Ocular Status, Health Seeking Behaviours and Barriers to Uptake Eye Care Services among Children of Slum Community in Chittagong, Bangladesh

Abstract

Syed Mohammad Didarul Alam, Abul Hasnat Golam Quddus, Rajib Husain and Jewel Das Gupta

Purpose: The purpose of this study was to find out the ocular status, ocular health seeking behaviors and barriers to uptake eye care services among children of slum community in Chittagong, Bangladesh. Methods: The study was conducted in several urban slums in Chittagong city, which is home of slum children. A total of 410 children aged 5 to 16 years were clinically examined. Their accompanying guardians were also interviewed for collecting data about health seeking behaviors and identifying the barriers, if any, to uptake eye care services. Three focus group discussions were also held with guardians. Results: About 47.3% of the sampled children were male and 52.7% female. About 40% of the children had some complain where we found 36.6% having some ocular abnormalities. Among the respondents (n=410), related with ocular abnormalities (n=150), the diagnosed problems were; Refractive Error (26.7%), Allergic Conjunctivitis (21.3%), Blepharitis (16.0%), Squint (7.3%), Convergence Insufficiency (6.6%), Meibomian Gland Dysfunction (8.7%), Dacryocystitis (3.3%), Conjunctivitis (4.0%), Congenital Cataract (2.7%), Corneal scar 2.0%, Pseudophakia 2.0%, Xerophthalmia (1.3%). Infrequently Entropin, Ptosis, Corneal Opacities, Retrobulbar Neuritis, Retinal Detachment, Episcleritis, Scleritis, Microphthalmos, Ocular FB, Chalazion, Stye, Nystagmus and Proptosis were also present in limited percentage. However 25.70% were referred to tertiary eye care center, 39.60% were treated with medicine, 22.20% were given optical correction, and 25.70% were given general measure. Most of them (73%) never went to an eye care specialist. The main reasons assigned for not going to a doctor were: financial constraints (16.30%), didn’t feel necessary (33.70%), lack of escort (3.4%), lack of time (3.7%), traditional belief (0.3%) and not aware of hospital doctor (4.5%). The Guardians consider recent cost of treatment is very high. They want low cost treatment, provide free spectacle, increase more hospital facilities and hold free eye camps. Conclusion: This study found very high ocular morbidities among slum children, the vast majority of the guardians’ cannot afford medical treatment for lack of money, awareness, escort, time and indifference to eyes. Though adequate eye care facilities are available in Chittagong city compared to many other urban and rural areas in Bangladesh, most of the slum dwellers can’t take advantage of it for financial reason and lack of knowledge.

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