Kilimanjaro Centre for Community Ophthalmology, P.O. Box 2254, Moshi, Tanzania.
Int Health. 2012 Dec;4(4):303-6. doi: 10.1016/j.inhe.2012.08.001.
Although uncommon, childhood blindness is a major contributor to blind-person years in Africa. Children with vision-related problems need urgent referral, but existing evidence suggests that there is delay in presentation. A pilot study in a random selection of government dispensaries in two districts of Kilimanjaro Region, Tanzania, was conducted to assess the knowledge and skills of primary healthcare workers regarding eye care needs of children. Questionnaires were administered to 16 healthcare workers, and in-depth interviews were conducted with 9 health workers and 2 key informants. Overall, 88% of workers recognised cataract in a picture, 63% knew that it required surgery but only 50% realised surgery was urgent. Only 38% recognised squint as needing referral and none considered this urgent. Moreover, 38% could correctly suggest a cause of a large corneal scar and 44% of workers believed that children with albinism need to attend schools for the blind. Poor knowledge of referral and treatment guidelines are likely due to a number of factors, including inadequate training and the rarity of childhood blindness. Primary eye care manuals should be reviewed to ensure that information regarding childhood blindness is adequate and appropriate. Referral pathways should also be revised.
虽然不常见，但儿童失明是非洲致盲年数的主要原因之一。有视力问题的儿童需要紧急转诊，但现有证据表明，转诊存在延误。坦桑尼亚乞力马扎罗地区的两个区的政府药房中进行了一项试点研究，以评估初级保健工作者对儿童眼保健需求的知识和技能。向 16 名保健工作者发放了问卷，并对 9 名卫生工作者和 2 名主要信息提供者进行了深入访谈。总体而言，88%的工作人员能在图片中识别白内障，63%知道白内障需要手术，但只有 50%的人意识到手术是紧急的。只有 38%的人能识别斜视需要转诊，没有人认为斜视是紧急的。此外，38%的人能正确指出大角膜瘢痕的原因，44%的工作人员认为白化病儿童需要上盲人学校。转诊和治疗指南知识不足可能有多个原因，包括培训不足和儿童失明的罕见性。应审查初级眼保健手册，以确保有关儿童失明的信息足够且适当。还应修订转诊途径。
