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The epidemiology of childhood blindness and severe visual impairment in Indonesia
  1. Mohammad Muhit1,2,
  2. Tasneem Karim1,2,
  3. Johurul Islam1,2,
  4. Denny Hardianto3,
  5. Habibah Setyawati Muhiddin4,
  6. Setia A Purwanta5,
  7. Suhardjo Suhardjo6,
  8. Doni Widyandana6,
  9. Gulam Khandaker1,2,7
  1. 1Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
  2. 2CSF Global, Dhaka, Bangladesh
  3. 3CSF Indonesia, Waikabubak, Indonesia
  4. 4Hasanuddin University, Makassar, Indonesia
  5. 5Dria Manunggal, Yogyakarta, Indonesia
  6. 6Department of Ophthalmology, Faculty of Medicine, Universitas Gadjah Mada (UGM), Yogyakarta, Indonesia
  7. 7Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Gulam Khandaker, The Children’s Hospital at Westmead (Clinical School), The University of Sydney, Westmead, NSW 2145, Australia; gulam.khandaker{at}health.nsw.gov.au

Abstract

Background The magnitude of blindness among children in Indonesia is unknown. In this study, we aimed to define the magnitude and aetiology of childhood blindness in two parts of Indonesia.

Method Children aged 0–15 years, identified through key informant method and from special schools and community-based rehabilitation programme in Sumba and Yogyakarta, were assessed following WHO protocol and definitions for ophthalmological assessment and classification of visual impairment and blindness among children.

Results Out of 195 children assessed, 113 had blindness/severe visual impairment (BL/SVI), 48 had visual impairment (VI) and 34 had no VI. 43.4% children with BL/SVI were female.

The main anatomical site of BL/SVI was lens (n=35, 31.0%), followed by retina (n=13, 11.5%) and cornea (n=9, 8.0%). Among the known aetiologies, childhood factors predominated (n=14, 12.4%), followed by hereditary diseases (n=12, 10.6%) where parental consanguinity was found among 33.3% (n=4) of them. Overall, 77.8% (n=88) had avoidable causes of BL/SVI: 69.0% (n=78) treatable and 8.8% (n=10) preventable causes.

The estimated prevalence of BL/SVI was 0.25 (95% CI 0.19 to 0.32) and 0.23 (95% CI 0.18 to 0.29) per 1000 children in Sumba and Yogyakarta, respectively. The estimated prevalence of cataract was 0.07 per 1000 children (95% CI 0.04 to 0.12) in Sumba and 0.05 per 1000 children (95% CI 0.03 to 0.09) in Yogyakarta. Based on our conservative estimates, there are 17 241 children with BL/SVI in Indonesia; 4270 are blind due to cataract.

Conclusion The magnitude of childhood BL/SVI in Sumba and Yogyakarta is high. Our study suggests that a large proportion of childhood BL/SVI in Indonesia is avoidable.

  • vision
  • epidemiology
  • child health (paediatrics)
  • eye (globe)
  • public health

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Footnotes

  • Contributors MM was responsible for study conception, securing funding, study implementation, data analysis and manuscript development. He is also the data custodian. GK contributed in study design, data analysis and development of the manuscript. TK was responsible for data entry, data analysis, study report writing and preparation of the first draft of the manuscript. JIJ, DH, HSM, SAP, SS and DW contributed in study implementation and manuscript development. All authors approved the final version to be published.

  • Funding This work was supported by Lions Clubs International Foundation (Grant Number: SF 1827/UND). The funder played no role in the study design, data collection, analysis, interpretation of the data and in the writing of the report.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Ethics approval Ethical approval was obtained from the ethics review committee of the Asian Institute of Disability and Development (AIDD HREC ref no: southasia-irb-2014-8-01), Bangladesh, Hasanuddin University, Sumba (HREC ref no: UH15100639) and Universitas Gadjah Mada (UGM), Yogyakarta, Indonesia (Ref no: KE/FK/600/EC/2016).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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