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Xerophthalmia in North Sumatra
Insights
Xerophthalmia, a vitamin A deficiency eye condition, is a public health concern in rural North Sumatra. A survey of 1754 children revealed higher prevalence in villages compared to urban areas.
Area of Science:
- Ophthalmology
- Public Health
- Nutritional Science
Background:
- Xerophthalmia, a leading cause of childhood blindness, is linked to vitamin A deficiency.
- Prevalence varies significantly based on geographical and socioeconomic factors.
- Early detection is crucial for effective intervention and prevention.
Purpose of the Study:
- To assess the prevalence of xerophthalmia in children aged 0-6 years in North Sumatra, Indonesia.
- To compare xerophthalmia rates in rural villages, a rubber estate, and urban settings (Medan).
- To evaluate the utility of a vital staining technique for early xerophthalmia diagnosis.
Main Methods:
- A clinical examination and vital staining technique using Rose-Bengal and Fluorescein sodium eyedrops were employed.
- A total of 1754 children were examined across different locations in North Sumatra.
- Prevalence rates were calculated based on WHO criteria and International Vitamin A Consultative Group guidelines.
Main Results:
- Conjunctival xerosis (XIA) was more prevalent in boys (28%) than girls (11%) at the rubber estate; Medan showed only 1% XIA.
- In rural villages, minimum point prevalence rates for X1B, X2+3, and XS were 0.29%, 0.16%, and 0.45%, respectively.
- No Bitot spots or acute corneal involvement were observed in the estate or Medan populations.
Conclusions:
- Xerophthalmia is a significant public health issue in the surveyed rural areas of North Sumatra.
- The vital staining technique shows potential for early diagnosis of xerophthalmia.
- Geographical location significantly impacts xerophthalmia prevalence, highlighting the need for targeted interventions.
Abstract:
During a preliminary survey on xerophthalmia in North Sumatra, Indonesia, a total of 1754 children of 0-6 years of age were examined clinically as well as with a vital staining technique, using Rose-Bengal 1%-Fluorescein sodium 1% eyedrops. Differences in prevalence were found between children from the rural villages, from Gunung Pamela rubber estate and from one Health Centre and two kindergartens in Medan town. None of the children in the estate and in Medan had Bitot spots or acute corneal involvement; conjunctival xerosis (XIA) was found in 28% among boys and 11% among girls at the rubber estate, whereas in Medan only 1% had XIA. In the village, the calculated minimum point prevalence rates for X1B, X2 + 3 and XS were respectively 0.29%, 0.16% and 0.45% for age-group 0-6 years, sexes combined. According to WHO criteria xerophthalmia should, therefore, be considered of public health importance in the rural area visited. The potential use of the vital staining technique in early diagnosis of xerophthalmia is discussed. WHO criteria for assessment of the magnitude of the xerophthalmia problem as well as the guidelines for xerophthalmia surveys from the International Vitamin A Consultative Group have been analysed in this survey as a casestudy.