Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh.
CSF Global, Dhaka, Bangladesh.
Br J Ophthalmol. 2018 Nov;102(11):1543-1549. doi: 10.1136/bjophthalmol-2017-311416. Epub 2018 Feb 6.
The magnitude of blindness among children in Indonesia is unknown. In this study, we aimed to define the magnitude and aetiology of childhood blindness in two parts of Indonesia.
Children aged 0-15 years, identified through key informant method and from special schools and community-based rehabilitation programme in Sumba and Yogyakarta, were assessed following WHO protocol and definitions for ophthalmological assessment and classification of visual impairment and blindness among children.
Out of 195 children assessed, 113 had blindness/severe visual impairment (BL/SVI), 48 had visual impairment (VI) and 34 had no VI. 43.4% children with BL/SVI were female.The main anatomical site of BL/SVI was lens (n=35, 31.0%), followed by retina (n=13, 11.5%) and cornea (n=9, 8.0%). Among the known aetiologies, childhood factors predominated (n=14, 12.4%), followed by hereditary diseases (n=12, 10.6%) where parental consanguinity was found among 33.3% (n=4) of them. Overall, 77.8% (n=88) had avoidable causes of BL/SVI: 69.0% (n=78) treatable and 8.8% (n=10) preventable causes.The estimated prevalence of BL/SVI was 0.25 (95% CI 0.19 to 0.32) and 0.23 (95% CI 0.18 to 0.29) per 1000 children in Sumba and Yogyakarta, respectively. The estimated prevalence of cataract was 0.07 per 1000 children (95% CI 0.04 to 0.12) in Sumba and 0.05 per 1000 children (95% CI 0.03 to 0.09) in Yogyakarta. Based on our conservative estimates, there are 17 241 children with BL/SVI in Indonesia; 4270 are blind due to cataract.
The magnitude of childhood BL/SVI in Sumba and Yogyakarta is high. Our study suggests that a large proportion of childhood BL/SVI in Indonesia is avoidable.
印度尼西亚儿童失明的严重程度尚不清楚。本研究旨在通过两种方法，定义印度尼西亚两个地区儿童失明的严重程度和病因。
通过关键知情人方法以及在松巴哇和日惹的特殊学校和社区康复项目中发现的 0-15 岁儿童，按照世界卫生组织的协议和儿童视力损害和失明的眼科评估和分类定义进行评估。
在评估的 195 名儿童中，有 113 名患有失明/重度视力损害（BL/SVI），48 名患有视力损害（VI），34 名无 VI。43.4%的 BL/SVI 患儿为女性。BL/SVI 的主要解剖部位是晶状体（n=35，31.0%），其次是视网膜（n=13，11.5%）和角膜（n=9，8.0%）。在已知病因中，儿童因素占主导地位（n=14，12.4%），其次是遗传性疾病（n=12，10.6%），其中 33.3%（n=4）的父母有血缘关系。总体而言，77.8%（n=88）的 BL/SVI 有可避免的病因：69.0%（n=78）可治疗，8.8%（n=10）可预防。BL/SVI 的估计患病率为松巴哇和日惹每 1000 名儿童分别为 0.25（95%CI 0.19 至 0.32）和 0.23（95%CI 0.18 至 0.29）。在松巴哇，每 1000 名儿童白内障的估计患病率为 0.07（95%CI 0.04 至 0.12），在日惹为 0.05（95%CI 0.03 至 0.09）。根据我们的保守估计，印度尼西亚有 17241 名儿童患有 BL/SVI；4270 名儿童因白内障失明。
松巴哇和日惹儿童 BL/SVI 的严重程度很高。我们的研究表明，印度尼西亚很大一部分儿童 BL/SVI 是可以避免的。
