Prevalence of Refractive Error Among School Children in Malawi

TL;DR

This study found that over half of school children in Malawi have refractive errors, highlighting the need for school-based eye health programs.

Contribution

The study provides new prevalence data on refractive errors among school children in Mzuzu City, Malawi.

Findings

The prevalence of refractive error was 55.3% among school children in Mzuzu City.

Hyperopia was the most common refractive error, affecting 52.0% of participants.

Adolescents had 1.445 higher odds of refractive errors compared to younger children.

Abstract

Uncorrected refractive errors are a significant public health concern. Refractive error remains a common cause of vision impairment. Children are vulnerable to uncorrected refractive errors, which can impact their development, education, and social welfare. Hence, it is essential to understand the extent of uncorrected refractive error in different populations to facilitate healthcare planning and the implementation of necessary interventions.

The study aimed to determine the prevalence of refractive error among school‐going children in five primary schools in Mzuzu City.

This was a cross‐sectional school‐based study conducted among school‐going children in Mzuzu City. A multistage sampling technique was used to recruit 1173 participants. Participants who met the study’s inclusion criteria were refracted under cycloplegia. The following was defined as ≥ 0.5 diopters, while hyperopia was ≥ +1.00 diopters. On the other hand, astigmatism was regarded as 0.50 Dcyl. The data were entered into excel then into SPSS Version 26. Binary logistic regression was used to determine associations. p < 0.05 was considered e statistically significant.

Among the study population, males and females contributed 586 (49.96%) and 587 (50.04%), respectively. The prevalence of refractive error was 649 (55.3%, CI = 0.5252.0.5828), with a higher incidence in males than that in females. Hyperopia was the most prevalent type of refractive error, occurring in 610 (52.0%) of the study participants. Accordingly, adolescents had 1.445 higher odds of having refractive errors compared with younger children (95% CI = 1.141.1.829, p = 0.002).

The high population of students who have refractive errors, without having undergone any form of screening, points to a need for greater efforts at establishing a sustainable school eye health program within the region. Therefore, this study recommends establishing a school eye health program to ensure that every child has the opportunity for visual screening. Furthermore, there is a need to abridge the cost of spectacles through ensuring the provision of readymade spectacles to indigent pupils whose parents may not afford regular spectacles.