KAMULI DISTRICT BLINDNESS PREVALENCE AND VITAMIN A DEFICEINCY ASSESSMENT SURVEY:

PROCEEDINGS OF THE KAMULI DISTRICT DISSEMINATION SEMINAR 16TH

JUNE, 1992.

KAMULI TOWN HALL, KAMULI DISTRICT

KAMULI DISTRICT ADMINISTRATION

MAKERERE UNIVERSITY MINISTRY OF HEALTH

SPONSORED BY: UNICEF-UGANDA

EDITED BY: GIMONO WAMAI

CHILD HEALTH AND DEVELOPEMENT CENTRE

P.O. BOX 6717, KAMPALA UGANDA.

ABSTRACT:

This report summarizes the proceedings of the district-level dissemination held in Kamuli on the 16th June 1992. Following completion of the Makerere University/Ministry of health/USAID/UNICEF/VITAL Kamuli district blindness prevalence and Vitamin A defieviency assessment survey. A community survey was conducted in Kamuli District in September and October, 1991 to determine the prevalence of blindness and assess vitamin A deficiency among the population in the district. Following completion of field work, data entry, analysis and draft report preparation, a district dissemination was organized on 16th June, 1992 to share with the leaders and communities in Kamuli the findings of the survey. The aim of dissemination was to draw attention of district officials, local authorities, health workers, members of the community and NGOs active in Kamuli to the Vitamin A deficiency and blindness problem in the district so as to enable them plan for and/or initiate interventions at local level.

The dissemination organized by the DMOs office Kamuli, Department of Ophthalmology and the Child Health and Development Centre Makerere University and was funded by UNICEF. Four papers were presented at the dissemination; one on health care in Kamuli and three on the survey findings. The seminar was attended by district officials, health workers, local leaders, women representatives, traditional healers, farmers, agricultural and community development officers, NGOs active in Kamuli and representatives from the school of Ophthalmology in Jinja.

Setting: Kamuli is a rural district 150 kilometers, East of Kampala, in Uganda. The population depends mainly on fishing, cattle keeping and peasant agriculture a source of income. The district has one missionary hospital and a number of other health units. Most health problems in the district are preventable. These include: childhood malnutrition, trachoma, malaria, respiratory tract infections, diarrhoeal diseases, worm infestation, lack of adequate and safe water and inadequate excretion disposal facilities.

Major findings: The level of blindness among the adult population in the district was 2.3% (including those blind in one and/or both eyes). The commonest cause of blindness was cataract (41%) followed by corneal scar (35%) other causes included: glaucoma, traumer and cancer.

Trachoma was a common eye problem in Kamuli. The prevalence of trachoma was was high in all the four counties of the district. The occurrence of trachoma was significantly lower in areas where water was available most of the time and personal hygiene valued and practiced.

The prevalence of clinical chronic lack of Vitamin A (xeropthalmia, thus excluding night blindness) was 3.0%. This was five times the WHO minimum level of 0.66%. Vitamin A deficiency in Kamuli is a big public health problem calling for urgent action at community, district and national levels.

Interventions suggested during the seminar included: breast feeding up to 18 months of age but preferably 24; early supplementation at 3-6 months with vitamin A rich foods, e.g., dark green leafy vegetables (DGLV). It was, however, observed that DGLV are seasonal and not intentionally grown; and children were not routinely given these vegetables. Local authorities were to encourage households to have a house garden where vegetables could be grown. Early consultation with a health worker in case of inability to see at night was also suggested.

Malnutrition among the under five year olds in the district was described as high. More than one third (36%) of children were stunted. Prevalence of fever, respiratory tract infections and diarrhoea was high. More than 90% of households had no access to safe water, less than 10% boiled water for drinking and very few had latrines.

In conclusion, blindness, vitamin A deficiency, trachoma and malnutrition are major health problems in Kamuli district. Other health problems were are a high prevalence of malaria, respiratory tract infections and diarrhoeal disease; lack of adequate water and excreta disposal facilities. The health problems in the district are confounded by lack of adequate funding for the health care system due to low income amongst the population and a narrow tax base for the district.

KEYWORDS[ nutrition, vitamin A deficiency, trachoma ]