Trend analysis of the burden of cataract in Small Island Developing States (SIDS) in the Caribbean from 1990 to 2016

ABSTRACT

Objective: To study the trends in the burden of cataract in SIDS in the Caribbean using disability-adjusted life-years (DALYs). Design and Methodology: National and regional age and sex specific cataract DALY numbers, crude DALY rates, and agestandardised DALY rates from 1990 to 2016 for the SIDS in the Caribbean, were extracted from the Global Burden of Disease Study 2016. The human development index, healthcare access and quality (HAQ) index, and the World Bank's classification of economies were used as indicators of socioeconomic status. The Gini coefficient, Atkinson, Theil and concentration indices were used to measure health inequality. Paired Wilcoxon signed rank test, Pearson correlation, and linear regression analyses were performed to evaluate the sociodemographic and socioeconomic factors associated with differences in cataract burden. Results: Men had higher age-standardised DALY rates than women (P < 0.001) with median rates of 90.72 (Interquartile range [IQR], 87.8-94.2) and 83.94 (IQR, 80.9-86.5), respectively. The burden of cataract increased with age. Upper-middle income countries had higher age-standardised DALY rates than high income countries (P < 0.001), with median rates of 90.1 (IQR, 86.8 ­ 93.4) and 79.8 (IQR, 77.5 ­ 81.8), respectively. Age-standardised DALY rates were inversely correlated with both HDI (r = -0.61, ) and HAQ ( ). Between-country inequality was negligible and the burden of cataract is greater among the poor. Conclusions: This study confirmed the trends seen at the global level, except for the finding of men having a higher cataract burden than women in SIDS in the Caribbean. This is an area for further research.