338 CHAPTER EIGHT TABLE 8-18. PREVALENCE, ESTIMATED NUMBER OF CASES, AND DISTRIBUTION BY CASTE, 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 Caste Brahmin Kshatria Vaish Shudra Other Subtotal Missing data 1,142 1,211 3,538 1,053 186 7,130 450 1,005 (332) 2,205 (1,309) 10,669 (7,966) 6,650 (5,596) 329 (329) 20,858 (15,534) 0 (0) 0.3 (0.1) 0.5 (0.3) 0.9 (0.6) 1.8 (1.5) 0.5 (0.5) 0.9 (0.6) NA (NA) 4.8 (2.2) 10.6 (8.4) 51.1 (51.3) 31.9 (36.0) 1.6 (2.1) 100.0 (100.0) NA (NA) Total 7,590 20,858 (15,534) 0.9 (0.6) 100.0 (100.0) Source: FR.002 AN.85, 101 M Note: Figures in parentheses refer to the estimated number of cases, prevalence, and distribution of cases of active xerophthalmia that are Bitot's spots. xerophthalmia and Bitot's spots by language group in Nepal. four major language groups (Nepali, Maithili, Bhojpuri, The and Tamang), together account for 30 percent of reported cases. Of these four, Nepali, reported as mother tongue by half of the survey respondents (46.2%), had the lowest prevalence of xerophthalmia (0.4%) and Bitot's spots (0.2%). The highest prevalence was in the Maithili-speaking community, which had a Bitot's spots prevalence of 2.2 percent and a xerophthalmia prevalence of 2.7%. Nearly half (44.7%) of all children with Bitot's spots come from families who report Maithili as their mother tongue,· even though only one in eight (12.2%) of the healthy children had Maithili as a mother tongue. The prevalence risk ratio for Bitot's spots between Maithili and Nepali is 11:1 and the odds ratio is 10.8:1, suggesting that children whose mother tongue is Maithili have nearly eleven times greater risk of Bitot's spots than Nepali speakers. The next highest prevalence rates are found in the Bhojpuri-speaking community, which had Bitot's spots prevalence of 1.0 percent and prevalence of active xerophthalmia of 1. 7 percent. The Maithili and Bhojpuri languages are both spoken in terai communities located near the Indian border, along the eastern half of the terai of Nepal. It is unclear if the factors that influence the high concentration of xerophthalmia in the Maithili community of the terai and to a lesser extent the Bhoj-
