Assessing the prevalence of refractive errors and accuracy of vision screening by schoolteachers in Liberia

Abstract

Background Evidence indicates that school-based vision screening by trained teachers is an effective way of identifying and addressing potential vision problems in schoolchildren. However, inconsistencies have been reported in both the testing methods and accuracy of the screeners. This study assessed the prevalence of refractive errors and accuracy of screening by teachers in Grand Kru County, Liberia. Methods We conducted a retrospective analysis of data from four schools where, in February 2019, children were screened for refractive errors by trained teachers and then re-examined by ophthalmic technicians. One row of five optotypes of the Snellen 6/9 (0.2 logMar) scale (tumbling E chart) was used at a distance of 3 m. The prevalence of visual impairment and associations with sex, age and school were explored. Sensitivity, specificity and predictive values were calculated. Results Data were available for 823 of 1095 eligible children with a mean age of 13.7 y (range 5–18) and male:female ratio of 1:0.8. Poor vision was identified in 24 (2.9%) children with no differences by either sex or age but small differences by school. Screening by teachers had a sensitivity of 0.25 (95% confidence interval [CI] 0.077 to 0.423) and a specificity of 0.996 (95% CI 0.992 to 1.000). Positive and negative predictive values were 0.667 (95% CI 0.359 to 0.975) and 0.978 (95% CI 0.968 to 0.988), respectively. The results were influenced by a high number of misclassifications in one of the four schools. Conclusions Teachers can be trained to conduct vision screening tests on schoolchildren to an acceptable level of accuracy, but strong monitoring and quality assurance systems should be built into screening programmes from the onset. In settings like Liberia, where many children do not attend school regularly, screening programmes should extend to community platforms to reach children out of school.

Skrining Kesehatan Indra: Upaya Peningkatan Kesehatan Anak Binaan LPKA Kelas II Ternate

“…Berbagai macam gangguan pada mata dapat mempengaruhi banyak hal dalam kehidupan salah satunya myopia atau rabun jauh yang merupakan kelainan refraksi yang paling umum dijumpai pada anak-anak hal ini dapat dinilai dari fokus penglihatan pada objek yang jauh tidak terfokus dan menyebabkan kesulitan dalam proses belajar seorang anak ketika membaca teks pada papan tulis dari kejauhan, selain myopia jenis kelainan refraksi lainnya yaitu hypermetropia atau rabun dekat adalah gangguan penglihatan yang membuat objek dekat tampak buram, dan astigmatisme yang mengganggu atau mengaburkan penglihatan pada jarak berapapun (Tobi et al, 2022). Gangguan penglihatan yang cukup banyak ditemukan juga adalah buta warna, buta warna dapat dibagi menjadi dua kategori yaitu buta warna total atau hanya dapat mengenali warna hitam dan putih, juga ada namanya buta warna parsial atau tidak dapat mengenali warna tertentu saja dan yang paling umum adalah kesulitan membedakan warna gabungan merah dan hijau (Romadhon et al, 2023).…”