Abstract
Background: Visual impairment among school children is relatively common and research provides evidence for integration of comprehensive eye care into school health programmes. Aim: To determine the prevalence and determinants of visual impairment in school-aged children in Southern Nigeria. Setting: School aged children from 10 public and private-owned schools in Cross River State, Southern Nigeria. Methods: This cross-sectional analytic study used a multistage random sampling technique to select 2418 school children aged 6–17 years. Comprehensive eye examinations were performed on the study. The logistic regression analysis with 95% confidence interval (CI) was used to test hypotheses. Results: Of the 2418 school children selected, 2110 (87%) were assessed. The prevalence ‘of uncorrected, presenting and best corrected visual acuity of 0.3 (20/40) or worse in the better eye’ was 7.3%, 7.2% and 0.19%, respectively. Errors of refraction were the cause of the impairment in 198 (70.7%; 63.5–76.0) eyes with reduced vision, followed by glaucoma suspects 38 (19.2%; 13.8–24.8), amblyopia (3.0%; 1.1–6.4) and corneal opacity 3 (1.5%; 0.3–4.3). The major and independent predictors of visual impairment were age (adjusted odds ratio [AOR] 1.97, 95% 1.45–2.67), high socio-economic status (adjusted odds ratio [AOR] 1.68, 95% 1.36–2.09) and female gender (AOR 1.35, 95% 1.00–1.88). Conclusion: The common causes of visual impairment in school-aged children are avoidable, and are mostly because of uncorrected refractive error, which could reflect inadequate refractive error services in the area.
Highlights
Vision problems, especially refractive error, amongst school-aged children are increasing globally.[1,2] Low vision and blindness can impede growth in a child’s education, literacy and motor development impairment.[3]
More than half of the children (52.9%) were females, 59.2% were in primary schools (6–11-year-olds) and 76.4% were in public schools (Table 1)
The major causes of visual impairment amongst schoolaged children were refractive error, glaucoma suspects, amblyopia and corneal opacity. Most of these causes are preventable and about 99.8% of them are correctible with spectacles, and only three out of those who need spectacles wore them; this implies that the uptake of refractive services amongst school-aged children is low
Summary
Especially refractive error, amongst school-aged children are increasing globally.[1,2] Low vision and blindness can impede growth in a child’s education, literacy and motor development impairment.[3]. We reported the prevalence of visual disorders of 32% in school children in Southern Nigeria and that only 1.8% of the children previously had an eye examination.[5] As such, early diagnosis and treatment of physical and eye health conditions are not readily available because of implementation of the various policies developed by the Federal Ministry of Health in Nigeria. There are numerous data available on visual impairment in school children in other countries. The prevalence of uncorrected, presenting and best-corrected visual acuity (VA) of 20/40 or worse in the better eye, respectively, for school children in South Africa was 1.4%, 1.2% and 0.32%,6 whereas for Ghana it was 3.7%, 3.5%, and 0.4%, respectively.[7] In Southern India, the same findings were 2.7%, 2.6% and 2.6%8; in China, it is 27%, 16.6% and 0.46%9; and in Malaysia, it is 17.1%, 10.1% and 1.4%.10. Visual impairment among school children is relatively common and research provides evidence for integration of comprehensive eye care into school health programmes
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