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American Journal of Epidemiology Vol. 124, No. 4: 561-568
Copyright © 1986 by The Johns Hopkins University School of Hygiene and Public Health

research-article

PREVALENCE AND SEVERITY OF XEROPHTHALMIA IN SOUTHERN MALAWI

JAMES M. TIELSCH1,, KEITH P. WEST, Jr.1, JOANNE KATZ1, MOSES C. CHIRAMBO2, LARRY SCHWAB3, GORDON J. JOHNSON4, TEFERRA TIZAZU3, JACK SWARTWOOD5 and ALFRED SOMMER1

1International Center for Epidemiologic and Preventive Ophthalmology of the Wilmer Eye Institute and the School of Hygiene and Public Health, The Johns Hopkins University School of Medicine Baltimore, MD
2Ophthalmology Department, Kamuzu Central Hospital, Lilongwe Malawi
3Malawi Blindness Prevention Program, International Eye Foundation Blantyre, Malawi
4Department of Ophthalmology, Memorial University of Newfoundland St. John's, NF, Canada
5Helen Keller International New York, NY

Reprint requests to Dr. James M. Tielsch, International Center for Epidemiologic and Preventive Ophthalmology, Wilmer Eye Institute, Room 120, 600 N. Wolfe Street, Baltimore, MD 21205

The first population-based study of xerophthalmia in Africa was conducted in the Lower Shire River Valley of Malawi in the autumn of 1983. A total of 5,436 children under six years of age were examined by three survey teams over an eight-week period. The prevalence of active xerophthalmia was 3.9%. Rates for night blindness and active corneal disease were more than five times the World Health Organization criterion for a problem of public health importance. Xerophthalmic corneal scarring occurred at a rate of 5.9/1,000, more than 10 times the World Health Organization criterion. All cases of bilateral blindness in this age group were considered to be due to vitamin A deficiency. Given recent evidence from Asia linking even subclinical vitamin A deficiency to increased risk of mortality and morbidity, this disease is not only a leading cause of blindness in this area, but may have an important impact on child survival as well.

prevalence studies; vitamin A deficiency; xerophthalmia


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