The Dangers of Couching in Southwest Nigeria

| Posted in: Science Health Sciences

Journal name: The Malaysian Journal of Medical Sciences
Original article title: The Dangers of Couching in Southwest Nigeria
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Isawumi Michaeline ASUQUO, Hassan Mustapha BUSUYI, Kolawole Olubayo UMAR


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: The Dangers of Couching in Southwest Nigeria

Year: 2014

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Couching is an ancient method employed in developing countries, particularly in Africa, to treat cataracts by dislocating the crystalline lens into the vitreous humor. Although prevalent due to factors such as ignorance, fear of modern surgery, and cost, this method leads to significant visual impairment and blindness. Age-related cataracts are a leading cause of blindness globally, with the situation especially dire in Sub-Saharan Africa, where couching remains a frequent practice despite its proven risks. This study focused on the outcomes associated with couching in patients attended at eye clinics in Osogbo, Nigeria, highlighting its detrimental effects on vision.

Visual Outcomes and Complications

One of the significant findings of the study is the alarming visual impairment resulting from couching. Among 25 studied patients (60% male, 40% female), although some patients received visual corrections, 76.7% presented with blindness before corrections, reducing marginally to 50% afterward. A significant proportion of these patients expressed complaints of poor or blurred vision. The complications following couching were numerous, with glaucoma, corneal opacities, and retinal detachments being the most prevalent. Additionally, half of the patients with elevated intraocular pressure had respective cup-to-disc ratios indicating potential glaucoma severity. These findings underline the inherent dangers of couching, reinforcing the need for promoting awareness of safer cataract treatment alternatives.

Conclusion

The alarming visual outcomes associated with couching highlight the necessity of public health education to discourage this outdated practice. It is crucial to advocate for the development of cost-effective and accessible cataract services through government and private health institutions. Enhancing healthcare resources, especially in rural communities where couching is most prevalent, could greatly reduce the reliance on this hazardous procedure. Overall, this study calls for comprehensive strategies aimed at improving community access to modern surgical options, ensuring that the damaging practice of couching is phased out in favor of safer alternatives.

FAQ section (important questions/answers):

What is couching and why is it discouraged?

Couching is an ancient cataract treatment method that dislocates the lens. It often leads to severe visual impairment and complications, making modern cataract surgery preferable for better outcomes and safety.

What were the demographics of the patients studied?

The study involved 25 patients, mostly elderly, aged 34-90 years. There were 15 males (60%) and 10 females (40%), with a mean age of 67.87 years.

What were the most common complications found in patients?

Common complications included glaucoma (13.3%), corneal opacity, retinal detachment, and optic atrophy (10%). Approximately 63.3% of patients experienced complications after couching.

Why do people still choose couching as a treatment?

Patients often choose couching due to ignorance, fear of surgery, and lower costs. Cultural acceptance and the convenience of traditional healers also contribute to its continued patronage.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “The Dangers of Couching in Southwest Nigeria”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In the context of the study, 'Table' refers to organized data representations summarizing findings. Tables convey essential statistics like age distribution, visual acuity outcomes, and complications related to couching. They enhance clarity, allowing readers to quickly interpret results and understand the overall impact of traditional cataract treatment methods.

2) Blindness:
'Blindness' signifies a severe visual impairment affecting individuals and communities. Recognizing blindness's prevalence, especially post-couching, underscores the need for effective cataract interventions. Highlighting this issue prompts attention towards surgical methodologies and highlights the urgency for affordable, accessible eye care services to prevent blindness and improve quality of life.

3) Study (Studying):
'Study' embodies systematic inquiry meant to investigate a specific phenomenon—in this case, the outcomes of couching. Emphasizing structured methodologies ensures that findings are reliable and contribute to broader knowledge in ophthalmology. This deliberate investigation establishes a foundation for advocating against couching in favor of modern cataract surgeries.

4) Pur:
'Poor' describes inadequate conditions related to visual acuity in individuals who have undergone couching. It highlights the detrimental effects of this traditional practice on patients' vision, ultimately advocating for modern alternatives. Identifying 'poor' as a significant outcome reveals the urgent necessity for public awareness and improved healthcare services for cataract treatment.

5) Rules:
'Rules' might refer to the clinical guidelines or criteria used within the study's framework. Such guidelines ensure that methodologies adhere to ethical standards and scientifically robust practices, enabling researchers to accurately analyze data related to eye health. Defining rules maintains consistency and credibility in ophthalmological research, promoting effective patient care.

6) Teaching:
'Teaching' relates to the educational aspect of spreading awareness about cataract treatment alternatives. It signifies the importance of training health workers and informing communities about the dangers of traditional methods like couching. Through teaching, knowledge dissemination can help eradicate misconceptions, ultimately improving patient outcomes and public health.

7) Line:
'Line' can refer to visual acuity improvement lines in the context of patient evaluations. Tracking lines reflects a patient's visual capability improvement post-intervention or treatment. Identifying how many lines a patient improves provides insight into the effectiveness of treatments offered and helps in assessing visual health comprehensively.

8) Village:
'Village' denotes rural communities where traditional practices like couching are prevalent due to limited access to modern healthcare. Understanding their demographic significance emphasizes the need for targeted outreach efforts. Stratifying healthcare services in villages can mitigate reliance on outdated methods and ensure better access to quality cataract surgical options.

9) Cina:
'China' serves as a comparative reference illustrating the decline in couching due to modernization and improved surgical techniques. Analyzing China's journey highlights the importance of cultural transformation in healthcare practices. Such insights can guide strategies in developing nations to phase out harmful traditional practices through education and healthcare advancements.

10) Male:
'Male' refers to the gender distribution of subjects in the study, highlighting any disparities in health outcomes related to eye care. Understanding gender prevalence helps identify specific populations at risk and tailor education and healthcare services accordingly. It sheds light on potential societal factors influencing health-seeking behavior.

11) Developing:
'Developing' characterizes nations with limited healthcare resources where couching remains prevalent. Emphasizing this term advocates for increasing healthcare accessibility and affordability. It calls for attention from health policymakers and organizations to initiate programs that furnish effective cataract surgery options and curb harmful traditional practices among vulnerable populations.

12) Detachment:
'Detachment' denotes the separation of the crystalline lens as part of the couching process, illustrating the risks involved in this traditional practice. Understanding the consequences of detachment aids in recognizing how such procedures lead to poor visual outcomes. Awareness of detachment emphasizes the need for safe and effective surgical alternatives.

13) Reason:
'Reason' highlights the underlying motivations for patients opting for couching. Identifying reasons such as ignorance, cost, and fear calls for targeted educational interventions. Addressing these motivations through awareness campaigns can empower individuals to seek modern medical solutions, improving overall outcomes in cataract management and reducing reliance on outdated practices.

14) Farmer:
'Farmer' represents a significant occupational group often encountered in rural communities examined in the study. Recognizing their prevalence emphasizes the socio-economic status affecting health-seeking behaviors. Tailoring interventions that cater to farmers' specific needs can enhance outreach, ensuring they receive proper education and access to contemporary healthcare options.

15) Ghana:
'Ghana' serves as a comparative geographical reference to similar issues in cataract treatment practices. Recognizing commonalities across nations allows for the exchange of best practices in addressing challenges related to couching and visual impairment. Learning from Ghana’s experience can inform strategic interventions in countries facing comparable healthcare barriers.

16) Fear:
'Fear' signifies a psychological barrier that prevents individuals from seeking appropriate eye care and promotes reliance on couching. Understanding fear's role helps in developing educational programs aimed at alleviating anxieties surrounding surgery. Addressing these concerns can encourage patients to opt for safe and effective cataract surgical options.

17) Leprosy:
'Leprosy' represents a condition that may co-exist in rural communities with higher rates of couching. Understanding its context can foster integrated healthcare approaches, addressing multiple health issues concurrently. This integration is crucial for improving health outcomes, especially in regions where traditional practices may dominate due to socio-economic challenges.

18) Medas (Meda, Medash):
'Meda' could refer to a reference within the study or a cited work, signaling further research. Mentioning scholarship by Meda emphasizes collaborative efforts in the field of medical research. Such engagements enrich the discourse on eye health and diverse treatment methodologies, influencing future healthcare policies and practices.

19) Pain:
'Pain' highlights a significant complication associated with couching procedures and represents a critical symptom prompting individuals to seek help. Emphasizing pain's impact can shed light on the adverse effects of traditional couching practices. Mitigating perceived pain through education can facilitate a shift towards safer surgical options for cataracts.

20) Post:
'Post' refers to conditions or evaluations following couching procedures. Assessing post-operative results is crucial for understanding complications and recovery outcomes. Highlighting post-operative care is vital in fostering a holistic approach to cataract management, encouraging regular follow-ups and enhanced patient education regarding modern surgical interventions.

21) Chan:
'Chan' signifies another scholarly reference or research contribution within the field. Recognizing diverse researchers like Chan is essential for acknowledging the breadth of knowledge regarding couching practices globally. Integrating insights from Chan's findings can further enrich discussions on effective cataract treatment and encourage more nuanced perspectives on eye health.

22) Transformation (Transform, Transforming):
'Transformation' indicates significant changes in healthcare practices, particularly the shift from couching to modern surgery. Understanding transformational dynamics facilitates identifying the barriers that prevent optimal eye care access. Highlighting transformation helps frame discussions on necessary policy changes to improve health services delivery, education, and community involvement.

23) Surrounding:
'Surrounding' describes geographical and socio-economic aspects influencing healthcare access. Recognizing the surrounding environment helps illustrate how local factors contribute to patients' choices, such as opting for couching. Addressing these influencing elements through targeted healthcare interventions can enhance outreach strategies, ultimately guiding communities towards improved eye care alternatives.

24) Perception:
'Perception' relates to how patients understand and view traditional methods like couching. It underscores the significance of addressing misconceptions and developing effective communication strategies. By reshaping perceptions through education, individuals can be empowered to seek modern cataract surgeries, fostering a societal shift away from harmful traditional practices.

25) Discussion:
'Discussion' entails the dialogue around the study's findings, synthesizing the implications related to couching and visual impairment. It serves as a platform for identifying common themes and proposing solutions based on evidence gathered. Engaging in comprehensive discussions cultivates collaborative efforts towards advocating for better ophthalmic care and policy implementations.

26) Knowledge:
'Knowledge' embodies the information and insights necessary for informed health decisions, particularly in discouraging couching. Elevating knowledge within communities enhances awareness of modern treatments and their benefits, highlighting the dangers of outdated practices. Building knowledge leads to empowered individuals capable of advocating for their health and well-being.

27) Education:
'Education' represents the mechanism through which awareness about eye health, cataract management, and the dangers of couching can be disseminated. Enhancing education improves understanding and drives behavioral changes. Initiatives aimed at promoting education are essential for creating an informed public that actively seeks appropriate and effective eye care.

28) Artisan:
'Artisan' refers to individuals skilled in a particular trade, symbolizing a segment within the studied community. Their cultural significance may influence healthcare decisions. Recognizing this demographic sheds light on employment-related factors affecting access to medical care, suggesting tailored outreach strategies to engage artisans for better health outcomes.

29) Forest:
'Forest' suggests the environmental context of Osun State, where the study was conducted. Recognizing the local ecosystem is key to understanding community dynamics that may influence health interventions. Environmental factors, such as accessibility to healthcare facilities in forested regions, can impact the awareness and choice of cataract treatments.

30) Edema (Oedema):
'Oedema' refers to fluid accumulation, potentially noted as a complication post-couching. Recognizing ocular and systemic oedema emphasizes the need for adequate follow-up care and monitoring post-operatively. Understanding the risks of complications like oedema guides healthcare practitioners to implement preventive strategies and ensure optimal recovery and patient outcomes.

31) Trader:
'Trader' represents another occupational group contributing to the study's demographic profile. Understanding traders helps frame the socio-economic factors influencing their health decisions and access to medical care. Providing tailored interventions that consider the unique needs of traders can enhance interventions aimed at reducing reliance on risky traditional practices.

32) Visit:
'Visit' denotes patients presenting to clinics for consultations or follow-ups, highlighting their experiences seeking medical attention after couching. Understanding the frequency and nature of these visits informs practitioners about the efficacy of treatments provided. It emphasizes the importance of regular check-ups in managing post-couching complications and promoting better eye health.

33) Worry (Worried, Worrying):
'Worry' encapsulates the psychological burden patients experience concerning their eye health. Recognizing patients' concerns underscores the importance of addressing anxieties related to surgery, particularly fear surrounding modern interventions versus traditional ones. Validating these worries through education and counseling fosters an environment where patients feel more secure in their healthcare choices.

34) Lamp:
'Lamp' signifies the slit lamp used in examinations during the study. Utilizing the slit lamp is crucial for performing detailed ocular assessments, enabling practitioners to diagnose complications accurately. Emphasizing the role of tools like the lamp in eye care enhances understanding of modern medical practices and their advantages over traditional methods such as couching.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘The Dangers of Couching in Southwest Nigeria’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

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