Global disease burden of uncorrected refractive error among adolescents from 1990 to 2019

Zhenlan Yang,Zijing Li,Yunru Liao,Yuqing Lan,Yichi Zhang,Xiang Gao,Guangming Jin

doi:10.1186/s12889-021-12055-2

Abstract

BackgroundTo estimate the global disease burden of uncorrected refractive error (URE) among adolescents and assess the contributions of various risk factors to disability-adjusted life-years (DALYs) due to URE.MethodsGlobal, regional and country-level DALY numbers and rates due to URE among adolescents were acquired from the Global Burden of Disease Study 2019 database. Human Development Index (HDI), Socio-Demographic Index (SDI) and other country-level data were obtained from other open databases as potential indicators. Regression analysis was used to evaluate associations between DALY rates among adolescents and potential predictors.ResultsGlobal DALYs due to URE among adolescents rose by 8% between 1990 and 2019 but moderately decreased by 4.8% during this period after adjusting for population size. Female adolescents showed higher DALY rates. DALY rates sharply increased from 5 to 9 years of age, then rose more slowly, reaching a plateau before 20 years of age. Country-level DALY rates in 2019 were positively associated with HDI, SDI, and urbanization rates but negatively correlated with primary school dropout rates. Higher disease burden of adolescents visually impaired from URE was associated with lower primary school dropout rates (β = − 0.257, 95% CI − 0.376 to − 0.138, P < 0.001) and higher urbanization rates (β = 0.257, 95% CI 0.067 to 0.256, P = 0.001).ConclusionsHigher socioeconomic status, urbanization rates and education levels are associated with a heavier disease burden of URE among adolescents. The findings of this study can provide a reference for policy making on resource allocation for URE prevention and control in teenagers.

Highlights

To estimate the global disease burden of uncorrected refractive error (URE) among adolescents and assess the contributions of various risk factors to disability-adjusted life-years (DALYs) due to URE
Trends in the disease burden of URE from 1990 to 2019 According to the Global burden of disease (GBD) 2019, the number of DALYs due to URE slightly increased by 8%, from 814,261.98 (95% uncertainty interval [UI] 502,307.00–1,239,889.76) in 1990 to 879,736.05 (95% UI 538,302.00–1,353,108.75) in 2019 (Fig. 1A)
Global disease burden of URE by age and sex Wilcoxon signed-rank tests showed that there were significant sex disparities, as total DALYs for women significantly exceeded those of men from 1990 to 2019 (Fig. 2 A and B)

Summary

Introduction

To estimate the global disease burden of uncorrected refractive error (URE) among adolescents and assess the contributions of various risk factors to disability-adjusted life-years (DALYs) due to URE. With an extremely high prevalence, URE ranks first among visual impairment causes, and the affected population is expected to continually grow [1]. Being at the critical period of eye development,children and adolescents could be sensitive to environmental factors and at high risk of suffering from refractive disorders. During the coronavirus disease 2019 (COVID-19) pandemic period, these school-aged children could be vulnerable to undiagnosed myopia owing to the home confinement policy and not attending class where myopic individuals can be highlighted through routine lessons (e.g. copying from the board) [2]. Access to ophthalmology outpatient services including optometry were limited during the peaks of the pandemic, and the need for these services is backlogged

Objectives

Methods

Results

Discussion

Conclusion