Jimma University Specialized Hospital, PO Box 1761, Jimma, Ethiopia.
Trans R Soc Trop Med Hyg. 2011 Sep;105(9):507-11. doi: 10.1016/j.trstmh.2011.04.007. Epub 2011 May 31.
There are very few population-based data on childhood blindness in the Horn of Africa. In Sekoru district, Ethiopia, we performed a whole-of-population cross-sectional survey using the key informant method to determine the magnitude and causes of childhood blindness (presenting visual acuity <3/60 in the better eye) and severe visual impairment (SVI; presenting visual acuity <6/60 but ≥3/60 in the better eye). Forty-two key informants were trained to identify blind/SVI children aged <16 years. Identified children were examined by an ophthalmologist. Causes of blindness/SVI were established by clinical examination. Key informants visited 94% of 22,666 households, identifying 112 children, of whom 36 (32%) were confirmed to be blind/SVI by the ophthalmologist. Twenty (56%) of the 36 were male. The mean age was 10.7 years. The district prevalence of childhood blindness/SVI was 0.062% (95% CI 0.042-0.082%). Lens-related abnormalities (mainly congenital cataract) were the commonest causes. Avoidable causes of blindness accounted for 89% of cases. Paediatric ophthalmic services are required here, as elsewhere in rural Ethiopia. Assessment by key informants has an acceptable positive predictive value in this setting. This method warrants further evaluation as a tool for measuring the prevalence of other rare conditions in rural and remote populations.
在非洲之角，几乎没有关于儿童失明的基于人群的数据。在埃塞俄比亚的 Sekoru 区，我们使用关键知情人方法进行了一项全人群横断面调查，以确定儿童失明（较好眼视力 <3/60）和重度视力障碍（SVI；较好眼视力 <6/60 但≥3/60）的严重程度和原因。42 名关键知情人接受了培训，以识别年龄<16 岁的盲/SVI 儿童。经眼科医生检查，确定了盲/SVI 儿童。通过临床检查确定失明/SVI 的原因。关键知情人访问了 22666 户家庭中的 94%，发现了 112 名儿童，其中 36 名（32%）经眼科医生确诊为盲/SVI。36 名中的 20 名（56%）为男性。该地区儿童失明/SVI 的患病率为 0.062%（95%CI 0.042-0.082%）。晶状体相关异常（主要是先天性白内障）是最常见的原因。可避免的失明原因占 89%。这里需要儿科眼科服务，就像在埃塞俄比亚农村的其他地方一样。在这种情况下，关键知情人的评估具有可接受的阳性预测值。该方法值得进一步评估，作为衡量农村和偏远地区其他罕见疾病患病率的工具。
