Changing scenario of cataract blindness in Kolar District, Karnataka, South India. The utility of rapid assessment of avoidable blindness in reviewing programs.

PURPOSE: To estimate the prevalence and causes of blindness in persons aged 50 years and over in Kolar district, India, using rapid assessment of avoidable blindness (RAAB) methodology and compare results with a similar study done in 1995. METHODOLOGY: A total of 61 clusters of 50 people aged 50 years and over were selected by probability proportional to size sampling. Households were selected by compact segment sampling. Participants were evaluated using standard RAAB methodology. RESULTS: Of 3050 people visited, 2907 were examined (95.3%). Prevalence of bilateral blindness (visual acuity, VA, <3/60 in the better eye with available correction) was 3.9%, and severe visual impairment (SVI; VA <6/60 - 3/60 in the better eye with available correction) was 3.5%. Untreated cataract was the leading cause of blindness (74.6%) and SVI (73.3%). Compared with the previous study, results showed a significant drop in prevalence of blindness from all causes from 8.0% to 3.9% (p < 0.001). Prevalence of cataract blindness (VA <3/60) had also decreased. Cataract surgical coverage (CSC) showed a significant increase from the previous survey (46.2% to 81.7%). CONCLUSION: Rapid assessments conducted once in 8-10 years at a district level, give reliable estimates on the prevalence of blindness and help monitor planning and implementation of eye care programs. Despite a turnaround in Kolar district seen over the last 16 years, with a decrease in the prevalence of blindness and increased CSC, untreated cataract continues to be the leading cause of blindness, warranting sustained service delivery efforts and careful planning.

Adverse events following immunisation with SA 14-14-2 Japanese encephalitis vaccine in children of Kolar in Karnataka.

Around 30 million children of 1 to 15 years have received the live attenuated SA 14-14-2 Japanese encephalitis (JE) vaccine in the campaign against JE in India from 2006 to 2007. This study aims to assess the short-term adverse events following JE vaccination as there is limited data on it in Indian children. A longitudinal study of children vaccinated in the campaign against JE in Kolar, in 2007 was undertaken. In July to August 2007, following the JE vaccination campaign in Kolar, 1640 children of 10 to 15 years were followed for four weeks. Events such as fever, pain at the injection site, cough, headache and nausea or vomiting were recorded. Surveillance was maintained on the referral hospitals for hospitalisation due to encephalitis and anaphylaxis following vaccination. The incidence of adverse events is summarised as frequencies and percentages with 95% confidence interval (CI). The analysis was performed using statistical package for social sciences (SPSS) 15.0 for Windows. The incidence of minor adverse events was 11.3% (95% CI 9.8-12.9%) for fever, 17% (15.2-18.8%) for pain at the injection site, 12.6% (11-14.2%) for cough, 2.6% (1.8-3.3%) for headache and 1.1% (0.6-1.6%) for nausea and/or vomiting. Severe adverse events were not observed. Mild adverse events following immunisation are common with SA14-14-2 JE vaccine. Hence the health personnel involved in JE control campaign should be aware of these adverse events.