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Estimating numbers of blind children for planning services: findings in Kilimanjaro, Tanzania
  1. S Shirima1,
  2. S Lewallen1,
  3. G Kabona2,
  4. C Habiyakare2,
  5. P Massae1,
  6. P Courtright1
  1. 1
    Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania
  2. 2
    Kilimanjaro Christian Medical College, Moshi, Tanzania
  1. Correspondence to Dr P Courtright, Kilimanjaro Centre for Community Ophthalmology, KCM College/Tumaini University, PO Box 2254, Moshi, Tanzania; pcourtright{at}


Aim: Childhood blindness is included in the VISION 2020 initiative. However, childhood blindness is rare, so there is limited population-based evidence to assist with the planning of services. We carried out a survey of childhood blindness in Kilimanjaro Region, Tanzania, to generate information needed for planning eye care services.

Methods: The study was carried out in parallel with a Rapid Assessment of Avoidable Blindness (RAAB) survey. Villages within Kilimanjaro Region were selected on a probability-proportional-to-size basis. Key informants in each village were trained to identify children with any vision problems; a visiting team assessed the children to determine visual status and arranged for further assessment as needed at hospital. The files of children at schools for the blind in the Region were reviewed to identify children in schools from the selected study villages.

Results: Among the 95 040 children in the 72 villages sampled, 13 children were identified as blind; an additional three children were found in the schools for the blind. The prevalence of blindness was 0.17 per 1000 children; the causes of blindness varied but there was no vitamin A- or measles-related corneal blindness and only one case of unoperated cataract.

Discussion: The low prevalence of blindness in children suggests that efforts at reducing childhood blindness in Kilimanjaro Region have been effective. Planners there should focus on community-based approaches to ensure that blind children have appropriate rehabilitation services and educational placements. While it remains impractical to carry out large childhood blindness surveys, this approach attached to a RAAB survey may be useful for generating information for planning services.

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  • Funding The paediatric work was supported by Simavi (the Netherlands). The Rapid Assessment of Avoidable Blindness (RAAB) was supported by CBM.

  • Competing interests None declared.

  • Ethics approval Ethics approval for the study was given by Kilimanjaro Christian Medical College/Tumaini University. Village leaders consented to all activities in their villages; head teachers at schools for the blind provided information on villages where students came from and visual acuity, but no names were attached to this information.

  • Patient consent Parents accompanied children to the examination site and oral consent was obtained at that time.

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