Prevalence of Visual Impairment and Associated Factors Among Primary Schoolchildren in Addis Ababa, Central Ethiopia

Background: Visual impairment (VI) refers to reduction of vision resulting in a lower than normal visual acuity (VA). Although school programs are recommended for early detection and timely interventions of VI, available information with regard to prevalence of VI and associated factors among primary schoolchildren near to the main city, Addis Ababa is inadequate. Thus, we assessed the prevalence of VI and the associated factors among children attending government primary schools of Lideta sub-city, Addis Ababa, Ethiopia.

Methods: This was a school-based cross-sectional study conducted from April to May 2019, using a two-stage cluster sampling method in Lideta sub-city, Addis Ababa, Ethiopia. From the total 18 government primary schools in Lideta sub-city, six were selected using probability proportionate to size (PPS) method. The study population was primary schoolchildren aged 7 to 17 years in the selected six primary schools. A total of 816 eligible primary schoolchildren were identified to be included in the study. The selected children were examined for the presence of VI. Children's parents/guardians were interviewed using structured pre-tested questionnaires. In this study, myopia and hyperopia were defined as difficulty in viewing distant and near objects, respectively. Similarly, astigmatism was a refractive error which results from an uneven cornea surface, which results in distorted images. Epi-data 3.1 and SPSS version 20 were used for data entry and analysis, respectively. Binary logistic regression was performed to check association between dependent and independent variables. Significance was set at p-value <0.05.

Results: From a total of 816 eligible primary schoolchildren, 773 children were examined for VI, making the response rate 94.7%. Out of the 773 children, 370 (47.9%) were male and 403 (52.1%) were female. The mean age of the participants was 11.69 years (SD 2.64 years). The prevalence of VI among schoolchildren was 4.4%. The causes of VI included myopia (43%), astigmatism with or without amblyopia (31%), hyperopia with or without amblyopia (20%), and others. The parents/guardians not being aware of their children's eye problem (AOR=2.2, 95% CI: 1.2-4.4) was the only significantly associated factor with VI.

Conclusion: In this study, the prevalence of VI among schoolchildren was high. The students being unaware about their eye problem was significantly associated with VI. Thus, close monitoring and regular screening for VI in schoolchildren are highly recommended to allow timely intervention.