Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes.


Wedner, S; Masanja, H; Bowman, R; Todd, J; Bowman, R; Gilbert, C; (2008) Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes. The British journal of ophthalmology, 92 (1). pp. 19-24. ISSN 0007-1161 DOI: https://doi.org/10.1136/bjo.2007.119198

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Abstract

PURPOSE: To compare whether free spectacles or only a prescription for spectacles influences wearing rates among Tanzanian students with un/undercorrected refractive error (RE). METHODS: DESIGN: Cluster randomised trial. SETTING: 37 secondary schools in Dar es Salaam, Tanzania. PARTICIPANTS: Distance visual acuity was measured in 6,904 year-1 students (90.2% response rate; median age 14 years; range 11-25 years) using a Snellen E-chart. 135 had RE requiring correction. INTERVENTIONS: Schools were randomly allocated to free spectacles (arm A) or prescription only (arm B). Primary outcome: Spectacle use at 3 months. RESULTS: The prevalence of un/undercorrected RE was 1.8% (95% CI: 1.5 to 2.2%). At 3 months, 27/58 (47%) students in arm A were wearing spectacles or had them at school compared with 13/50 (26%) in arm B (adjusted OR 2.4, 95% CI 1.0 to 6.7). Free spectacles and myopia were independently associated with spectacle use. CONCLUSIONS: The low prevalence of un/undercorrected RE and poor uptake of spectacles, even when provided free, raises doubts about the value of vision-screening programmes in Tanzanian secondary schools. Policy decisions on school vision screening in middle- and low-income countries should take account of the cost-effectiveness as well as competing demands for scarce resources.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: The International Centre for Evidence in Disability
International Centre for Eye Health
Centre for Maternal, Reproductive and Child Health (MARCH)
Centre for Global Non-Communicable Diseases (NCDs)
Population Studies Group
PubMed ID: 18156372
Web of Science ID: 252054700005
URI: http://researchonline.lshtm.ac.uk/id/eprint/8341

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