Centre for Public Health, Queen's University Belfast, Belfast, UK.
Harvard T H Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
BMJ Open. 2022 May 10;12(5):e060379. doi: 10.1136/bmjopen-2021-060379.
To describe the demographic characteristics and ocular needs of children attending four child eye clinics in Cross River State, Nigeria, to inform the development of a sustainable spectacle cross-subsidisation scheme.
Retrospective analysis of clinic records.
Four child eye clinics in Calabar, Ogoja, Ikom and Ugep, Cross River State, Nigeria, from 1 May 2017 to 30 June 2019.
Children who failed the vision screening in schools and visited assigned child eye clinics, and self-referred children from the community.
Children's age, sex, residence, diagnosis, disease management, presenting and corrected visual acuity, history of spectacle wear and magnitude of refractive errors in spherical equivalent in the worse eye.
Of all the 3799 records reviewed, data were available for 3774 children (mean age 10.6±4.35 years; 61.6% girls; 69.1% from urban settings); 30.8% (n=1162) of them had vision impairment. Of those children, 71.2% (n=827) were diagnosed with refractive error. For management, 48.6% (n=1833) were prescribed spectacles and 40.5% (n=1527) were prescribed ocular medications. Children prescribed spectacles were significantly more likely to be girls (68.0%, p<0.001), and older than 13 years of age (53.6%, p<0.001). The most common range of spherical equivalent (in the worse eye) was <-0.50 DS to +1.75 DS (51.6%, n=945), followed by >-0.25 DS to -3.00DS (39.7%, n=727). Non-refractive eye conditions such as cataract (33.3%) and corneal disorders (14.1%) contributed to almost half of the total blindness.
The findings show that spectacles provisions and ocular medications are the primary and secondary needs for children who attended child eye clinics seeking eye care services. Further research is needed to understand parents' willingness to pay for spectacles to set strategic multitier pricing for a sustainable cross-subsidisation scheme.
描述在尼日利亚十字河州四个儿童眼科诊所就诊的儿童的人口统计学特征和眼部需求，为制定可持续的眼镜交叉补贴计划提供信息。
诊所记录的回顾性分析。
尼日利亚十字河州卡拉巴尔、奥戈贾、伊科和乌格佩的四个儿童眼科诊所，时间为 2017 年 5 月 1 日至 2019 年 6 月 30 日。
在学校视力筛查中失败并前往指定儿童眼科诊所就诊的儿童，以及来自社区的自我转诊儿童。
儿童年龄、性别、居住地、诊断、疾病管理、就诊时和矫正后的视力、眼镜佩戴史以及较差眼等效球镜的屈光不正程度。
在所审查的 3799 份记录中，有 3774 名儿童的数据可用（平均年龄 10.6±4.35 岁；61.6%为女孩；69.1%来自城市地区）；其中 30.8%（n=1162）有视力障碍。在这些儿童中，71.2%（n=827）被诊断为屈光不正。在管理方面，48.6%（n=1833）被开处眼镜处方，40.5%（n=1527）被开处眼部药物。开眼镜处方的儿童明显更可能是女孩（68.0%，p<0.001），年龄大于 13 岁（53.6%，p<0.001）。较差眼等效球镜（in the worse eye）最常见的范围是<-0.50 DS 至 +1.75 DS（51.6%，n=945），其次是>-0.25 DS 至-3.00DS（39.7%，n=727）。非屈光性眼病，如白内障（33.3%）和角膜疾病（14.1%），导致近一半的失明。
研究结果表明，在寻求眼科保健服务的儿童中，眼镜供应和眼部药物是首要和次要需求。需要进一步研究以了解家长对眼镜的支付意愿，以便为可持续的交叉补贴计划制定战略分层定价。
