CHILDHOOD BLINDNESS 351 TABLE 8-27. PREVALENCE, ESTIMATED NUMBER OF CASES, AND DISTRIBUTION BY AGRICULTURAL LAND OWNERSHIP, ACTIVE XEROPHTHALMIA (AND BITOT'S SPOTS), CHILDREN UNDER AGE 6, DECEMBER-APRIL (NBS 1981) Estimated Number of Children Affected Prevalence per 100 Children Percentage of Nepal's Total Sample N Land Own Own some land and rent some land Rent Other (including urban) Subtotal 5,373 11,706 (8,574) 0.6 (0.4) 57.4 (55.2) 822 371 3,474 (2,773) 3,778 (3,074) 1.2 (1.0) 2.9 (2.3) 17.0 (17.8) 18.5 (19.8) 623 7,189 391 7,580 1,457 (1.113) 20,415 (15,534) 443 (0) 20,858 (15,534) 0.7 (0.5) 0.8 (0.6) NA (NA) 0.8 (0.6) 7.1 (7.2) 100.0 (100.0) NA (NA) Missing data Total 100.0 (100.0) Source: FR8.002 AN.147, 163 M Note: Figures in parentheses refer to the estimated number of cases, prev- alence, and distribution of cases with active xerophthalmia that are Bitot's spots. wealth (brick, cement, wood, stone) is negatively correlated with xerophthalmia. These so-called "non-found" materials probably suggest a higher socioeconomic status rather than specific environ- mental risk factors associated with physical household construction. The possession of modern objects is another indirect way of as- sessing socioeconomic status in Nepal. Tables 8-29 and 8-30 show the relationship between xerophthalmia prevalence and the possession of watches and radios by any family or household member. Only one household in seven, for example, reports ownership of a radio. Not a single case of xerophthalmia comes from such a relatively wealthy family. Likewise, children in families without a watch in the household have a prevalence of xerophthalmia nearly twice (1.8 times) that of those who do have a watch in the family. Again, confounding by terrain may be a factor (access to cities and markets is easier in the terai), but these objects are easy to carry and the elite in the mountains and hills have ready access to them. • Access to water is another indicator of family well-being. Table 8- 31 shows the prevalence of xerophthalmia by source of drinking water. Again, terrain is confounding, because tube wells are more common in the plains and rivers and streams in the mountains and
