Wedner S H, Ross D A, Balira R, Kaji L, Foster A
Infectious and Tropical Diseases Department, London School of Hygiene and Tropical Medicine, London, UK.
Br J Ophthalmol. 2000 Nov;84(11):1291-7. doi: 10.1136/bjo.84.11.1291.
The study measured the prevalence of eye diseases in primary school children between 7 and 19 years of age in a rural area of Tanzania, and investigated whether teachers could successfully provide the first component of a school eye screening service.
Teachers from each of three primary schools in Mwanza Region tested visual acuity using a Snellen's E chart in 1438 pupils. 1386 of these pupils were then interviewed and underwent a full eye examination by an eye team.
10 pupils (0.7%) had bilateral poor eyesight (visual acuity worse than 6/12), and an additional 14 pupils (1.0%) had unilateral poor eyesight. Significant refractive errors causing visual acuity less than 6/12 (1.0%), strabismus (0. 5%), and amblyopia (0.2%) were uncommon. Overall, 76 pupils (5.5%) had active trachoma, though the prevalence was 15.5% in the poorest school. 73 pupils (5.3%) reported night blindness, eight (0.6%) had Bitot's spots, and 11 (0.8%) had corneal scars. Simple screening by teachers correctly identified 80% of the pupils who were found to have bilateral poor eyesight by the eye team, with 91% specificity.
The prevalence of significant refractive errors was not high enough to justify a school eye screening programme solely for this purpose. However, a programme may be justified in areas where trachoma is common. Further research is needed to validate the frequent reports of night blindness and to establish the public health importance of vitamin A deficiency in this age group.
本研究测量了坦桑尼亚农村地区7至19岁小学生的眼病患病率,并调查了教师是否能够成功提供学校眼部筛查服务的第一部分。
姆万扎地区三所小学的教师使用斯内伦E视力表对1438名学生进行视力测试。随后,对其中1386名学生进行了访谈,并由眼科团队进行了全面的眼部检查。
10名学生(0.7%)双眼视力差(视力低于6/12),另有14名学生(1.0%)单眼视力差。导致视力低于6/12的显著屈光不正(1.0%)、斜视(0.5%)和弱视(0.2%)并不常见。总体而言,76名学生(5.5%)患有活动性沙眼,不过在最贫困的学校患病率为15.5%。73名学生(5.3%)报告有夜盲症,8名(0.6%)有比托斑,11名(0.8%)有角膜瘢痕。教师进行的简单筛查正确识别出了眼科团队发现的80%双眼视力差的学生,特异性为91%。
显著屈光不正的患病率不足以单独为此开展学校眼部筛查项目。然而,在沙眼常见的地区开展这样一个项目可能是合理的。需要进一步研究来验证频繁报告的夜盲症情况,并确定该年龄组维生素A缺乏对公共卫生的重要性。