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Emmanuel Kobia-Acquah, Ian Flitcroft, Prince Akowuah, Gareth Lingham, James Loughman; Prevalence of childhood myopia in Africa: a systematic review and meta-analysis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):259 – A0113.
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Myopia is a growing public health problem due to its association with sight-threatening conditions. In Africa, the problem is exacerbated by lack of ophthalmic services and spectacle coverage, such that uncorrected refractive error is the leading cause of vision impairment. This study was designed to provide contemporary and future estimates of childhood myopia prevalence in Africa.
A systematic online literature search (PubMed, Google Scholar, Cochrane Library, Africa Journals Online, Scopus) was conducted for articles on myopia (≤-0.50D or VA≤6/9.5 correctable with minus lenses) from 2001-2021 in Africa. Meta-analysis [OpenMeta (analyst)] was performed to estimate the prevalence of childhood myopia and high myopia. Freeman-Tukey double arcsine transformation was used to minimize the effects of high/low prevalence on the overall pooled estimates. Myopia prevalence from subgroup analysis for urban and rural settings were used as baseline for generating a prediction model using linear regression (SPSS V28).
Forty studies from 19 (of 54) African countries were included in the meta-analysis (N=735400). Overall prevalence of childhood myopia and high myopia was 4.7% (95% CI: 3.8%–5.8%) and 0.4% (95% CI: 0.2%–0.8%), respectively (Fig 1). Prevalence of myopia from 2011-2020 was approximately double that from 2001-2010 for all studies combined and between 2 and 2.5 times higher for ages 5-11 and 12-18 years, for males and females and urban and rural settings, separately. Childhood myopia prevalence is expected to increase in urban settings to 11.1% by 2030, 14.4% by 2040, and 17.7% by the year 2050, marginally higher than expected in the overall population (16.4% by 2050) and noticeably higher than in rural settings (8.4% by 2050) (Fig 2).
Prevalence of childhood myopia has approximately doubled since 2010, with a further 3-fold increase predicted by 2050. This trend has potentially serious implications despite the comparatively low myopia prevalence in Africa. Provision of myopia control treatments is desirable, but implementing basic myopia prevention programs, enhancing spectacle coverage and ophthalmic services as well as generating more data to better understand the changing myopia epidemiology in Africa merit greater attention.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Fig 1. Pooled prevalence of myopia (A) and high myopia (B) in Africa.
Fig 2. Urban (A), rural (B) and combined (C) childhood myopia prevalence: 2001 to 2050.
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