Understanding Vision Impairment: A Comprehensive Study of Uncorrected Refractive Errors among Primary School Teachers and Pupils in Nongowa Chiefdom, Kenema District, Sierra Leone

Abstract

Introduction: Uncorrected Refractive Error (URE) is a major concern globally, particularly in developing nations like Sierra Leone, where limited access to eye care services pose challenges.

Aim: This study aims to investigate the prevalence of URE and associated knowledge, attitudes, and practices among primary school pupils and teachers.

Methods: Descriptive cross-sectional designs, incorporating both qualitative and quantitative methods were used. A structured survey questionnaire and visual acuity screening tools were used to assess uncorrected refractive errors among 692 randomly selected participants, and data analysis involved descriptive statistics and qualitative content analysis.

Results: A total of 374 pupils participated in this study, out of which 170 (45%) were boys and 204 (55%) were girls and a total of 318 teachers out of which 224 (70%) were males and 94 (30%) were females drawn from 145 public and 14 private schools, respectively. The prevalence of uncorrected refractive error to vision impairment was 66% with hypermetropia being the most prevalent while that of blindness was 0.13%. Girls contributed 29% of cases of uncorrected refractive error to vision impairment compared with 25% in boys and males and females 32% and 14% respectively. The age group most affected by uncorrected refractive error to vision impairment was 5-17 years at 54. Public schools contributed 91% of cases of uncorrected refractive error to vision impairment with private schools, accounting for 14%.  Zones and type of school, with peri-urban characteristics contributed 24% of uncorrected refractive error to vision impairment cases while purely urban zones contributed 76%. Economic status and education influenced prevalence. Pupils exhibited varied knowledge, and teachers actively promoted eye health. Economic factors may have contributed to the observed differences in uncorrected refractive errors. Teachers played a vital role in promoting eye health education in primary schools.

Conclusion: The study highlighted the multifaceted nature of URE, involving demographic, economic, and educational factors. Addressing these complexities through targeted interventions is crucial for mitigating the burden of visual impairment in the region.

Keywords: Uncorrected Refractive Error, Visual Impairment, Sierra Leone, Primary School, Eye Health Education