Presentation on theme: "Dr. Margaret W Njuguna Dr. Lucy Njambi Ombaba"— Presentation transcript:
1 Dr. Margaret W Njuguna Dr. Lucy Njambi Ombaba PREVALENCE, KNOWLEDGE, ATTITUDE AND PRACTICES IN REFRACTIVE ERROR AMONG HIGH SCHOOL STUDENTS IN NAIROBI COUNTYDr. Margaret W NjugunaDr. Lucy Njambi Ombaba
2 Review of research literature Uncorrected refractive error(RE)Global magnitude of uncorrected RE- leading cause of visual impairment and blindness43% of visual impairment due to Uncorrected RE80% of visual impairment worldwide can be avoided or curedIn children it may hinder school performance and lead to development of amblyopia.Among the causes of blindness, refractive error ranks second to cataracts as a cause of blindness.Uncorrected refractive error accounts for visual impairment in 153 million people.Eighty percent of all visual impairment worldwide can be avoided or cured. About 90% of the world’s visually impaired live in developing countries1. Uncorrected refractive errors have a huge socioeconomic and psychological impact. In children it may hinder school performance and lead to development of amblyopia1.Resnikoff S, Pascolini D, Mariotti SP, et al. Global Magnitude of visual impairment caused by uncorrected refractive errors in Bull world health Organ 2008; 862.WHO fact sheet on RE 2014
3 Review of research literature Knowledge, attitude and practices(KAP) of refractive errorLack of knowledge and stigmas plays a major role in uptake of refractive services in different continentsthe lack of knowledge and awareness of RE are important risk factors for uncorrected RE 2,3,42.Congdon N., Z. m. (2008). prevalence and determinants of spectacle non-wear among rural Chinese secondary school children. Arch Ophthalmol.,3.Ebeigbe, J. (2013). attitude and beliefs of Nigerian undergraduates to spectacle wear. Ghana Medical Journal.4.Rosman M, W. T. (2009). Knowledge and beliefs associated with refractive errors and undercorrection: the Singapore Malay Eye Study. Br J Ophthalmol.
4 Study justification Uncorrected RE -public health concern. Uncorrected RE hampers performance at school, reduces productivity and impairs quality of life.Lack of knowledge, stigma and erroneous beliefs towards RE plays a major role in uptake of refractive services .2,3,4Hardly any studies address KAP in refractive errorAssessing KAP gaps will justify intervention programmes1.H.Nzuki. (2004). 2. Helen Significant refractive errors as seen in standard eight pupils attending public schools in langata Division, Nairobi, K2.Congdon N., Z. m. (2008). prevalence and determinants of spectacle non-wear among rural Chinese secondary school children. Arch Ophthalmol.,3.Ebeigbe, J. (2013). attitude and beliefs of Nigerian undergraduates to spectacle wear. Ghana Medical Journal.4.Rosman M, W. T. (2009). Knowledge and beliefs associated with refractive errors and undercorrection: the Singapore Malay Eye Study. Br J Ophthalmol enya 2004
5 Study Objectives Broad objective To determine the prevalence, knowledge, attitude and practice in refractive errors among high school students in Nairobi county.Specific objectivesTo determine the prevalence of refractive error among high school studentsTo assess the knowledge of refractive error among high school studentsTo determine the attitude of high school students towards refractive errorsTo determine the practice in refractive error of high school students
6 Methodology Study design Cross sectional school based study with a qualitative componentStudy populationForm 3 high school students in public high schools in Nairobi CountyStudy areaNairobi county-80 public high schools in 10 divisions
7 Methodology Sample size calculation and Sampling Method Parameters Estimate of the expected proportion (p)Desired level of absolute precision (d)Estimated design effect (DEFF)Confidence limit (usually 95% and Z score
8 Methodology Sample size calculation and Sampling Method n = x 0.1 x 0.9 (1.5)n = 1297To estimate the assumed prevalence of refractive error 10% with 95% CI (8% - 12%) among high school students, adjusting for the design effect of 1.5 and confidence limit (usually 95% and Z score = 1.96), the final minimal sample size will be 1297Factor 10% to end up with 1500Total number 37580
9 Methodology Sampling the Procedure Stratification/Categories of schools- National schools, County schools and District schoolsSub-stratified into boy, girl & mixedSchools from each category will be randomly selected using spreadsheet programParticipants will be form 3 studentsParticipants will be allocated a study number
10 Study area- Nairobi County starehewestlandsdagoretti
11 Sampling frame of high school students in Nairobi County News letter of high school performancein National schools, in County schools and in the District schools
12 Data collection procedure Presenting VA-Log MAR chart 3mVA better than 6/12 in better eye. Record VASpectacles-VA sc&cc RE&LEVA worse or equal to 6/12 in the better eyePower of spectacle - LensometerObjective refraction & subjective refractionPlano/ 0.25 DS/DCRE ≥0.50 DS/DCVA doesn’t improve by 2 linesVA improves 2 lines or more=REAnterior and posterior segment examination- recordyytyffcnhhgKAP=FGD or IDIKAP FGD or IDI
13 Data managementData analysis -SPSS and Computer Assisted/Aided Qualitative Data Analysis Software (CAQDAS).Double data entry to ensure accuracy.Proportions will be used to estimate the prevalence of R.E and proportion of students knowledgeable in refractive errors.Responses to the KAP questions will be scored.Participants with RE will be assessed in terms of KAP towards RE and access to ophthalmic services.Results will be presented using ratio, proportion, rates, tables and diagrams wherever appropriate.
14 Ethical considerations Approval -Ethical Committee of University of Nairobi – Kenyatta National Hospital.Permission -Permanent Secretary, Ministry of Education and Head teachers of schoolsAssent- Participants.Confidentially of participants records.Spectacle prescription and follow up for participants with RE.Students with other ocular disease will be referred to eye centers.
15 Tentative Timetable Ethical Approval by April 2014 Collection of data May- June 2014Data Analysis July-August 31st 2014Presentation of results September 2nd 2014Hand in bound book by January 1st 2015