孟加拉国儿童严重视力损害和失明的原因：对1935名儿童的研究
Causes of severe visual impairment and blindness in Bangladesh: a study of 1935 children.
作者信息
Muhit M A, Shah S P, Gilbert C E, Foster A
机构信息
International Centre for Eye Health, Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
出版信息
Br J Ophthalmol. 2007 Aug;91(8):1000-4. doi: 10.1136/bjo.2006.108019. Epub 2007 Mar 14.
OBJECTIVE
To identify the anatomical site and underlying aetiology of severe visual impairment and blindness (SVI/BL) in children in Bangladesh.
DESIGN
A national case series.
METHODS
Children were recruited from all 64 districts in Bangladesh through multiple sources. Causes were determined and categorised using standard World Health Organization methods.
RESULTS
1935 SVI/BL children were recruited. The median age was 132 months, and boys accounted for 63.1% of the sample. The main site of abnormality was lens (32.5%), mainly unoperated cataract, followed by corneal pathology (26.6%) and disorders of the whole eye (13.1%). Lens-related blindness was the leading cause in boys (37.0%) compared with corneal blindness in girls (29.8%). In 593 children, visual loss was due to childhood factors, over 75% being attributed to vitamin A deficiency. Overall 1338 children (69.2%) had avoidable causes. Only 2% of the country's estimated SVI/BL children have access to education and rehabilitation services.
CONCLUSIONS
This is the first large-scale study of SVI/BL children in Bangladesh over two-thirds of whom had avoidable causes. Strategies for control are discussed.
目的
确定孟加拉国儿童严重视力损害和失明（SVI/BL）的解剖部位及潜在病因。
设计
全国性病例系列研究。
方法
通过多种途径从孟加拉国所有64个地区招募儿童。采用世界卫生组织标准方法确定病因并进行分类。
结果
共招募了1935名SVI/BL儿童。中位年龄为132个月，样本中男孩占63.1%。主要异常部位是晶状体（32.5%），主要为未手术治疗的白内障，其次是角膜病变（26.6%）和全眼球疾病（13.1%）。与女孩的角膜性失明（29.8%）相比，晶状体相关性失明是男孩失明的主要原因（37.0%）。在593名儿童中，视力丧失是由儿童期因素导致的，超过75%归因于维生素A缺乏。总体而言，1338名儿童（69.2%）的视力损害有可避免的病因。该国估计的SVI/BL儿童中只有2%能够获得教育和康复服务。
结论
这是孟加拉国首次针对SVI/BL儿童开展的大规模研究，超过三分之二的儿童有可避免的病因。文中讨论了控制策略。
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