Abstract
BackgroundThe prevalence of myopia and associated risk factors among children in Chongqing has not yet been determined. This study investigated the prevalence of myopia and possible relationships between myopia and several related factors among school children in Chongqing.MethodsThis cross-sectional study assessed a sample of 997 children (7–13 years of age) attending primary school in Chongqing. Data were obtained from visual acuity and refractive error measurements and a structured questionnaire. Myopia was defined as visual acuity < 5.0 and refractive error (spherical equivalent) of < − 0.50 diopters (D) in either eye. Multilevel modeling was applied to investigate potential risk factors.ResultsThe overall prevalence of myopia was 33.9% [95% confidence interval (CI) = 31.0–36.8]; myopia prevalence significantly increased with age. Girls were at a higher risk of myopia than boys [odds ratio (OR) = 1.449, 95% CI = 1.060–1.979]. Children with paternal myopia (OR = 2.130, 95% CI = 1.376–3.297) or maternal myopia (OR = 1.861, 95% CI =1.153–3.002) had a higher risk of myopia than those without myopic parents. Children who spent more than 1 h daily outdoors were less likely to have myopia; meanwhile, children who did homework more than 3 h daily (OR = 2.237, 95% CI = 1.041–4.804), watched television more than 3 h daily (OR = 2.106, 95% CI = 1.200–3.697), or played electronics more than 1 h daily (OR = 2.983, 95% CI = 2.088–4.262) had a higher risk of myopia.ConclusionsMyopia in school children is a serious public health problem in Chongqing. Myopia was significantly positively associated with higher age, female sex, parental myopia, and spending a long time indoors; notably, playing with electronics had the greatest influence on the risk of myopia.
Highlights
The prevalence of myopia and associated risk factors among children in Chongqing has not yet been determined
Ordinary logistic regression was performed in many prior studies [1, 9, 11, 12] to identify myopia risk factors, the data emanating from student environments are often hierarchically structured; the ordinary logistic regression model cannot recognize the existence of clustering, resulting in the underestimation of standard errors of regression coefficients [13]
The analysis revealed that myopia was associated with age; female sex; paternal and maternal myopia; less time spent outdoors; more time spent on homework, watching television, and playing with electronics
Summary
The prevalence of myopia and associated risk factors among children in Chongqing has not yet been determined. Ordinary logistic regression was performed in many prior studies [1, 9, 11, 12] to identify myopia risk factors, the data emanating from student environments are often hierarchically structured; the ordinary logistic regression model cannot recognize the existence of clustering, resulting in the underestimation of standard errors of regression coefficients [13]. A preferable statistical approach, multilevel modeling, is more suitable for analyzing these data, as it can identify the existence of clustering within hierarchically structured data, thereby improving estimation of effects and corresponding standard errors [14]
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