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Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes
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Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes
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Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes
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Journal Article
Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes
2008
Overview
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.
Publisher
BMJ Publishing Group Ltd,BMJ,BMJ Publishing Group LTD
Subject
/ Adult
/ Biological and medical sciences
/ Child
/ Eyeglasses - supply & distribution
/ Female
/ Humans
/ Male
/ Patient Compliance - statistics & numerical data
/ Refractive Errors - epidemiology
/ Refractive Errors - physiopathology
/ School Health Services - organization & administration
