Xerophthalmia in North Sumatra

Abstract

During a preliminary survey on xerophthalmia in North Sumatra, Indonesia, a total of 1754 children of 0-6 years of age were examined clinically as well as with a vital staining technique, using Rose-Bengal 1%-Fluorescein sodium 1% eyedrops. Differences in prevalence were found between children from the rural villages, from Gunung Pamela rubber estate and from one Health Centre and two kindergartens in Medan town. None of the children in the estate and in Medan had Bitot spots or acute corneal involvement; conjunctival xerosis (XIA) was found in 28% among boys and 11% among girls at the rubber estate, whereas in Medan only 1% had XIA. In the village, the calculated minimum point prevalence rates for X1B, X2 + 3 and XS were respectively 0.29%, 0.16% and 0.45% for age-group 0-6 years, sexes combined. According to WHO criteria xerophthalmia should, therefore, be considered of public health importance in the rural area visited. The potential use of the vital staining technique in early diagnosis of xerophthalmia is discussed. WHO criteria for assessment of the magnitude of the xerophthalmia problem as well as the guidelines for xerophthalmia surveys from the International Vitamin A Consultative Group have been analysed in this survey as a casestudy.