Epidemiology of Uncorrected Refractive Error and Vision Impairment Among Pupils in Bindura, Zimbabwe: A Cross-sectional Study
DOI:
https://doi.org/10.71637/tnhj.v25i1.1001Keywords:
refractive error, vision impairment, children, Zimbabwe, pupilsAbstract
Background: Uncorrected refractive error is a major global cause of vision impairment, affecting education, development, and productivity, especially in children. The study examined the distribution of refractive errors and vision impairment among primary school children in Bindura City.
Methods: This descriptive cross-sectional study was conducted in three primary schools in Bindura, Zimbabwe, from April 2022 to April 2024. A multistage sampling method was used to select schools based on their administrative type, and data were collected through questionnaires, visual acuity tests, refraction, and fundoscopy.
Results: 3038 pupils were recruited and screened for the study, with 50.2% females and age ranging from 4-15 years (mean age = 9.19 ± 2.86 years). The prevalence of uncorrected refractive error was 3.1% (95% CI: 2.5% - 3.8%), with myopia at 2.6%; (95% CI: 2.1% - 3.6%), and hyperopia 0.5%; (95% CI: 0.3% - 0.8%). The prevalence of distance vision impairment was 0.36% (95% CI: 0.18% - 0.65%), and chi-squared test revealed that it was significantly associated with geographical setting (X2 = 18.26, df = 2, p < 0.001), but not with uncorrected refractive error (X2 = 2.626, df = 4,p = 0.622) or age (F [11, 3026] = 0.648; p = 0.499). There was no significant association between a child's age and uncorrected refractive error (F [11, 3026] = 0.942; p = 0.499).
Conclusion: Although the prevalence of uncorrected refractive error and visual impairment amongst the pupils was lower than in similar studies in Zimbabwe, the most common type of refractive error was myopia.
Downloads
References
1. World Health Organization. Blindness and vision impairment [Internet]. 2022 Oct [cited 2023 Feb 5]. Available from: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment
2. Sheeladevi S, Seelam B, Nukella PB, Modi A, Ali R, Keay L. Prevalence of refractive errors in children in India: a systematic review. Clin Exp Optom. 2018;101(4):495–503.
3. Harrington SC, Stack J, Saunders K, O’Dwyer V. Refractive error and visual impairment in Ireland schoolchildren. Br J Ophthalmol. 2019;103(8):1112–8. Available from: https://pubmed.ncbi.nlm.nih.gov/30315130/
4. Carlton J, Kaltenthaler E. Amblyopia and quality of life: a systematic review. Eye. 2011;25(4):403–13.
5. Kwarteng MA, Mashige KP, Kyei S, Govender-Poonsamy P, Dogbe DSQ. Impact of spectacle wear on the quality of life of learners with hearing impairment in Ghana. African Vision and eye Health. 2024;83(1):a875. https://doi.org/10.4102/aveh.v83i1.875
6. Pirindhavellie GP, Yong AC, Mashige KP, Naidoo KS, Chan VF. The impact of spectacle correction on the well-being of children with vision impairment due to uncorrected refractive error: a systematic review. BMC Public Health. 2023;23(1):1575. https://doi.org/10.1186/s12889-023-16484-z
7. Steinmetz JD, Bourne RRA, Briant PS, Flaxman SR, Taylor HRB, Jonas JB, et al. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9(2):e144–60.
8. Kahoto VE, Kwarteng MA, Afriyie BO, Zaabaar E, Kyei S. Epidemiology and trends in the uptake of refractive error services in Harare, Zimbabwe: a hospital-based retrospective study. Malawi Med J. 2024;35(4):214–9.
9. Tagoh S, Kyei S, Kwarteng MA, Aboagye E. Prevalence of refractive error and visual impairment among rural dwellers in Mashonaland Central Province, Zimbabwe. J Curr Ophthalmol. 2020;32(4):402–7.
10. Mzyece B, Malemane O, Chimatira A, Macheka B. Severe Visual Impairment in Schools (A PEEK Study). Open J Ophthalmol. 2022;12(03):307–21.
11. Kwarteng MA, Katsvanga CC, Kyei S. Childhood vision impairment and refractive error in Zimbabwe: A hospital-based retrospective study. Ethiop J Health Sci. 2022;32(4):723–8. Available from: https://doi.org/10.4314%2Fejhs.v32i4.8
12. Helliker K, Bhatasara S. Inside the Land Occupations in Bindura District, Zimbabwe. African Studies Quarterly. 2018;18(1):1-18.
13. Food and Nutrition Council. Bindura District Food and Nutrition Security Profile-Education Information. 2022 [cited 2024 Nov 12]. Available from: http://www.fnc.org.zw/wp-content/uploads/2023/04/Bindura-District-Profile.pdf
14. The World Bank. Country Economic Memorandum: Accelerating Growth and Jobs in Zimbabwe. https://www.worldbank.org/en/news/feature/2022/10/12/accelerating-growth-and-jobs-in-zimbabwe. 2022.
15. Kwarteng MA, Mashige KP, Kyei S, Govender-Poonsamy P, Dogbe DSQ. Compliance with spectacle wear among learners with hearing impairment in Ghana. Afr J Disabil. 2024;13(0):a1314. https://doi.org/10.4102/ajod.v13i0.1314
16. Kedir J, Girma A. Prevalence of Refractive Error and Visual Impairment among Rural School-Age Children of Goro District, Gurage Zone, Ethiopia. Ethiop J Health Sci. 2014;24(4):353. Available from: https://doi.org/10.4314%2Fejhs.v24i4.11
17. Kumah BD, Ebri A, Abdul-Kabir M, Ahmed AS, Koomson NY, Aikins S, et al. Refractive Error and Visual Impairment in Private School Children in Ghana. Optom Vis Sci. 2013;90(12):1456–61. Available from: https://doi.org/10.1097%2Fopx.0000000000000099
18. Ezinne NE, Mashige KP. Refractive error and visual impairment in primary school children in Onitsha, Anambra State, Nigeria. Afr Vis Eye Health. 2018;77(1):a455. Available from: https://doi.org/10.4102%2Faveh.v77i1.455
19. Yamamah GAN, Alim AATA, Mostafa YSED, Ahmed RAAS, Mahmoud AM. Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt. Ophthalmic Epidemiol. 2015;22(4):246–52. Available from: https://doi.org/10.3109%2F09286586.2015.1056811
20. Nassr M, Massoud MohamedSH. Refractive errors among students enrolled in Assiut University, Egypt. J Egyptian Ophthalmolog Soc. 2015;108(2):21. Available from: https://doi.org/10.4103%2F2090-0686.161373
21. Bhutia K, Bhutia S, Gupta N, Shenga D. Prevalence of refractive errors among the school-going children in East Sikkim. Indian J Ophthalmol. 2021;69(8):2018. Available from: https://doi.org/10.4103%2Fijo.ijo_112_21
22. Alghamdi W. Prevalence of Refractive Errors among Children in Saudi Arabia: A Systemic Review. Open Ophthalmol J. 2021;15(1):89–95. Available from: https://doi.org/10.2174%2F1874364102115010089
23. Saxena R, Vashist P, Tandon R, Pandey RM, Bhardawaj A, Menon V, et al. Prevalence of Myopia and Its Risk Factors in Urban School Children in Delhi: The North India Myopia Study (NIM Study). Zhou X, editor. PLoS One. 2015 Feb;10(2):e0117349. Available from: https://doi.org/10.1371%2Fjournal.pone.0117349
24. Al-Rowaily MA. Prevalence of refractive errors among pre-school children at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Saudi J Ophthalmol. 2010;24(2):45–8. Available from: https://doi.org/10.1016%2Fj.sjopt.2010.01.001
25. Wedner SH, Ross DA, Todd J, Anemona A, Balira R, Foster A. Myopia in secondary school students in Mwanza City, Tanzania: the need for a national screening programme. Bri J Ophthalmol. 2002 Nov;86(11):1200–6. Available from: https://doi.org/10.1136%2Fbjo.86.11.1200
26. Naidoo KS, Raghunandan A, Mashige KP, Govender P, Holden BA, Pokharel GP, et al. Refractive Error and Visual Impairment in African Children in South Africa. Invest Ophthalmol Visual Sci. 2003;44(9):3764. Available from: http://dx.doi.org/10.1167/iovs.03-0283
27. Asare FA, Morjaria P. Prevalence and distribution of uncorrected refractive error among school children in the Bongo District of Ghana. Cogent Med. 2021;8(1): 1911414. Available from: https://www.tandfonline.com/doi/abs/10.1080/2331205X.2021.1911414
28. Ali AM, Talha AB, Elmadina AE. Refractive errors status among children examined at optical center in Khartoum state. Sudanese J Ophthalmol. 2016;8(1):10. Available from: https://doi.org/10.4103%2F1858-540x.184236
29. Zimbabwe National Statistics Agency. Zimbabwe Population Census 2012: National Report. 2012 [cited 2023 Feb 7]. Available from: https://www.zimstat.co.zw/wp-content/uploads/publications/Population/population/census-2012-national-report.pdf
30. Belaynew W, Destaye S, Yared A, Zelalem E, Ayanaw T. Prevalence of refractive errors among school children in Gondar town, northwest Ethiopia. Middle East Afr J Ophthalmol. 2012;19(4):372. Available from: https://doi.org/10.4103%2F0974-9233.102742
31. Ovenseri-Ogbomo G, Osuagwu UL, Ekpenyong BN, Agho K, Ekure E, Ndep AO, et al. Systematic review and meta-analysis of myopia prevalence in African school children. PLoS One. 2022 Feb 3;17(2):e0263335.
32. Balarabe A, Adamu I, Abubakar A. Vision screening to detect refractive errors in three selected secondary schools in Birnin Kebbi, North West, Nigeria. Sahel Med J. 2015;18(2):61. Available from: https://doi.org/10.4103%2F1118-8561.160799
33. Wang Y, Liu L, Lu Z, Qu Y, Ren X, Wang J, et al. Rural-urban differences in prevalence of and risk factors for refractive errors among school children and adolescents aged 6-18 years in Dalian, China. Front Public Health. 2022;10:917781. Available from: https://pubmed.ncbi.nlm.nih.gov/36106164
34. Flitcroft DI. Emmetropisation and the aetiology of refractive errors. Eye (Lond). 2014/01/10. 2014;28(2):169–79. Available from: https://pubmed.ncbi.nlm.nih.gov/24406411
35. Mutti DO, Mitchell GL, Jones LA, Friedman NE, Frane SL, Lin WK, et al. Axial Growth and Changes in Lenticular and Corneal Power during Emmetropization in Infants. Invest Ophthalmol Visual Sci. 2005;46(9):3074. Available from: http://dx.doi.org/10.1167/iovs.04-1040
Published
Issue
Section
License
Copyright (c) 2025 Michael Agyemang Kwarteng, Frederick Afum Asare, Samuel Kyei, Abigail Masuka, Rumbidzai Muza, Starlyn Nyamhenda, Takunda Jakopo

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.