb H2, Woto
Ponde C3, Ngoie Maloba Viviane4, Chenge Borasisi G4
1Specialist doctor in ophthalmology, Sainte Yvonne
Ophthalmological Clinic
2Ophthalmologist and Head of the Faculty of Medicine at Unilu,
University Clinics of Lubumbashi
3Data manager Lubumbashi Health Zone, Bureau Central
4Ophthalmologist and Professor at the Faculty of Medicine at
Unilu, Lubumbashi University Clinics
*Corresponding author: Viviane Ngoie Maloba, Ophthalmologist
and Professor at the Faculty of Medicine at Unilu, Democratic Republic of the
Congo. Tel: +243 998248966. Email: vivianemaloba@yahoo.fr
Received Date: 21 May, 2019; Accepted
Date: 05 June, 2019; Published
Date: 12 June, 2019
Citation: Ngoy MB, Kalumba NBF, Ndumb
TH, Ponde WC, Maloba VN, et al. (2019) Epidemioclinic Cataract in Children 0 to 15 Years: Case of the Saint
Yvonne Ophthalmic Clinic in Lubumbashi / DRC. Ophthalmol Res Rep 4: 133. DOI:
10.29011/ORRT-133.100033
Introduction: Cataract is the opacification of the lens that can cause
reversible blindness or not. The purpose of this work was to describe the
epidemiological and clinical profile of cataract in children in the city of
Lubumbashi.
Method: This is a cross-sectional descriptive study with
retrospective data collection. Included in this study were the medical records
of patients aged 0 to 15 years old, having consulted at the St. Yvonne
Ophthalmology Clinic during the period from January 01, 2012 to December 31,
2016; and in whom the diagnosis of cataract was retained. The study variables
were: patient age, gender, origin, type of cataract, location of opacities,
laterality, time to view, compliance with treatment, and type of treatment.
Results: Of a total of 15696 medical records compiled, cataract was
diagnosed in 392 children, a prevalence of 2.5% of cases, making a total of 553
eyes with cataracts. The average age of patients was 6.4-4.5 years, with a male
predominance of 64.45%. Among them, 43.04% of patients were aged between 0 and
5 years. Cataract was congenital in 42.53% of eyes; she was traumatic in 26.47%
of eyes; infantile cataract was retained in 17.65% of eyes. The crystalline
opacities were either total or cortical or nuclear with respectively 54.45%,
28.68%, 7.07% of eyes. Cataract was bilateral in 57.1% of cases, 49, 55% of
right eyes and 50.45% of left eyes. In our series, the average consultation
time was 31.28 ± 30 months, non-compliance with treatment was observed in 13%
of patients and surgical treatment was performed in 75% of eyes.
Conclusion: This study revealed that the cataract of the child is a
real visual health problem, in the city of Lubumbashi, requiring a good
awareness campaign of the parents, an early diagnosis and an adequate
management in order to avoid the occurrence of low vision and blindness.
Keywords: Epidemiology; Cataract; Child
1. Introduction
Cataract is an eye condition caused by the presence of opacity
in the lens, normally transparent. The latter is used for the development of
images on the retina from which the presence of opacities within it is
responsible for visual disorders, low vision and blindness [1]. The hypotheses
implicated in the pathogenesis of opacification are either protein denaturation
or an alteration of the fibers, or even a superior migration of epithelial
cells [2]. In children, the authors evoke genetic predisposition, embryopathies,
trauma, and endo-ocular diseases greatly influence its development [3].
Cataract is manifested by leucocoria, photophobia, visual
disturbances in older children, or strabismus or nystagmus. It is confirmed by
a specialized examination after dilation of the pupil, with the flashlight but
better with the slit lamp not to be confused with retinoblastoma, a retinal
detachment or a Coats disease [4,5].
The early diagnosis and the complete and timely management by a
surgical intervention makes it possible to prevent the occurrence of an
amblyopia Mergier [6]. In some cases, optical treatment and orthoptic
monitoring are often recommended to ensure visual recovery for the child [7,8].
In Africa, an estimated 20 to 100 children with cataracts per million
populations per year [9]. In our community, no work has been done on this
subject and our study aims to reveal the epidemiological and clinical aspects
of cataract of the child aged 0 to 15 in the city of Lubumbashi
2. Method
This study was conducted in Lubumbashi (DR Congo) at the Saint
Yvonne ophthalmic clinic. This is a cross-sectional descriptive study with
retrospective collection of data from patients consulted during the period from
01 January 2012 to 31 December 2016, i.e., a period of 5 years. Our study
population consisted of children aged 0 to 15 years, we compiled the medical
records of 15696 children of whom 392 were included according to the following
criteria: The presence of cataract, being 0 to 15 years old and having
consulted during the period of our study. Of the selected group 51 of them did
not consent to the proposed treatment. To collect the data, we used the
following variables: age, gender, provenance, complaints, consultation time,
types of cataracts, location of opacities, treatment received. The result
analysis was done using the Excel 2007 and Epi Info 7 software. The results
were presented as text, figure and table. We used the usual statistical tests
for the interpretation of the results, it is the percentage, the sex ratio, the
average and the standard deviation, the median and the mode (Table 1).
3. Results
The Figure 1 below shows a prevalence of cataract of 2.5% (392
children) out of a total of 15696 children (100%).
The Table 3 shows that 28.57% of the patients came from the outlying
commune, 16.84% from the Katuba commune and 1.53% from the Kamalondo commune.
Taking into account the consultation period, the average consultation time was
31.28 ± 30 months.
From this chart, 57.40% of patients with no reported history
were identified; 29.34% had a history of trauma; 10.20% had a history of
previous surgery (Table 4).
The Table 5 above shows that the cataract was unilateral in
40.86% of cases including 22.06% on the right side and 20.80% on the left side.
Bilateral cataract was present in 57.14% of cases. The predominance was
masculine, 64.45% of the cases.
With respect to this table, total opacities were present in
53.9% of cataracts, followed by cortical opacities in 28.2% of cataracts and
nuclear was the least numerous in 7.1% of cataracts.
This Table 6 shows that 86.22% of the patients were operated on,
9.97% received medical treatment and only 3.81% of the patients had no
treatment.
4. Discussion
Figure 1 has shown that the frequency of cataract is 2.5% this
figure is close to that of observed in the world in general. Gyawali went to
him to find 19.7% in Eritrea the probability that a weak sample could explain
this difference in numbers [10,11].
From Table 1, 44.64% of the patients were aged 0 to 5 years’ old
this could be related to the fact that the little boys are more turbulent than
the girls the average age in our study was 6.7 years with a male predominance.
This is similar to the Randrianotahina HC study in Madagascar, which found an
average age of 6.9 years [12]. Gogate and All found him 3 years old [13] Umar
in Nigeria 6.88 years, Umar [14] and Kinori in Ethiopia found him 8.6 years
Kinori [15]. However, Gilbert CE has found a male predominance of 36.5% girl,
Gogate R [13] 52% male this male predominance may be due to the privilege of
boys compared to girls in developing countries [16].
The analysis of Table 2 in the distribution of patients
according to their origin and the consultation period showed that the adjoining
commune which surrounds the whole city was the one from which the patients came
from at 28.57%, followed by the one in Katuba where the hospital is located at
16.84% the average consultation time was 31 months. We attribute this delay of
consultation to the organization of the sanitary system of the place that has
not yet integrated ophthalmology into the primary health care or the patients
closest to the health facility are those which directs the most and those
located in the remote areas of the hospital are the many fewer come later [16].
Table 4 shows the distribution of the patients according to the
antecedents to 57.4% of the patients is reported no antecedent is 81.2% of the
non-traumatic cataract. This result confirms the literature that says that the
mechanism of cataract development is still poorly understood and that the
influence of maternal infection during pregnancy is the most known factor until
now, but represents only a small percentage (0.25%) in the occurrence of
cataract in children [4].
From Table 5 unilateral cataracts were present on the right at
about 51% of unilateral cataracts. This figure is similar to that of Umar in
Nigeria who found 52.5% of his eyes right [14].
Table 6 analysis to show that the type of congenital cataracts
dominated at 43.04% followed by traumatic cataract at 20.8% Umar in Nigeria to
find 62% of congenital cataract and SAA found 12% of traumatic cataract. The
location of the opacities was total in 53.9% of cataract it means that the
consultation is late [14,17].
In view of table, the surgical management of patients was 75% or
86.99% of compliant patients and Umar in Nigeria observed 84.3% of those who
showed that the obstacle due to belief not yet fully lifted [14,18].
5. Conclusion
At the end of our work, we remember that cataract in children is
a real visual health problem in the city of Lubumbashi. It requires a good
awareness campaign of parents, early diagnosis and adequate care to avoid the
occurrence of low vision and blindness.
Figure 1: Prevalence of cataracts.
Age groups
(years) |
Numbers |
% |
0-5 |
175 |
44.64 |
6-10 |
119 |
30.36 |
11-15 |
98 |
25.00 |
Total |
392 |
100.00 |
Table 1. Distribution of patients by age.
Consultation time |
||||||||||
Commune of Origin |
0-60 month |
% |
61-120 month |
% |
121-180 month |
% |
Unknown |
% |
Total |
% |
Annex |
81 |
20.66 |
12 |
3.06 |
0 |
0.00 |
19 |
4.85 |
112 |
28.57 |
Kampemba |
30 |
7.65 |
5 |
1.28 |
3 |
0.77 |
4 |
1.02 |
42 |
10.71 |
Katuba |
53 |
13.52 |
6 |
1.53 |
0 |
0.00 |
7 |
1.79 |
66 |
16.84 |
Cameldo |
4 |
1.02 |
0 |
0.00 |
1 |
0.26 |
1 |
0.26 |
6 |
5.61 |
Kenya |
20 |
5.10 |
0 |
0.00 |
0 |
0.00 |
2 |
0.51 |
22 |
5.61 |
Lubumbashi |
36 |
9.18 |
6 |
1.53 |
4 |
1.02 |
11 |
2.81 |
57 |
14.54 |
Soar |
23 |
5.87 |
3 |
0.77 |
1 |
0.26 |
5 |
1.28 |
32 |
8.16 |
Other |
43 |
10.97 |
6 |
1.53 |
1 |
0.26 |
5 |
1.28 |
55 |
10.03 |
Total |
290 |
73.98 |
38 |
9.69 |
10 |
2.55 |
54 |
13.78 |
392 |
100.00 |
Table 2: Distribution of patients by source and consultation
time.
antecedents |
Effective |
% |
No |
225 |
57.40 |
Growth retardation |
3 |
0.77 |
Rubella |
3 |
0.77 |
Infections during pregnancy |
1 |
0.25 |
microphthalmos |
2 |
0.51 |
Glaucoma |
1 |
0.25 |
Polymalformative Syndrome |
1 |
0.25 |
Trauma |
115 |
29.34 |
Previous surgery |
40 |
10.20 |
Marfan Syndrome |
1 |
0.25 |
Total |
392 |
100.00 |
Table 3: Patient Distribution by History.
Laterality |
Sex |
Total |
|||||
Male |
FeMale |
||||||
Effective |
% |
Effective |
% |
Effective |
% |
||
OD |
88 |
15.91 |
34 |
6.15 |
122 |
22.06 |
|
OG |
71 |
12.84 |
44 |
7.96 |
115 |
20.80 |
|
ODG |
96 |
17.36 |
62 |
11.21 |
316 |
57.14 |
|
Total |
351 |
46.11 |
202 |
25.32 |
553 |
100.00 |
Table 4: Distribution of patients according to the laterality
and sex.
|
Location of Opacities |
|
||||
Cataract |
Total |
capsular |
cortical |
Nuclear |
Total |
% |
Congenital |
128 |
6 |
74 |
30 |
238 |
43.04 |
Traumatic |
96 |
1 |
18 |
0 |
115 |
20.80 |
Infantile |
52 |
5 |
45 |
9 |
111 |
20.61 |
Complicated |
22 |
5 |
19 |
0 |
46 |
8.32 |
Secondary |
0 |
43 |
0 |
0 |
43 |
7.23 |
Total |
298 (53.9%) |
60 (10.8%) |
156 (28.2%) |
39 (7.1%) |
553 (100.0%) |
100.00 |
Table 5: Distribution of patients according to opacities
according to the type of cataract.
Effective |
Support |
% |
Refusal |
51 |
13.01 |
medical |
34 |
8.67 |
expectation |
13 |
3.32 |
surgical |
294 |
75.00 |
Total |
392 |
100.00 |
Table 6: Distribution of patients according to care.
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