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Abstract
Introduction. Visual impairment (VI) in children is a public health problem especially in resources limited setting. We aimed to determine the prevalence and main causes of visual impairment in children in two hospitals in Douala (Cameroon). Methods. An observational cross sectional and retrospective study was carried out from January to April 2018 at the General Hospital and at the Laquintinie Hospital in Douala on the files of children aged 5 to 15 years who consulted from January 2013 to December 2017. The files of children aged 5 to 15 with a diagnosis of VI (low vision and blindness) were included. Low vision was defined as visual acuity less than 6/18 but better than 3/60. Blindness was defined as visual acuity less than 3/60. Variables collected from patient charts included age, sex, medical history and causes of visual impairment. Results. The prevalence of visual impairment was 1.3 %. Boys were affected in 57% of cases and the sex ratio was 1.32. The mean age at diagnosis was 9.58 ± 3.6 years. Low visual acuity (83.7%) and ocular pain (23.3%) were the main presenting complaints. According to the type of visual impairment, 39.5% of children were blind whereas 60.5 % had low vision. A total of 22 children (64.7%) aged 5-9 years were blind. Adolescents were mainly affected by low vision. Glaucoma 16 (18.6%) was the most common cause of VI, followed by cortical blindness (15.1%), severe refractive errors (11.6%) and cataract (9.3%). Conclusion. Glaucoma and cortical blindness are the most common causes of visual impairment in children in our setting.
RÉSUMÉ
Introduction. La déficience visuelle (DV) chez l’enfant est un problème de santé publique, en particulier dans les pays à ressources limitées. Notre objectif était de déterminer la prévalence et les principales causes de déficience visuelle chez les enfants dans deux hôpitaux à Douala, au Cameroun. Méthodes. Nous avons réalisé une étude observationnelle transversale rétrospective à l'Hôpital Général et l'Hôpital Laquintinie de Douala sur les dossiers d'enfants de 5 à 15 ans consultés de Janvier 2013 à Décembre 2017. Les dossiers d'enfants de 5 à 15 avec un diagnostic de DV (basse vision et cécité) ont été inclus. La basse vision était définie comme une acuité visuelle (AV) inférieure à 6/18 mais supérieure à 3/60 et la cécité (AV < 3/60). Les variables étudiées étaient l'âge, le sexe, les antécédents médicaux et les causes de la déficience visuelle. Résultats. La prévalence de la déficience visuelle était de 1,3%. L'âge moyen au moment du diagnostic était de 9,58 ± 3,6 ans. Les motifs de consultation étaient la baisse de l’acuité visuelle (83,7%) et la douleur oculaire (23,3%). La cécité concernait 39,5% des enfants et 60,5% avaient une basse vision. Au total, 22 enfants (64,7%) âgés de 5 à 9 ans étaient aveugles. Les adolescents étaient principalement affectés par la basse vision. Le glaucome était la cause la plus fréquente de déficience visuelle, suivi de la cécité corticale (15,1%), des erreurs de réfraction sévères (11,6%) et de la cataracte (9,3%). Conclusion Le glaucome et la cécité corticale sont les causes les plus fréquentes de la déficience visuelle chez les enfants dans notre contexte.
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References
- Steinkuller PG, Du L, Gilbert C, Foster A, Collins ML, Coats DK. Childhood blindness. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 1999;3(1):26‑32.
- Gilbert C, Foster A. Childhood blindness in the context of VISION 2020--the right to sight. Bull World Health Organ. 2001;79:227–232.
- Ezeh EI, Ibanga AA, Duke RE. Visual status of special needs children in special education schools in Calabar, Cross River State, Nigeria. Niger Postgrad Med J. 2018;25(3):161‑5.
- Alabi AS, Aribaba OT, Alabi AO, Ilo O, Onakoya AO, Akinsola FB. Visual impairment and ocular morbidities among schoolchildren in Southwest, Nigeria. Niger Postgrad Med J. 2018;25(3):166‑71.
- Nallasamy S, Anninger WV, Quinn GE, Kroener B, Zetola NM, Nkomazana O. Survey of childhood blindness and visual impairment in Botswana. Br J Ophthalmol. 2011;95(10):1365‑70.
- Kedir J, Girma A. Prevalence of refractive error and visual impairment among rural school-age children of Goro District, Gurage Zone, Ethiopia. Ethiop J Health Sci. 2014;24(4):353‑8.
- Eballe AO, Bella LA, Owono D, Mbome S, Mvogo CE. [Eye disease in children aged 6 to 15 years: a hospital-based study in Yaounde]. Santé. 2009; 19 (2):61‑66.
- Ajaiyeoba AI, Isawumi MA, Adeoye AO, Oluleye TS. Prevalence and causes of blindness and visual impairment among school children in south-western Nigeria. Int Ophthalmol. 2005;26 (4‑5):121‑5.
- Gyawali R, Bhayal BK, Adhikary R, Shrestha A, Sah RP. Retrospective data on causes of childhood vision impairment in Eritrea. BMC Ophthalmol. 2017;17(1):209.
- Noche CD, Bella AL. [Frequency and causes of blindness and visual impairment in schools for the blind in Yaoundé (Cameroon)]. Sante Montrouge Fr. 2010; 20 (3):133‑8.
- Global, regional, and national burden of meningitis, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(12):1061‑82.
- Bella AL, Dohvoma VA, Eballe AO, Abdouramani O. Pattern of corneal pathologies in children seen at Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Cameroon. Clin Ophthalmol Auckl NZ. 2013; 7:2007‑10.
- Maake MM, Oduntan OA. Prevalence and causes of visual impairment in patients seen at Nkhensani Hospital Eye Clinic, South Africa. Afr J Prim Health Care Fam Med. 2015;7(1):728.
- Kinengyere P, Kizito S, Kiggundu JB, Ampaire A, Wabulembo G. Burden, etiology and predictors of visual impairment among children attending Mulago National Referral Hospital eye clinic, Uganda. Afr Health Sci. 2017;17 (3):877‑85.
- Shrestha JB, Gnyawali S, Upadhyay MP. Causes of Blindness and Visual Impairment among Students in Integrated Schools for the Blind in Nepal. Ophthalmic Epidemiol. 2012;19(6):401‑6.
- Njuguna M, Msukwa G, Shilio B, Tumwesigye C, Courtright P, Lewallen S. Causes of severe visual impairment and blindness in children in schools for the blind in eastern Africa: changes in the last 14 years. Ophthalmic Epidemiol. 2009;16 (3):151‑5.
- Verzoni D da S, Zin AA, Barbosa ADM. Causes of visual impairment and blindness in children at Instituto Benjamin Constant Blind School, Rio de Janeiro. Rev Bras Oftalmol. 2017;76(3):138‑43.
- Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74 Suppl 1:35‑49.
- Yamamah GAN, Talaat Abdel Alim AA, Mostafa YSED, Ahmed RAAS, Mohammed AM, Mahmoud AM. Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt. Ophthalmic Epidemiol. 2015 ;22(4): 246‑52.
References
Steinkuller PG, Du L, Gilbert C, Foster A, Collins ML, Coats DK. Childhood blindness. J AAPOS Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 1999;3(1):26‑32.
Gilbert C, Foster A. Childhood blindness in the context of VISION 2020--the right to sight. Bull World Health Organ. 2001;79:227–232.
Ezeh EI, Ibanga AA, Duke RE. Visual status of special needs children in special education schools in Calabar, Cross River State, Nigeria. Niger Postgrad Med J. 2018;25(3):161‑5.
Alabi AS, Aribaba OT, Alabi AO, Ilo O, Onakoya AO, Akinsola FB. Visual impairment and ocular morbidities among schoolchildren in Southwest, Nigeria. Niger Postgrad Med J. 2018;25(3):166‑71.
Nallasamy S, Anninger WV, Quinn GE, Kroener B, Zetola NM, Nkomazana O. Survey of childhood blindness and visual impairment in Botswana. Br J Ophthalmol. 2011;95(10):1365‑70.
Kedir J, Girma A. Prevalence of refractive error and visual impairment among rural school-age children of Goro District, Gurage Zone, Ethiopia. Ethiop J Health Sci. 2014;24(4):353‑8.
Eballe AO, Bella LA, Owono D, Mbome S, Mvogo CE. [Eye disease in children aged 6 to 15 years: a hospital-based study in Yaounde]. Santé. 2009; 19 (2):61‑66.
Ajaiyeoba AI, Isawumi MA, Adeoye AO, Oluleye TS. Prevalence and causes of blindness and visual impairment among school children in south-western Nigeria. Int Ophthalmol. 2005;26 (4‑5):121‑5.
Gyawali R, Bhayal BK, Adhikary R, Shrestha A, Sah RP. Retrospective data on causes of childhood vision impairment in Eritrea. BMC Ophthalmol. 2017;17(1):209.
Noche CD, Bella AL. [Frequency and causes of blindness and visual impairment in schools for the blind in Yaoundé (Cameroon)]. Sante Montrouge Fr. 2010; 20 (3):133‑8.
Global, regional, and national burden of meningitis, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(12):1061‑82.
Bella AL, Dohvoma VA, Eballe AO, Abdouramani O. Pattern of corneal pathologies in children seen at Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Cameroon. Clin Ophthalmol Auckl NZ. 2013; 7:2007‑10.
Maake MM, Oduntan OA. Prevalence and causes of visual impairment in patients seen at Nkhensani Hospital Eye Clinic, South Africa. Afr J Prim Health Care Fam Med. 2015;7(1):728.
Kinengyere P, Kizito S, Kiggundu JB, Ampaire A, Wabulembo G. Burden, etiology and predictors of visual impairment among children attending Mulago National Referral Hospital eye clinic, Uganda. Afr Health Sci. 2017;17 (3):877‑85.
Shrestha JB, Gnyawali S, Upadhyay MP. Causes of Blindness and Visual Impairment among Students in Integrated Schools for the Blind in Nepal. Ophthalmic Epidemiol. 2012;19(6):401‑6.
Njuguna M, Msukwa G, Shilio B, Tumwesigye C, Courtright P, Lewallen S. Causes of severe visual impairment and blindness in children in schools for the blind in eastern Africa: changes in the last 14 years. Ophthalmic Epidemiol. 2009;16 (3):151‑5.
Verzoni D da S, Zin AA, Barbosa ADM. Causes of visual impairment and blindness in children at Instituto Benjamin Constant Blind School, Rio de Janeiro. Rev Bras Oftalmol. 2017;76(3):138‑43.
Blencowe H, Lawn JE, Vazquez T, Fielder A, Gilbert C. Preterm-associated visual impairment and estimates of retinopathy of prematurity at regional and global levels for 2010. Pediatr Res. 2013;74 Suppl 1:35‑49.
Yamamah GAN, Talaat Abdel Alim AA, Mostafa YSED, Ahmed RAAS, Mohammed AM, Mahmoud AM. Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt. Ophthalmic Epidemiol. 2015 ;22(4): 246‑52.