Increasing prevalence of myopia and the impact of education in primary-school students in Xi'an, north-western of China

Lu Ye; Yan-Qi Yang; Guo-Yun Zhang; Wen-Jun Wang; Mei-Xia Ren; Pan Ge; Jian Zhang; Nan Zhang; Xing-Zhou Liu; Ming-Lei Zhang; Yu-Jiao Tong; Liang-Cai Lu; Mo-Qi Lv; Dang-Xia Zhou; Cheng Pei

doi:10.3389/fpubh.2022.1070984

Increasing prevalence of myopia and the impact of education in primary-school students in Xi'an, north-western of China

Front Public Health. 2022 Dec 19:10:1070984. doi: 10.3389/fpubh.2022.1070984. eCollection 2022.

Authors

Lu Ye^{1

2}, Yan-Qi Yang³, Guo-Yun Zhang², Wen-Jun Wang², Mei-Xia Ren², Pan Ge³, Jian Zhang³, Nan Zhang³, Xing-Zhou Liu¹, Ming-Lei Zhang¹, Yu-Jiao Tong¹, Liang-Cai Lu¹, Mo-Qi Lv³, Dang-Xia Zhou³, Cheng Pei⁴

Affiliations

¹ Health Science Center, Xi'an Jiaotong University, Xi'an, China.
² Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, China.
³ Department of Pathology, School of Basic Medical Sciences, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
⁴ Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Abstract

Purpose: The present study was performed to detect the prevalence of myopia among primary-school students in Xi'an, north-western of China.

Methods: The present study was a school-based study with students aged from 6 to 13 years old. All the individuals underwent ophthalmological examination and spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Myopia was defined as a SE of ≤ -0.5 diopters (D), and further divided into three stratified groups based on SE: low myopia (≤ -0.5 to >-3.0 D), moderate myopia (≤ -3.0 to >-6.0 D), and high myopia (≤ -6.0 D). Relative risk factors, including age, sex, grade and ethnicity were investigated using questionnaire.

Results: A total of 4,680 individuals were eligible for this survey and 4,654 (99.4% participation rate) were finally included (51.2% boys). The mean age of participants was 8.756 ± 1.727 years. The whole city-level prevalence of total myopia was 57.1% (95% CI: 55.7-58.6%). Additionally, the prevalence of low, moderate, and high myopia was 45.0% (95% CI: 43.5-46.4%), 11.1% (95% CI: 10.2-12.0%), and 1.0% (95% CI: 0.7-1.3%), respectively. Moreover, grade (education level) instead of age, sex and ethnicity was the most essential risk factor for prevalence of overall myopia (OR = 1.844, 95% CI: 1.605-2.119), and an increase of prevalence by 84.4% per grade was seen. Furthermore, similar associations of grade were significant with low myopia (OR = 1.613, 95% CI: 1.385-1.877) and moderate myopia (OR = 2.186, 95% CI: 1.693-2.823), meanwhile, prevalence of low myopia and moderate myopia demonstrated an increase of prevalence by 61.3 and 118.6% per grade, respectively. None of the factors included in the present study was significant risk factor for high myopia.

Conclusions: The present study investigated a non-negligible high prevalence of myopia among primary-school students in Xi'an, north-western of China, and a gradual increasing in proportion with education level.

Keywords: Xi'an city; cross-sectional studies; myopia; north-western China; prevalence; primary school.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
China / epidemiology
Educational Status
Female
Humans
Male
Myopia* / epidemiology
Prevalence
Students