Utility for Uncorrected Refractive Errors in Adolescent Schoolchildren in Kakamega County, Kenya.

SIGNIFICANCE: Uncorrected refractive errors (UREs) present an enormous lifetime burden in children. Despite this, there is a dearth of knowledge on URE-related preference-based quality of life (QoL) in East Africa. This study demonstrates the positive impact of interventions on UREs; hence, it provides an empirical justification for advocacy to improve the QoL of children with URE. PURPOSE: This study investigated the preference-based QoL (utility) for URE in school-going adolescents of Kakamega County, in Kenya. METHODS: An observational cross-sectional study with multistage sampling was conducted on randomly selected secondary school adolescents. School-going adolescents in Forms 1 to 4 were clinically examined for the presence of URE and classified according to their URE types. Pre-screened students who met the selection criteria were classified into two groups: URE and normal sight. Participants in the normal-sight group were randomly selected from among screened students without URE. Selected participants were administered a previously validated adolescent-specific utility weighting instrument-Assessment of Quality of Life-Six Dimensions. RESULTS: A total of 330 participants aged 17.32 ± 1.60 years (URE, 17.50 ± 1.58 years; normal-sight, 17.15 ± 1.61 years) were included in the study. The mean utility score, as elicited by the Assessment of Quality of Life-Six Dimensions scoring algorithm, was better in the normal-sight group (URE, 0.496 ± 0.22; normal sight, 0.567 ± 0.25) at baseline, whereas the reverse was true at follow-up (URE, 0.655 ± 0.20; normal sight, 0.603 ± 0.25). In all cases, the differences were significant ( P < .05); however, there was no significantly better ( P > .05) utility elicited by any URE subtype at any given time point. Nonetheless, the URE group showed significantly better utility ( P < .05) after spectacle correction. CONCLUSIONS: Uncorrected refractive errors are associated with reduced utility in school-going adolescents, regardless of URE subtype. Spectacle correction resulted in a significantly improved utility for those with URE. Thus, this study recommends early public health strategies and spectacle interventions in schools for adolescents with URE.

Building consensus for the development of child eye care services in South Darfur State of Sudan using the Delphi technique.

BACKGROUND:  Global estimates suggest there are almost 19 million visually impaired children worldwide, most of whom reside in poor countries, with the major cause being treatable. AIM:  To determine the barriers to accessing childhood eye care services and to develop an eye care plan for children in South Darfur State, Sudan. SETTING:  The study took place in South Darfur State, Sudan. METHODS:  The classical Delphi technique was used to build consensus on a list of statements, which were generated based on the themes established by the experts, as well as on an extensive literature review. RESULTS:  Response rates ranged from 90% in the first round (n = 18), 100% in the second round (n = 18) to 89% in the third and final round (n = 16). The total number of statements recommended by the Delphi panellists for development of the paediatric eye care plan, was 60 based on a consensus level of 80% agreement or more. The expert's consensus on the following key elements for promotion and improvement of child eye care: The main barriers to accessing child eye care were high poverty rate, unavailability of child eye services and a lack of community awareness. The challenges facing visually impaired children were an absence of paediatric ophthalmologists, low vision and orthoptic services. CONCLUSION:  The main barriers to accessing child eye care services were financial, clinical access and lack of knowledge. There should be greater collaboration between the Ministries of Health, Education and non-governmental organisations (NGOs), to work together in addressing these barriers.