Xerophthalmia Control Project

Given here are the details of this project. For more details please contact the Hospital administration.

Health care services to rural population living in hilly difficult to approach region.

Ratnagiri District, Maharashtra, India
Organizations Involved
Hindu Society of Ottawa-Carleton, Inc.
P. O. Box 72017, Kanata, Ontario K2K 2P4
Contact: Datta Saigaonkar, President
Phone: (613) 592-8978
Fax: (613) 592-8978
E-Mail : hindusociety@ottawa.com

Shree Vitthalrao Joshi Charities Trust’s - B.K.L.Walawalkar Hospital & Diagnostic Centre
Shreekshetra Dervan, Taluka - Chiplun,
District - Ratnagiri, M.S.-415606, India
Telephone No.-91-2355-34137/34149.
Fax N0. : 91-2355-34181

Aim: To study the epidemiology of xerophthalmia in rural India and carry out appropriate intervention measures.

Objectives:

      To study the prevalence of vitamin A deficiency eye signs in the twenty-seven villages selected by stratified random sampling technique.

      To study the age distribution of the affected children.

      To look for the gender difference.

      To study the difference in the pattern of xerophthalmia in the villages under survey.

      To meet the felt need of people by running general O.P.D. once a fortnight in the selected 27 villages.

      To understand the causes of vitamin A deficiency disorders in rural Maharashtra.

      To deworm all the affected children.

      To treat the affected children with oral doses of Vitamin A solution.

      To continue six monthly prophylaxis with oral vitamin A of all the surveyed children till they complete six years of age.

      To hold meeting with parents of the affected children to explain to them the condition of their children and its preventive and control measures.

      To provide nutrition education to all women in the surveyed villages.

National Health Policy Statement: The Central Council of Health, Government of India, in the year 1975, has stated in the National Health Policy that, 'One of the basic human rights is the right to see. We have to ensure that no citizen goes blind needlessly, or being blind does not remain so, if, by reasonable deployment of skill and resources, his sight can be prevented from deteriorating, or if already lost, can be restored' This statement gives an idea of the political commitment at the national level.

National Goal: National commitment to control blindness became obvious with the launch of National Trachoma Control Programme by the Government of India, in the year 1963. This was later merged with the National Programme for Control of Blindness launched in the year 1976. The ultimate goal of the National Programme was to reduce blindness in the country to 0.3% by 2000AD.

The target achieved till 2000 AD was successful reduction of blindness to 0.6 to 0.7%. As we have just crossed 2000 AD the new goal for the programme is not yet available.

Vitamin A deficiency increases case fatality due to common childhood diseases and is particularly marked following measles. Reduction in prevalence and degree of Vitamin A deficiency levels are important for reducing childhood mortality and preventing irreversible blindness in children.

Surveys indicate that the intake of Vitamin A is, on an average, about half the recommended dietary intake. It is important that the dietary practices are improved and intake of Vitamin A rich foods be actively promoted. Advice to women on nutrition, starting with exclusive breast-feeding and weaning, is an important measure for promoting healthy growth of children and for reducing morbidity and mortality rates.

Night-blindness is an easily recognisable sign of Vitamin A deficiency. However, when clinical signs appear, the degree of Vitamin A deficiency is severe. A child with night-blindness needs immediate treatment with Vitamin A. Since other children in the area may also have Vitamin A deficiency (although overt clinical signs may not be apparent), coverage with Vitamin A should be assessed in the area from where a case of night-blindness has been reported. Coverage with Vitamin A should similarly be checked following outbreaks, particularly measles, since infections deplete vitamin A reserves and mortality rates are high in children with Vitamin A deficiency>.

Causes of Blindness in India:

The main causes of blindness in India are cataract, trachoma and associated infections, small pox, malnutrition (Vitamin A deficiency), injuries, glaucoma and a group of other causes like congenital disorders, uveitis, detachments, tumours, leprosy, diabetes, hypertension, diseases of the nervous system etc. Out of these, small pox has already been eradicated. Efforts are being made to control the other preventable causes of blindness.

Causes of Blindness in Children

Malnutrition is an important cause of blindness among the pre-school and school going children. About 30% of blind in India are known to have lost their eye-sight before they reached 20 years. Amongst these, many are under five years of age. Trachoma, conjunctivitis and malnutrition (vitamin A deficiency) are important causes of blindness in this age group.

Clinical features of vitamin A deficiency eye disorders

The earliest signs of vitamin A deficiency involve the eye. It results in night blindness, conjunctival xerosis, bitot’s spots, corneal Xerosis, corneal ulceration and keratomalacia.

Vitamin A

Importance of Vitamin A

Vitamin A is essential for normal vision. It is necessary for maintaining integrity of the epithelial lining of the skin and mucous membrane, plays an important role in the skeletal growth and is also known to be anti-infective.

Sources of Vitamin A

In case of blindness due to vitamin A deficiency prevention is the most important intervention. Adequate intake of vitamin A in the diet is necessary. Animal sources rich in vitamin A are liver, egg yolk, butter, cheese, whole milk, fish and fish liver oils. Plant sources rich in vitamin A are fresh dark green leafy vegetables such as spinach, amaranth, methi, cabbage, drumsticks and drumstick leaves; coloured vegetables such as carrots, pumpkin; and fruits such as mangoes and papayas. Certain food items such as dalda, margarine are fortified with vitamin A. Though one of the main causes of xerophthalmia is poor intake of vitamin A rich foods, it is also associated with poverty, ignorance, faulty feeding habits among the entire population but young children in particular.

Currently available control measures and long terms perspectives:

Government of India launched national vitamin A prophylaxis program in 1970 for prevention of blindness in children of endemic States. Under this program vitamin A is orally administered to all children between six months to six years of age at six monthly intervals. This can be an effective method to control Xerophthalmia in the form of short-term intervention program. Intensive nutrition education has to reach the population to bring about a lasting impact in the community and to control nutritional blindness permanently. The results are slow but long lasting.

The project will directly benefit about 15,000 children and their mothers and indirectly benefit the residents of the selected 27 villages comprising a population of around 54,000.

Children of pre-school age group mainly and other children in the school going age are affected by Xerophthalmia. One of the important causes of Xerophthalmia in children is maternal deficiency of vitamin A, which is manifested in children. Breast milk is an important source of vitamin A. The social structure in villages requires the women to take care of the diet of the entire family and young children in particular. Therefore by educating the woman of the house we expect that the entire family would benefit from the program.

Many cases of Xerophthalmia were noticed during school health check-up Program carried out among schools of Ratnagiri district. The other point noted was that in the same district the number of cases observed in different villages varied widely. Hence this project was undertaken to study the prevalence of vitamin A deficiency in different villages of Ratnagiri district; treat the affected cases, provide prophylactic doses of oral vitamin A to children; and bring about a lasting change in the community by providing nutrition education to the villagers.