| BackgroundAt present,myopia has become a common disease among primary and middle school students.The prevalence of myopia among primary and middle school students is 59.4%to 82.5%,and it is increasing year by year.The number of myopia in China is ranked first in the world.Myopia can induce a variety of eye diseases,and can cause adolescent inattention,unresponsiveness,trance and other sub-health state.Therefore,myopia has become one of the most serious public health problems Jining city is located in the southwest of Shandong Province,is an important historical and cultural city.Jining city consists of 2 Districts,7 counties,and 2 county-level city.Because the key points of regional development are different,the development priorities of different administrative regions in Jining are different.There are great differences between urban and rural areas.The difference between ideology and educational concept may have some influence on Teenagers’ eyesight.Although there are many studies on myopia among the students,but relatively few studies has been conducted on the differences across the city,county,township.To fully understand the status of myopia in primary and middle school students in Jining,this study investigated eyesight among primary and middle school students in different areas.Objectives(1)To understand the occurrence of myopia in primary and middle school students in Jining.(2)To understand the overall situation of eye use among primary and middle school students in city,county and township of Jining.(3)To analyze possible factors influencing the myopia among primary and middle school students in Jining and to provide evidence for the formulation of health care policies and measures for local adolescents.MethodsCross-sectional study was conducted by using a stratified cluster sampling method.Six representative counties and urban districts were selected in different administrative areas of Jining.A total of 24 schools,including primary and junior high schools,were randomly selected from each area at the urban,county and township levels.Second year and third year students were selected in junior high schools,fourth and fifth grade students were selected in primary schools.Fifty students were randomly selected in each school,and the total number of participants is 2400.The selected students were examined by visual acuity.Meanwhile,a questionnaire survey was conducted to investigate the eye environment and eye use habits.Descriptive analysis were performed and then unconditional Logistic regression was used to analyze the possible influencing factors of myopia.Results(1)Among the 2267 primary and middle school students in Jining City who were included in the effective questionnaire,761 students were diagnosed with myopia.The detection rate of myopia was 33.6%.Among them,391 were mild myopia,accounting for 51.4%of total myopia;344 were moderate myopia,accounting for 45.2%of the total number of myopia;26 cases of severe myopia,accounting for 3.4%of the total number of myopia.It can be seen that primary and junior high school students with myopia were mildly myopic and moderately close,and the proportion of primary and middle school students with severe myopia was small.(2)There were 1116 junior high school students and 1151 primary school students in this study.Among the 761 myopia students detected,502 were junior high school students,the detection rate of myopia was 45.0%;the primary school students were 259,the detection rate of myopia was 22.5%.The detection rate of myopia in junior high school students is higher than that of primary school students.The myopia of junior high school students and primary school students is mainly mild myopia and moderate nearness.(3)There were 1109 male students and 1158 female students in this study.Among the 761 myopia students detected,346 were male students and 415 were female students.The detection rate of myopia for boys was 31.2%,and the detection rate of myopia for girls was 35.8%.The detection rate of myopia in girls is higher than that of boys.There were more girls than boys with mild myopia,moderate myopia and severe myopia.(4)The numbers of primary and junior high school students in urban,county and townships included in the study were 743,758 and 766 respectively.The detection rate of myopia in urban primary and junior high school students was 40.0%,the detection rate of myopia in primary and junior high school students was 31.9%,and the detection rate of myopia in primary and junior high school students is 29.0%.The detection rate of myopia in primary and junior high school students in urban areas is higher than that in county towns.The detection rate of myopia in primary and junior high school students in county towns is higher than that in towns and villages,especially in urban areas where primary and junior high school students have more severe myopia,while students in county and townships have more myopia.The difference in visual acuity levels between different regions was statistically significant(P<0.001).(5)Chi-square test analysis results showed that the student’s gender,region,student age,body mass index,parents eyesight,eye exercises,time spent on homework,frequency of reading while walking,and time to read,the frequency of watching publicity and education materials,the difference between the sleep time and the appropriate degree of height of the table and chair had statistically significant influence on the proportion of students’ nearsightedness(P<0.05).Among them,girls were more likely to be nearsighted than boys,and urban students were more likely.Students in county towns and townships were more likely to be nearsighted.Students with myopia in their parents were more likely to be nearsighted.Students with shorter sleep periods were more likely to have nearsightedness.(6)Multivariate Logistic regression showed that junior high school students were more likely to suffer from myopia than primary school students(OR=2.013,95%CI:1.454～2.787),boys were less likely to suffer from myopia than girls(OR =0.778,95%CI:0.645～0.938);students in counties and towns were less likely to suffer from myopia(OR=0.624,95%CI:0.496～0.785;OR=0.502,95%CI:0.396～0.637)compared with those in urban areas;students whose parents were with myopia were more likely to suffer from myopia(OR=4.335,95%CI:3.043～6.175);using occasional eye exercises as a control,daily eye exercises wasassociated withfor myopia(OR=1.407,95%CI:1.143～1.733;compared with the students who spent less than 1 hour for homework,the students who took 1 to 2 hours and more than 2 hours in homework were more likely to suffer from myopia(OR=1.622,95%CI:1.206～2.183;OR=1.946,95%CI:1.325～2.856));and when using the table and chair were suitable as control,the higher table and chair appeared as protective factor(OR=0.509,95%CI:0.285～0.907).Conclusion(1)The detection rate of myopia in primary and junior high school students in Jining City was 33.6%,among which the detection rate of myopia of junior high school students was 45.0%,the detection rate of myopia of primary school students was 22.5%.The prevalence of myopia increased with the increase of grades.Because both primary and junior high school students were light and moderate,it is recommended to conduct regular eyesight examinations,establish tracking files,detect visual changes in time,and seize the opportunity to prevent and treat mild to moderate myopia.(2)There were several influencing factors in the occurrence of myopia in primary and junior high school students.Gender,grade,urban and rural territory,parental visual acuity,eye excises,and time spent on homework were important factors in myopia.It is recommended to strengthen preventive health education so that young people can establish good eye habits.It is necessary to further implement the burden reduction policies for primary and junior high schools inside and outside schools.The government,schools,parents and medical institutions and other parties should work together and take a multi-pronged approach to reduce the occurrence of myopia among young students. |
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