A survey of childhood blindness in three schools for the blind in Zambia

aim: To assess the causes and distribution of blindness in children in three schools for the blind in Zambia, and to estimate the average cost of primary education per child per year. The results of this study will be used to develop baseline data for planning a nationwide intervention. Methods: This was a descriptive, cross-sectional study with a quantitative component, conducted in three schools for the blind in Zambia. The World Health Organization Prevention of Blindness childhood blindness proforma was used to collect data and a questionnaire on cost was developed and administered to the head teachers. The data were recorded in Excel and analysed in the Epi Info TM statistical software package, version 6. results: A total of 133 children were examined. The sex distribution was 91 males (68.4%) and 42 females (31.6%), giving a male to female ratio of 2.2:1. The age range was 6–24 years with a mean age of 13.9 years. A total of 64.7% of the children were below 16 years of age. Whereas 1.5% of the children were found to have no visual impairment, the majority (60.9%) were blind. The major anatomical site for visual loss was the retina (30.8%). Oculocutaneous albinism accounted for 68.3% of all visual loss affecting the retina. Hereditary diseases (36.8%) were the most common cause. Measles and vitamin A deficiency combined accounted for 65.2% of all causes due to childhood factors. A total of 60.2% of children were blind from conditions that could have been avoided. Fifty per cent of children changed visual status from blind to severely visually impaired after refraction. Overall, 23.3% of children were recommended for enrolment into mainstream education. The three schools had unique features, which meant there was a wide variation between them in the total yearly cost per pupil. It was therefore not possible to determine a yearly cost per child that could be used as a guide for the whole country. Conclusion: If low vision aids are provided, a significant proportion of visually impaired children can be given the same opportunities and educational experiences as sighted children.