CHILDHOOD BLINDNESS 343 TABLE 8-22. PREVALENCE, ESTIMATED NUMBER OF CASES, AND DIS- TRIBUTION BY DENSITY OF HOUSES, 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 Densi- ty Compacta Separateb Scatteredc Subtotal Missing data 1,848 2,467 2,840 7,155 425 11,271 (8,913) 5,002 (3,917) 4,585 (2,704) 20,858 (15,534) 6 (0) 1.8 (1.4) 0.6 (0.4) 0.5 (0.3) 0.9 (0.6) NA (NA) 54.0 (57.4) 24.0 (25.2) 22.0 (17.4) 100.0 (100.0) NA (NA) Total 7,580 20,858 (15,534) 0.9 (0.6) 100.0 (100.0) Source: FRS.002 AN.123, 139 M Note: Figures in parentheses refer to the estimated number of cases, prevalence, and distribution of active xerophthalmia that are Bitot's spots. aCompact: more than two-thirds of all houses are less than a 30- minute walk apart. bSeparate: fewer than two-thirds of all houses are less than a 30- minute walk apart but more than half the houses are less than an hour walk apart. cScattered: more than half the houses are more than an hour walk apart. higher prevalence of xerophthalmia in areas with access to medical facilities than in areas without access. While it is possible that this is at least in part due to confounding, it is still clear that increased access to medical care facilities has not prevented xerophthalmia in those panchayats in which doctors and hospitals are nearby. In the case of radio, postal service, and secondary schools, the prevalence of xerophthalmia is virtually the same in villages with and without these services. However, the distribution of these facilities is more uniform across terrain type than electricity and medical facilities. Crops Cultivated in the Village: In Nepal, families often have access only to food that is locally grown. It is difficult and time- consuming to carry heavy food items such as grain in the moun- tains. Seasonal rains can further isolate villages, which may al- ready be weeks away from any large market. In addition, the absence of a cash economy in many communities makes families dependent not only on what is grown in their village, but often upon what is grown by their own household. Food consumption patterns
