Assessing the accuracy and feasibility of a refractive error screening program conducted by school teachers in pre-primary and primary schools in Thailand.

Tailoi Chan-Ling,Suwat Kusakul,Supaporn Tengtrisorn,Chaw-Yin Myint,Kwanjai Wongkittirux,Yot Teerawattananon,Surapong Orprayoon,Bunyong Chinkulkitnivat,Kanlaya Teerawattananon,Watanee Jenchitr

doi:10.1371/journal.pone.0096684

Abstract

IntroductionAs part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers.ObjectiveTo assess the accuracy and feasibility of screening by teachers.MethodsA cross-sectional descriptive and analytical study was conducted in 17 schools in four provinces representing four geographic regions in Thailand. A two-staged cluster sampling was employed to compare the detection rate of refractive error among eligible students between trained teachers and health professionals. Serial focus group discussions were held for teachers and parents in order to understand their attitude towards refractive error screening at schools and the potential success factors and barriers.ResultsThe detection rate of refractive error screening by teachers among pre-primary school children is relatively low (21%) for mild visual impairment but higher for moderate visual impairment (44%). The detection rate for primary school children is high for both levels of visual impairment (52% for mild and 74% for moderate). The focus group discussions reveal that both teachers and parents would benefit from further education regarding refractive errors and that the vast majority of teachers are willing to conduct a school-based screening program.ConclusionRefractive error screening by health professionals in pre-primary and primary school children is not currently implemented in Thailand due to resource limitations. However, evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs.

Highlights

As part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers
Evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs
On World Sight Day in 2006, the World Health Organization (WHO) revealed that 153 million people aged older than five years were visually impaired due to uncorrected distance refractive error [2]

Summary

Introduction

As part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers. On World Sight Day in 2006, the World Health Organization (WHO) revealed that 153 million people aged older than five years were visually impaired due to uncorrected distance refractive error [2]. The prevalence of refractive errors was reported in primary school children in rural Tanzania at less than 1% [4], 8% in Kathmandu (Nepal) [5], 15% in Malaysia [6], 37% in Hong Kong [7], and more than 50% in Singapore [8]. In Thailand, the 4th National Survey of Blindness in 2006–07 estimated that 15 million people were living with visual impairment due to uncorrected refractive error [9]. The prevalence of refractive error in primary school children (6–12 years old) in Bangkok was recently reported at approximately 13% [10]

Methods

Results

Conclusion