Regional variations and temporal trends of childhood myopia prevalence in Africa: A systematic review and meta‐analysis

Abstract

Purpose To provide contemporary and future estimates of childhood myopia prevalence in Africa. Methods A systematic online literature search was conducted for articles on childhood (≤18 years) myopia (spherical equivalent [SE] ≤ −0.50D; high myopia: SE ≤ −6.00D) in Africa. Population‐ or school‐based cross‐sectional studies published from 1 Jan 2000 to 30 May 2021 were included. Meta‐analysis using Freeman–Tukey double arcsine transformation was performed to estimate the prevalence of childhood myopia and high myopia. Myopia prevalence from subgroup analyses for age groups and settings were used as baseline for generating a prediction model using linear regression. Results Forty‐two studies from 19 (of 54) African countries were included in the meta‐analysis (N = 737,859). Overall prevalence of childhood myopia and high myopia were 4.7% (95% CI: 3.3%–6.5%) and 0.6% (95% CI: 0.2%–1.1%), respectively. Estimated prevalence across the African regions was highest in the North (6.8% [95% CI: 4.0%–10.2%]), followed by Southern (6.3% [95% CI: 3.9%–9.1%]), East (4.7% [95% CI: 3.1%–6.7%]) and West (3.5% [95% CI: 1.9%–6.3%]) Africa. Prevalence from 2011 to 2021 was approximately double that from 2000 to 2010 for all studies combined, and between 1.5 and 2.5 times higher for ages 5–11 and 12–18 years, for boys and girls and for urban and rural settings, separately. Childhood myopia prevalence is projected to increase in urban settings and older children to 11.1% and 10.8% by 2030, 14.4% and 14.1% by 2040 and 17.7% and 17.4% by 2050, respectively; marginally higher than projected in the overall population (16.4% by 2050). Conclusions Childhood myopia prevalence has approximately doubled since 2010, with a further threefold increase predicted by 2050. Given this trajectory and the specific public health challenges in Africa, it is imperative to implement basic myopia prevention programmes, enhance spectacle coverage and ophthalmic services and generate more data to understand the changing myopia epidemiology to mitigate the expanding risk of the African population.

Prevalence of myopia in school-age children in Ethiopia: A systematic review and meta-analysis

“…The finding of this meta-analysis (5.26%) is consistent with the results of meta-analyses done in children in India in 2018 (5.3%) 60 and Nepal in 2023 (7.1%). 61 It is also in line with the result of a meta-analysis of childhood myopia and myopia in school children in Africa in 2022 (4.7%) 12 , 62 and comparable with the study finding in Ethiopia among school students (5.10%), 13 based on the results of 16 articles. The similarity in the study results may be due to approximate similarities in the study populations specifically their age.…”

Urban Living Environment and Myopia in Children

“…In addition to studies that generalized to simple urban-rural divisions, Zhang et al found that average population density in administrative divisions was associated with myopia risk among Chinese children independent of factors such as academic activities, outdoor time, family educational level, and economic development. Similarly, studies conducted in Africa projected an increase in childhood myopia prevalence in urban settings . Additionally, the presence of green spaces within school campuses is associated with a lower prevalence of myopia at the school level and potentially with reduced risk of myopia development in individuals .…”

“…Similarly, studies conducted in Africa projected an increase in childhood myopia prevalence in urban settings. 30 Additionally, the presence of green spaces within school campuses is associated with a lower prevalence of myopia at the school level and potentially with reduced risk of myopia development in individuals. 17 , 18 In our study, we systematically examined various environmental variables with population density as a reference point.…”

Baseline metrics that may predict future myopia in young children

“…General inclusion criteria, as determined at the baseline visit, were as follows: (1) between 6 and <9 years of age; (2) uncorrected distance visual acuity (VA) of 0.1 LogMAR or better in each eye and (3) refractive error (spherical equivalent, M, determined by cycloplegic open-field autorefraction) of no less than −0.25D and no more than +2.50D in the right eye, with less than or equal to 0.75D of anisometropia or 0.75D of astigmatism in either eye (determined by cycloplegic open-field autorefraction).…”

“…Myopia is a major public health concern precipitated by its increasing prevalence worldwide 1–7 and the associated risk of potentially blinding conditions 8–12 . Projections indicate that by the year 2050, over half of the world's population will have myopia, with 10% of those having high myopia 13 .…”