Sheeladevi Sethu, Seelam Bharani, Nukella Phanindra B, Modi Aditi, Ali Rahul, Keay Lisa
School of Health Sciences, City, University of London, London, UK.
The George Institute for Global Health, New Delhi, India.
Clin Exp Optom. 2018 Jul;101(4):495-503. doi: 10.1111/cxo.12689. Epub 2018 Apr 22.
Uncorrected refractive error is an avoidable cause of visual impairment which affects children in India. The objective of this review is to estimate the prevalence of refractive errors in children ≤ 15 years of age. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in this review. A detailed literature search was performed to include all population and school-based studies published from India between January 1990 and January 2017, using the Cochrane Library, Medline and Embase. The quality of the included studies was assessed based on a critical appraisal tool developed for systematic reviews of prevalence studies. Four population-based studies and eight school-based studies were included. The overall prevalence of refractive error per 100 children was 8.0 (CI: 7.4-8.1) and in schools it was 10.8 (CI: 10.5-11.2). The population-based prevalence of myopia, hyperopia (≥ +2.00 D) and astigmatism was 5.3 per cent, 4.0 per cent and 5.4 per cent, respectively. Combined refractive error and myopia alone were higher in urban areas compared to rural areas (odds ratio [OR]: 2.27 [CI: 2.09-2.45]) and (OR: 2.12 [CI: 1.79-2.50]), respectively. The prevalence of combined refractive errors and myopia alone in schools was higher among girls than boys (OR: 1.2 [CI: 1.1-1.3] and OR: 1.1 [CI: 1.1-1.2]), respectively. However, hyperopia was more prevalent among boys than girls in schools (OR: 2.1 [CI: 1.8-2.4]). Refractive error in children in India is a major public health problem and requires concerted efforts from various stakeholders including the health care workforce, education professionals and parents, to manage this issue.
未矫正的屈光不正乃是导致视力损害的一个可避免因素，它影响着印度的儿童。本综述的目的是估算15岁及以下儿童屈光不正的患病率。本综述遵循了系统评价与Meta分析的首选报告项目指南。利用考克兰图书馆、医学期刊数据库和循证医学数据库，进行了详细的文献检索，纳入1990年1月至2017年1月间印度发表的所有基于人群和学校的研究。根据为患病率研究的系统评价所开发的关键评估工具，对纳入研究的质量进行了评估。纳入了四项基于人群的研究和八项基于学校的研究。每100名儿童中屈光不正的总体患病率为8.0（置信区间：7.4 - 8.1），在学校中为10.8（置信区间：10.5 - 11.2）。基于人群的近视、远视（≥ +2.00 D）和散光患病率分别为5.3%、4.0%和5.4%。与农村地区相比，城市地区单纯屈光不正和近视的患病率更高（优势比[OR]：2.27 [置信区间：2.09 - 2.45]）和（OR：2.12 [置信区间：1.79 - 2.50]）。学校中单纯屈光不正和近视的患病率在女孩中高于男孩（OR：1.2 [置信区间：1.1 - 1.3]和OR：1.1 [置信区间：1.1 - 1.2]）。然而，学校中男孩的远视患病率高于女孩（OR：2.1 [置信区间：1.8 - 2.4]）。印度儿童的屈光不正问题是一个重大的公共卫生问题，需要包括医疗保健人员、教育专业人员和家长在内的各利益相关方共同努力来解决这一问题。
