Measuring the burden of childhood blindness

Globally, the prevalence of blindness among children is estimated to be approximately one tenth of that in adults, at around 0.7 per 1000.1-3 However, blindness in childhood has far reaching implications for the affected child and family, and throughout life profoundly influences educational, employment, personal, and social prospects.4 Thus, the control of childhood blindness has been identified as a priority of the World Health Organisation’s (WHO) global initiative for the elimination of avoidable blindness by the year 2020.5

Measures of disease frequency alone, however, afford a limited understanding of the public health significance of childhood blindness. The global financial cost of blindness with an onset during childhood, in terms of loss of earning capacity (per capita GNP), is greater than the cost of adult blindness and has recently been estimated to be between US$6000 million and $27 000 million.6 Most of this is accounted for by children living in high income countries, where the prevalence is less, but life expectancy and earning capacity greater, than in low income countries. These financial costs alone, however, provide only one perspective of the public health burden of blindness. Improved understanding and quantification require the application of indicators which measure the impact of blindness in terms of morbidity (years of disability suffered) as well as mortality (years of life lost through premature blindness associated death). Such indicators are useful in identifying those in the population in greatest need and for setting priorities in provision of health services. They are also important in the assessment of effectiveness of interventions and …