Survey of childhood blindness and visual impairment in Botswana.
OBJECTIVE
In terms of blind-person years, the worldwide burden of childhood blindness is second only to cataracts. In many developing countries, 30-72% of childhood blindness is avoidable. The authors conducted this study to determine the causes of childhood blindness and visual impairment (VI) in Botswana, a middle-income country with limited access to ophthalmic care.


METHODS
This study was conducted over 4 weeks in eight cities and villages in Botswana. Children were recruited through a radio advertisement and local outreach programmes. Those ≤ 15 years of age with visual acuity <6/18 in either eye were enrolled. The WHO/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision was used to record data.


RESULTS
The authors enrolled 241 children, 79 with unilateral and 162 with bilateral VI. Of unilateral cases, 89% were avoidable: 23% preventable (83% trauma-related) and 66% treatable (40% refractive error and 31% amblyopia). Of bilateral cases, 63% were avoidable: 5% preventable and 58% treatable (33% refractive error and 31% congenital cataracts).


CONCLUSIONS
Refractive error, which is easily correctable with glasses, is the most common cause of bilateral VI, with cataracts a close second. A nationwide intervention is currently being planned to reduce the burden of avoidable childhood VI in Botswana.
University of Botswana, School of Medicine, P/Bag 00713, Gaborone, Botswana. nkomazanao@mopipi.ub.bw
Sudha
S
Nallasamy
William V
WV
Anninger
Graham E
GE
Quinn
Brian
B
Kroener
Nicola M
NM
Zetola
Oathokwa
O
Nkomazana
D000293:Adolescent; D001766:Blindness / Q000453:epidemiology*; D001902:Botswana / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006302:Health Services Research; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D015354:Vision, Low / Q000453:epidemiology*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*
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