Blindness in Childhood in Developing Countries Time for a Reassessment 英文参考文献.docVIP

PolicyForum BlindnessinChildhoodinDevelopingCountries:Time foraReassessment? ParikshitGogate1,KhumboKalua2,PaulCourtright3* 1LionsJuhuInstituteofCommunityOphthalmology,Orbis-SupportedDepartmentofPediatricOphthalmology,H.V.DesaiEyeHospital,Pune,India,2LionsSightFirst Eye Hospital, College of Medicine, University of Malawi, Blantyre, Malawi, 3Kilimanjaro Centre for Community Ophthalmology, Good Samaritan Foundation, Moshi, Tanzania OurUnderstandingof ChildhoodBlindnessatthe SummaryPoints AdoptionofVISION2020in 1999 N Childhood blindness is a priority area for VISION 2020, a global initiative to eliminate avoidable blindness, because blind and visually impaired children havealifetimeofblindnessaheadofthem. MagnitudeofChildhoodBlindness Theglobalinitiative—VISION2020:The RighttoSight—launchedin1999,targeted blindnessinchildrenasoneofthefivepriority areasofdiseasecontrol[1].Selectingchild- hood blindness was based on the fact that blindnessinchildhoodcanleadtodecadesof life spent blind and because the major interventionstocontrolchildhoodblindness were public health in nature (vitamin A supplementationandmeaslesimmunization) forthecontrolofvitaminA-relatedcorneal blindness.Childhoodblindnesscausessignif- icant economic burden on the family and community[2].Atthetime,itwasestimated that globally there were 1.4 million blind children,twicethisnumberwithlowvision, andanestimated500,000childrenbecoming blind each year [3]. It was anticipated that manyoftheincidentblindwouldnotsurvive because of vitamin A deficiency, so the annual cumulative annual incidence would beonlyabout200,000peryear[4]. N N Globally, vitamin A deficiency– and measles-related blindness in children has declinedsubstantiallyalthoughitpersistsinsomefocalsettings. Withreductionsinnutritionalandinfectiouscausesofblindness,intra-uterine andgeneticcausesofblindness(e.g.,cataractandcongenitalanomalies)have assumed increasedimportanceandneedtertiary care–levelinterventionsand long-termfollow-uptoachievegoodv