Muhit Mohammad A, Shah Shaheen P, Gilbert Clare E, Hartley Sally D, Foster Allen
International Centre for Eye Health, Clinical Research Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1 7HT. UK.
Br J Ophthalmol. 2007 Aug;91(8):995-9. doi: 10.1136/bjo.2006.108027. Epub 2007 Apr 12.
Most information on the causes of blindness has come from examining children in special education. To obtain a more representative population-based sample of children, a novel method was developed for ascertaining severe visually impaired (SVI) or blind (BL) children by training local volunteers to act as key informants (KIs).
To compare the demography and cause of blindness in children recruited by KIs with other ascertainment methods.
Children with SVI/BL were recruited in all 64 districts of Bangladesh. Three sources for case ascertainment were utilised: schools for the blind (SpEdu), community-based rehabilitation (CBR) programmes and KIs. All data were recorded using the standard WHO/PBL Eye Examination Record.
1935 children were recruited. Approximately 800 KIs were trained. The majority of the children were recruited by the KIs (64.3%). Children recruited by KIs were more likely to be female (odds ratio (OR) 1.6, p<0.001), of pre-school age (OR 14.1, p<0.001), from rural areas (OR 5.9, p<0.001), be multiply impaired (OR 3.1, p = 0.005) and be suffering from treatable eye diseases (OR 1.3, p = 0.005) when compared with those in SpEdu. Overall a child with an avoidable causes of SVI/BL had 40% (adjusted CI 1.1 to 1.7, p = 0.015) and 30% (CI 1.0 to 1.7, p = 0.033) higher odds of being ascertained using the KIs compared with SpEdu and CBR methods, respectively.
Using this innovative approach has resulted in one of the largest studies of SVI/BL children to date. The findings indicate that KIs can recruit large numbers of children quickly, and that the children they recruit are more likely to be representative of all blind children in the community.
关于失明原因的大多数信息来自对特殊教育中的儿童进行检查。为了获得更具代表性的基于人群的儿童样本，开发了一种新方法，通过培训当地志愿者作为关键信息提供者（KIs）来确定严重视力障碍（SVI）或失明（BL）儿童。
比较由关键信息提供者招募的儿童与其他确定方法中儿童的人口统计学特征和失明原因。
在孟加拉国的所有64个地区招募SVI/BL儿童。利用了三种病例确定来源：盲人学校（SpEdu）、社区康复（CBR）项目和关键信息提供者。所有数据均使用标准的WHO/PBL眼科检查记录进行记录。
共招募了1935名儿童。大约800名关键信息提供者接受了培训。大多数儿童是由关键信息提供者招募的（64.3%）。与SpEdu中的儿童相比，由关键信息提供者招募的儿童更可能为女性（优势比（OR）1.6，p<0.001）、学龄前儿童（OR 14.1，p<0.001）、来自农村地区（OR 5.9，p<0.001）、有多种障碍（OR 3.1，p = 0.005）且患有可治疗的眼病（OR 1.3，p = 0.005）。总体而言，与SpEdu和CBR方法相比，因可避免原因导致SVI/BL的儿童通过关键信息提供者确定的几率分别高40%（调整后的CI 1.1至1.7，p = 0.015）和30%（CI 1.0至1.7，p = 0.033）。
使用这种创新方法已促成了迄今为止关于SVI/BL儿童的最大规模研究之一。研究结果表明，关键信息提供者可以快速招募大量儿童，并且他们招募的儿童更有可能代表社区中所有失明儿童。
