Original Research Prevalence of childhood ocular morbidity in a peri- urban setting in Bangladesh: a community-based study A.H.M.E. Hussain a , T. Roy b,c,* , N. Ferdausi c , U. Sen c a Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh b Interactive Research and Development (IRD), Dhaka, Bangladesh c National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh article info Article history: Received 24 July 2018 Received in revised form 14 February 2019 Accepted 27 February 2019 Keywords: Ocular morbidity Prevalence Children Population-based research Bangladesh abstract Objectives: To test a model of integrated pediatric eye care delivery and examine the prevalence and factors associated with childhood ocular morbidity in a peri-urban setting in Bangladesh. Study design: Cross-sectional, population-based study. Methods: The study was conducted in three phases among children aged 15 years. Trained community health workers (CHWs) conducted awareness intervention and identified children with ocular problems. These children were then referred to the base hospital for examination and treatment by ophthalmologists. A pediatric ophthalmologist further examined the children with complicated eye diseases and ensured treatment at a tertiary public eye hospital. Awareness, referral patterns, and health-seeking behavior were also examined. All data were analyzed statistically using Statistical Package for Social Sciences. Results: CHWs screened 33,549 eligible children and identified 1887 cases with ocular morbidity. The prevalence of ocular morbidity and childhood blindness were 5.63% (95% confidence interval [CI] ¼ 5.27e6.16) and 0.060% (95% CI ¼ 0.03e0.11), respectively. The most commonly observed ocular morbidities were refractive error (3.24%; 95% CI ¼ 3.11 e3.45), allergic eye conditions (1.2%; 95% ¼ CI 0.74e1.27), and nasolacrimal duct obstruction (0.52%; 95% CI ¼ 0.25e0.74). Blindness was more frequently seen in children aged <5 years than in those aged 5e15 years (c 2 ¼ 7.25; P ¼ 0.007). The causes of blindness were corneal opacity, congenital eye anomaly, cataract, retinopathy of prematurity, and retinoblastoma. The prevalence of ocular morbidity was higher among older children, boys, children with low parental education and income, and children from households dwelling in slums. Conclusions: This study demonstrated that in a setting where screening and treatment for vision problems remain low, ocular morbidity among children could be easily identified through well-designed community-based screening programs involving appropriately trained CHWs. Community mobilization, awareness, and early detection of childhood eye * Corresponding author. Interactive Research & Development (IRD) Bangladesh, Country Director, Level 05, Suite E2, House 07, Road 23A Gulshan 1, Dhaka, 1212 Bangladesh. Tel.: þ8801712124335; fax: þ88029894687. E-mail addresses: paedeye@yahoo.com (A.H.M.E. Hussain), dr.tapash.roy@gmail.com (T. Roy), nf.nahid@gmail.com (N. Ferdausi), drutpalsen@yahoo.com (U. Sen). Available online at www.sciencedirect.com Public Health journal homepage: www.elsevier.com/puhe public health 170 (2019) 103 e112 https://doi.org/10.1016/j.puhe.2019.02.026 0033-3506/© 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.