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PREVALENCE, KNOWLEDGE, ATTITUDE AND PRACTICES IN REFRACTIVE ERROR AMONG HIGH SCHOOL STUDENTS IN NAIROBI COUNTY Dr. Margaret W Njuguna Dr. Lucy Njambi Ombaba.

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Presentation on theme: "PREVALENCE, KNOWLEDGE, ATTITUDE AND PRACTICES IN REFRACTIVE ERROR AMONG HIGH SCHOOL STUDENTS IN NAIROBI COUNTY Dr. Margaret W Njuguna Dr. Lucy Njambi Ombaba."— Presentation transcript:

1 PREVALENCE, KNOWLEDGE, ATTITUDE AND PRACTICES IN REFRACTIVE ERROR AMONG HIGH SCHOOL STUDENTS IN NAIROBI COUNTY Dr. Margaret W Njuguna Dr. Lucy Njambi Ombaba

2 Review of research literature Uncorrected refractive error(RE) Global magnitude of uncorrected RE- leading cause of visual impairment and blindness 43% of visual impairment due to Uncorrected RE 80% of visual impairment worldwide can be avoided or cured In children it may hinder school performance and lead to development of amblyopia. 1.Resnikoff S, Pascolini D, Mariotti SP, et al. Global Magnitude of visual impairment caused by uncorrected refractive errors in Bull world health Organ 2008; 86 2.WHO fact sheet on RE 2014

3 Review of research literature Knowledge, attitude and practices(KAP) of refractive error Lack of knowledge and stigmas plays a major role in uptake of refractive services in different continents the lack of knowledge and awareness of RE are important risk factors for uncorrected RE 2,3,4 2.Congdon N., Z. m. (2008). prevalence and determinants of spectacle non-wear among rural Chinese secondary school children. Arch Ophthalmol., 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. 2,3,4 Hardly any studies address KAP in refractive error Assessing KAP gaps will justify intervention programmes 1.H.Nzuki. (2004). 2. Helen Significant refractive errors as seen in standard eight pupils attending public schools in langata Division, Nairobi, K 2.Congdon N., Z. m. (2008). prevalence and determinants of spectacle non-wear among rural Chinese secondary school children. Arch Ophthalmol., 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 objectives 1. To determine the prevalence of refractive error among high school students 2. To assess the knowledge of refractive error among high school students 3. To determine the attitude of high school students towards refractive errors 4.To determine the practice in refractive error of high school students

6 Methodology Study design Cross sectional school based study with a qualitative component Study population Form 3 high school students in public high schools in Nairobi County Study area Nairobi 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 = 1297 To 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 1297 Factor 10% to end up with 1500 Total number 37580

9 Methodology Sampling the Procedure Stratification/Categories of schools- National schools, County schools and District schools Sub-stratified into boy, girl & mixed Schools from each category will be randomly selected using spreadsheet program Participants will be form 3 students Participants will be allocated a study number

10 Study area- Nairobi County starehe dagoretti westlands

11 Sampling frame of high school students in Nairobi County News letter of high school performance in National schools, in County schools and in the District schools

12 Data collection procedure Presenting VA-Log MAR chart 3m VA better than 6/12 in better eye. Record VA VA worse or equal to 6/12 in the better eye RE ≥0.50 DS/DC Power of spectacle - Lensometer Objective refraction & subjective refraction Plano/ 0.25 DS/DC VA doesn’t improve by 2 lines VA improves 2 lines or more=RE KAP=FGD or IDI Anterior and posterior segment examination- recordyytyffcnhhg Spectacles-VA sc&cc RE&LE KAP FGD or IDI

13 Data management Data 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 1. Approval -Ethical Committee of University of Nairobi – Kenyatta National Hospital. 2.Permission -Permanent Secretary, Ministry of Education and Head teachers of schools 3.Assent- Participants. 4.Confidentially of participants records. 5.Spectacle prescription and follow up for participants with RE. 6.Students with other ocular disease will be referred to eye centers.

15 Tentative Timetable Ethical Approval by April 2014 Collection of data May- June 2014 Data Analysis July-August 31 st 2014 Presentation of results September 2 nd 2014 Hand in bound book by January 1 st 2015

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