Analysis of Pediatric Vision Screening Data: Incidence, Predictors, and Barriers to Eye Care in Pwani Region, Tanzania
Name: Nivedita Ravi
School: Vagelos College of Physicians and Surgeons, Class of 2026; Varmus Global Scholar 2023
Mentor: Lisa Park, MD
Abstract
Research Question: The present study examines (i) the incidence of pediatric (ages 3-19 years) vision conditions over three years, (ii) relationships between vision health and physical measurements, and (iii) differences between post-screening follow-up rates at hospital and mobile clinics.
Background: Vision screening is critical for early detection and prevention of vision loss in pediatric populations. In Tanzania, a shortage of eye health workers has prevented regular screenings. Vision Care, an international blindness relief organization, has partnered with the Tanzanian ophthalmological community to train teachers to conduct vision screenings in five primary schools in the Pwani region.
Methods: Screening records were compiled and digitized, and statistical analyses were conducted in R.
Results: Findings indicate a growing incidence of vision conditions in Pwani: 2.4 per 100 person-years (n=2169; 2021), 4.3 per 100 person-years (n=4971; 2022), 6.7 per 100 person-years (n=2578; 2023) (p=6.002e-12). When controlling for age and sex, results demonstrate a negative relationship between conjunctivitis and height-for-age (p=0.011) and positive relationship between refractive error and height-for-age (p=0.003) among children who failed screenings in 2022. Higher follow-up rates were observed for patients assigned to the mobile health clinic on school grounds (96%) when compared to the hospital clinic (71%) (p=2.443e-07); of three schools assigned to hospital follow-up, a higher follow-up rate was observed in the school located closest to the hospital (p=0.026).
Conclusions: This study advocates for annual vision screenings and mobile eye health clinics and proposes possible links between vision health, height, and chronic malnutrition. Findings carry implications for policy recommendations concerning access to vision care in Pwani.