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R. S. Sitorus, S. Abidin, J. Prihartono; Measles Blindness in Indonesia: Results From Schools for the Blind Study in Java. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4851.
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© ARVO (1962-2015); The Authors (2016-present)
To define the prevalence of measles blindness among the avoidable causes of blindness and severe visual impairment (BL/SVI) in schools for the blind in Java, and to evaluate its temporal trends.
Four-hundred-seventy-nine of total 504 cases were examined in 5 schools for the blind in Java. Data was collected using a modified-WHO/PBL eye examination record for children.
Anatomical site of SVI/BL were whole globe in 35.9%, retina 18.8%, lens 16.5%, cornea 16.1%; while the major underlying aetiology of BL/SVI was undetermined in 32.8% cases, hereditary factors 31.7%, and childhood/postnatal disorders 28.6%. Corneal scars, corneal staphyloma and phtisical eye were predominant in the postnatal disorders, which mainly attributed to eye infection due to measles and vitamin A deficiency. Overall, 60.1% (288 cases) had potentially avoidable causes of BL/SVI. Measles blindness accounted for 22.9 % of the avoidable causes. Corneal scars, corneal staphyloma and phtisical eye mainly due to measles (110 cases) were responsible for the highest proportion in the preventable blindness group. The high proportion of measles causing blindness was also reported in other developing countries in North India, Ethiopia and Nigeria. It has been known that there is a close relationship between malnutrition, vitamin-A deficiency and the severity of measles infections. Exploration on trends of SVI/BL among four different age groups 5-8 years, 9-12 years, 13-15 years and ≥16years suggest that childhood disorders and corneal factors have declined .The proportion of cases blind form corneal disorders was 0% (0) were aged 5-8 years, 7.4% (2) were aged 9-12 years, 6.7%(3) aged 13-15 years and 18.1% (72) were ≥16 years (p= 0.01, chi2-test for trend). Study of etiological factors showed that childhood disorders were responsible for 0.0% (0) in 5-8 year olds, 22.2% (6) in 9-12 year, 17.8% (8) in13-15 year and 31.0% (123) in ≥16 year olds. (p= 0.010, chi-test for trend). Changing trend over the period of age groups for corneal disorders and childhood disorders, may suggest that problem of measles/vitamin-A related blindness have declined over a period of 10 years or more.
The decline in the proportion of corneal diseases and childhood factors causing blindness may reflect improved vitamin A supplementation and measles vaccination coverage in Indonesia in the past 10 years or more. Nevertheless ensuring high coverage rates of measles vaccination and vitamin-A supplementation in the short and long term still need to be pursued rigorously.
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