Wedner, S., Masanja, H., Bowman, R., Todd, J., Bowman, R. and Gilbert, C. Two strategies for correcting refractive errors in school students in Tanzania: randomised comparison, with implications for screening programmes. The British journal of ophthalmology, 92 (1). pp. 19-24. ISSN 1468-2079
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To compare whether free spectacles or only a prescription for spectacles influences wearing rates among Tanzanian students with un/undercorrected refractive error (RE). Cluster randomised trial. 37 secondary schools in Dar es Salaam, Tanzania. 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. Schools were randomly allocated to free spectacles (arm A) or prescription only (arm B). Primary outcome: Spectacle use at 3 months. 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. The low prevalence of /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.
|Keywords:||Refractive errors, students, schools, Tanzania screening programmes, adolescent, school health services, spectacles, distance visual acuity|
|Subjects:||Emerging and Re-emerging Infectious Diseases|
|Divisions:||Ifakara Health Institute > Biomedical|
|Depositing User:||Mr Joseph Madata|
|Date Deposited:||13 Jul 2012 09:22|
|Last Modified:||03 Oct 2012 08:46|
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