Estimating numbers of blind children for planning services: findings in Kilimanjaro, Tanzania.
OBJECTIVE
Childhood blindness is included in the VISION 2020 initiative. However, childhood blindness is rare, so there is limited population-based evidence to assist with the planning of services. We carried out a survey of childhood blindness in Kilimanjaro Region, Tanzania, to generate information needed for planning eye care services.


METHODS
The study was carried out in parallel with a Rapid Assessment of Avoidable Blindness (RAAB) survey. Villages within Kilimanjaro Region were selected on a probability-proportional-to-size basis. Key informants in each village were trained to identify children with any vision problems; a visiting team assessed the children to determine visual status and arranged for further assessment as needed at hospital. The files of children at schools for the blind in the Region were reviewed to identify children in schools from the selected study villages.


RESULTS
Among the 95 040 children in the 72 villages sampled, 13 children were identified as blind; an additional three children were found in the schools for the blind. The prevalence of blindness was 0.17 per 1000 children; the causes of blindness varied but there was no vitamin A- or measles-related corneal blindness and only one case of unoperated cataract.


CONCLUSIONS
The low prevalence of blindness in children suggests that efforts at reducing childhood blindness in Kilimanjaro Region have been effective. Planners there should focus on community-based approaches to ensure that blind children have appropriate rehabilitation services and educational placements. While it remains impractical to carry out large childhood blindness surveys, this approach attached to a RAAB survey may be useful for generating information for planning services.
Shirima
S
S
Kilimanjaro Centre for Community Ophthalmology, KCM College/Tumaini University, Moshi, Tanzania.
Lewallen
S
S
Kabona
G
G
Habiyakare
C
C
Massae
P
P
Courtright
P
P
D000293:Adolescent; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006285:Health Planning / Q000379:methods; D006306:Health Surveys; D006801:Humans; D008297:Male; D020380:Needs Assessment; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology