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The status of childhood blindness and functional low vision in the Eastern Mediterranean region in 2012.

Khandekar R, Kishore H, Mansu RM, Awan H - Middle East Afr J Ophthalmol (2014 Oct-Dec)

Bottom Line: The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region.An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed.To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children.

View Article: PubMed Central - PubMed

Affiliation: Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia.

ABSTRACT
Childhood blindness and visual impairment (CBVI) are major disabilities that compromise the normal development of children. Health resources and practices to prevent CBVI are suboptimal in most countries in the Eastern Mediterranean Region (EMR). We reviewed the magnitude and the etiologies of childhood visual disabilities based on the estimates using socioeconomic proxy indicators such as gross domestic product (GDP) per capita and <5-year mortality rates. The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region. The current study determined the rates of bilateral blindness (defined as  Best corrected visual acuity(BCVA)) less than 3/60 in the better eye or a visual field of 10° surrounding central fixation) and functional low vision (FLV) (visual impairment for which no treatment or refractive correction can improve the vision up to >6/18 in a better eye) in children <15 years old. We used the 2011 population projections, <5-year mortality rates and GDP per capita of 23 countries (collectively grouped as EMR). Based on the GDP, we divided the countries into three groups; high, middle- and low-income nations. By applying the bilateral blindness and FLV rates to high, middle- and low-income countries from the global literature to the population of children <15 years, we estimated that there could be 238,500 children with bilateral blindness (rate 1.2/1,000) in the region. In addition, there could be approximately 417,725 children with FLV (rate of 2.1/1,000) in the region. The causes of visual disability in the three groups are also discussed based on the available data. As our estimates are based on hospital and blind school studies in the past, they could have serious limitations for projecting the present magnitude and causes of visual disabilities in children of EMR. An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed. The objectives, strategies, and operating procedures for child eye-care are presented. Variables impacting proper screening are discussed. To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children.

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Gross domestic product in US$ and <5 mortality per 1000 live births in member countries of Eastern Mediterranean Region of the World Health Organization
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Figure 1: Gross domestic product in US$ and <5 mortality per 1000 live births in member countries of Eastern Mediterranean Region of the World Health Organization

Mentions: As an example, gross domestic product (GDP) per capita and mortality rates of children < 5-year of age have been shown to be reliable proxy indicators to determine the magnitude of childhood blindness.11 These are reliable indicators due to the intimate relationship between some causes of blindness (measles, Vitamin A deficiency, ophthalmia neonatorum, rubella, etc.) and diseases with high morbidity and mortality in developing countries. Developing countries have a low level of socioeconomic development and suboptimal health resources to prevent or treat these conditions. To estimate the number of children with bilateral blindness in each EMR country on basis of socioeconomic indices such as GDP and under 5-year of age mortality rate, we grouped the 23 EMR countries into 3 categories using the data from the 2011 annual report of the Regional Director of WHO EMR.12 Countries with GDP over US$15,000 were classified as Group 1, countries with GDP of US$1,500-US$15,000 were classified in Group 2 and countries with GDP < US$1,500 were classified in Group 3. We also grouped the countries into three sets based on the childhood mortality rates of under 5-year of age: Set 1 included children with a mortality rate of < 20/1,000 live births; Set 2 with a mortality rate between 20 and 50/1,000 live births and; Set 3 countries with a mortality rate > 50/1,000 live births [Figure 1]. We determined that this classification coincided well with the GDP grouping of countries.


The status of childhood blindness and functional low vision in the Eastern Mediterranean region in 2012.

Khandekar R, Kishore H, Mansu RM, Awan H - Middle East Afr J Ophthalmol (2014 Oct-Dec)

Gross domestic product in US$ and <5 mortality per 1000 live births in member countries of Eastern Mediterranean Region of the World Health Organization
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219227&req=5

Figure 1: Gross domestic product in US$ and <5 mortality per 1000 live births in member countries of Eastern Mediterranean Region of the World Health Organization
Mentions: As an example, gross domestic product (GDP) per capita and mortality rates of children < 5-year of age have been shown to be reliable proxy indicators to determine the magnitude of childhood blindness.11 These are reliable indicators due to the intimate relationship between some causes of blindness (measles, Vitamin A deficiency, ophthalmia neonatorum, rubella, etc.) and diseases with high morbidity and mortality in developing countries. Developing countries have a low level of socioeconomic development and suboptimal health resources to prevent or treat these conditions. To estimate the number of children with bilateral blindness in each EMR country on basis of socioeconomic indices such as GDP and under 5-year of age mortality rate, we grouped the 23 EMR countries into 3 categories using the data from the 2011 annual report of the Regional Director of WHO EMR.12 Countries with GDP over US$15,000 were classified as Group 1, countries with GDP of US$1,500-US$15,000 were classified in Group 2 and countries with GDP < US$1,500 were classified in Group 3. We also grouped the countries into three sets based on the childhood mortality rates of under 5-year of age: Set 1 included children with a mortality rate of < 20/1,000 live births; Set 2 with a mortality rate between 20 and 50/1,000 live births and; Set 3 countries with a mortality rate > 50/1,000 live births [Figure 1]. We determined that this classification coincided well with the GDP grouping of countries.

Bottom Line: The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region.An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed.To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children.

View Article: PubMed Central - PubMed

Affiliation: Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia.

ABSTRACT
Childhood blindness and visual impairment (CBVI) are major disabilities that compromise the normal development of children. Health resources and practices to prevent CBVI are suboptimal in most countries in the Eastern Mediterranean Region (EMR). We reviewed the magnitude and the etiologies of childhood visual disabilities based on the estimates using socioeconomic proxy indicators such as gross domestic product (GDP) per capita and <5-year mortality rates. The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region. The current study determined the rates of bilateral blindness (defined as  Best corrected visual acuity(BCVA)) less than 3/60 in the better eye or a visual field of 10° surrounding central fixation) and functional low vision (FLV) (visual impairment for which no treatment or refractive correction can improve the vision up to >6/18 in a better eye) in children <15 years old. We used the 2011 population projections, <5-year mortality rates and GDP per capita of 23 countries (collectively grouped as EMR). Based on the GDP, we divided the countries into three groups; high, middle- and low-income nations. By applying the bilateral blindness and FLV rates to high, middle- and low-income countries from the global literature to the population of children <15 years, we estimated that there could be 238,500 children with bilateral blindness (rate 1.2/1,000) in the region. In addition, there could be approximately 417,725 children with FLV (rate of 2.1/1,000) in the region. The causes of visual disability in the three groups are also discussed based on the available data. As our estimates are based on hospital and blind school studies in the past, they could have serious limitations for projecting the present magnitude and causes of visual disabilities in children of EMR. An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed. The objectives, strategies, and operating procedures for child eye-care are presented. Variables impacting proper screening are discussed. To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children.

Show MeSH
Related in: MedlinePlus