Strabismus prevalence and associated factors among pediatric patients in southern Ethiopia: a cross-sectional study

Abstract

Objective To assess the strabismus prevalence and associated factors among children aged ≤15 years. Methods This hospital-based cross-sectional study was conducted from March 2017 to October 2017 in the Department of Ophthalmology & Optometry, Hawassa University Comprehensive Specialized Hospital. Interviewer-administered questionnaires were used to collect relevant data and clinical examinations were performed for patient diagnosis. Results Overall, 582 children participated in the study (response rate, 97%). The prevalence of childhood strabismus was 17.9% [95% confidence interval: 14.6–21.1]. Additionally, 9.6%, 16.7%, and 9.6% of the children had anisometropia, amblyopia, and dense cataract, respectively. Among the 16.7% of children with amblyopia, 56.7% had strabismus; among the 22.5% of children with clinically significant refractive error, 52.7% had strabismus. Moreover, among the 9.6% of children with anisometropia, 58.9% had strabismus. The presence of amblyopia (adjusted odds ratio [95% confidence interval]: 3.9, 1.7–8.6), age <5 years (13.5 [5.0–36.1]), age 5 to 10 years (6.1 [2.3–16.3]), and clinically significant refractive error (13.3 [5.8–30.6]) were significantly associated with childhood strabismus. Conclusions The prevalence of strabismus was relatively high among patients in this study. Early screening for childhood strabismus is essential. A well-controlled community-based study is needed to confirm strabismus prevalence and predictors.

Prevalence of Strabismus and Its Associated Factors Among School-Age Children Living in Bahir Dar City: A Community-Based Cross-Sectional Study

“…In agreement with other similar studies done in America, 9 Nigeria, 26 and Ethiopia 8 having a positive family history of strabismus was independently associated with the occurrence of strabismus (AOR= 3.9). The possible justification could due to most ocular disorders including strabismus being related to genetic conditions and the risk of developing strabismus increases as the children had an additional sibling with a history of eye turn/strabismus.…”

“…On the other side, the results of other similar studies done in Japan 18.3% at near and 13.5 at distance, 23 in Chile 9.86%, 24 and in Ethiopia 17.96% 8 are higher as compared to the result of the present study. This could due to the above studies were hospital/institution based in which children with the problem had a high chance to be included in the study that in turn increases the proportion of strabismus in the above studies.…”

“…This was supported by other similar studies done in America, 9 United Kingdom, 13 Australia, 20 Nigeria, 26 and Ethiopia. 8 Hyperopia of +3.00 Ds and more is highly associated with the occurrence of esotropia and the odds of developing esotropic strabismus increases as the degree of hyperopia increases. 3 , 4 …”

“…The minimum sample size to carry out this study was determined using double proportion population formula using Epi-info by taking the following assumptions; 95% CI, 4% margin of error, power as 80%, ratio 1:1, and proportion of strabismus from the previous study as 17.9%. 8 Finally, from all healthy students from five weeks in spring 2019 in Bahir Dar city, Ethiopia, 632 recruited assuming 1.5 as design effect and only 10% non-response rate.…”

“…4,5 The pooled prevalence of any strabismus, exotropia, and esotropia was 1.93%, 1.23%, and 0.77%, respectively, globally 6 and in Ethiopia, its prevalence ranges from 1.53% 7 to 17.9%. 8 Family history, ethnicity, genetic conditions, smoking, prematurity, low birth weight, refractive error, and neuro disability are the most common risk factors associated with the development of strabismus. 4,9 Hyperopic refractive error of +3.00Diopters (Ds) and above is highly associated with esotropic strabismus and the odds of developing strabismus increases as the spherical equivalent of hyperopia and degree of astigmatism identified increases.…”