Analysis On The Current Situation And Influencing Factors Of Myopia Among Primary And Secondary School Students In Shanxi Province

Objective:In the context of the rising myopia rate of primary and secondary school students nationwide,the myopia rate and related influencing factors of primary and secondary school students in Shanxi Province were investigated to provide scientific basis for further prevention of myopia among students.Methods:This study conducted a cross-sectional study of myopia among primary and secondary school students in Shanxi Province from September 2020 to November 2020.The method of multistage stratified cluster random sampling is adopted.The sampling covers 11prefecture-level cities in Shanxi Province.Each prefecture-level city randomly selects one urban area and one county,of which six schools(two primary schools,two junior high schools and two senior high schools)are selected from each urban area,five schools(two primary schools,two junior high schools and one senior high school)are selected from each county,students from grade four to six are selected from primary schools,and students from all grades are selected from middle schools,At least 80 students were selected from each grade as the research object,and the selected students participated in the survey with the whole class as the unit.The trained optometrist will check the vision of the students.Those who are judged to be nearsighted by one eye will be counted as the number of nearsightedness,and the students who wear the night corneal plastic glasses will also be counted as the number of nearsightedness.The students’demographic characteristics,eye use environment,outdoor activities,genetic factors,psychological factors and other information were collected in the form of questionnaires.In addition to psychological factors,the questionnaire used for other factors is the questionnaire in the monitoring and intervention of common diseases and health influencing factors of students carried out by the Shanxi Provincial Center for Disease Control and Prevention in 2020,which is respectively Monitoring Table of Key Common Diseases of Students(Primary and Secondary School Students Version)and Special Questionnaire of Poor Vision and Influencing Factors of Students.The information of students’psychological factors(depression)was collected by using the center for epidemiological studies depression scale(CES-D).Usingχ~2 and Logistic regression model was used to analyze the influence of demographic characteristics,eye use environment,outdoor activities,genetic factors and psychological factors on students’myopia.Results:1.A total of 29153 students were investigated in this study,and the qualified sample was 28058,with a sample effective rate of 96.2%.The average age of the respondents was13.41±2.52 years old.Including 13936 boys(49.7%)and 14122 girls(50.3%);There were14279 students(50.9%)in urban areas and 13779 students(49.1%)in suburban areas.2.The overall myopia detection rate of primary and secondary school students in Shanxi Province is 58.6%.The detection rate of myopia in girls(62.4%)was higher than that in boys(54.9%),and the difference was statistically significant(P<0.001).The detection rate of myopia was the highest in the middle economic area(61.6%),followed by the poor economic area(56.0%),and the lowest in the better economic area(53.5%).The difference was statistically significant(P<0.001).The detection rate of myopia in urban students(62.6%)was higher than that in suburban students(54.6%),and the difference was statistically significant(P<0.001).With the increase of learning stage,the detection rate of myopia in students showed an upward trend:the detection rate of myopia in primary school students,junior high school students and senior high school students was 43.1%,60.4%and76.0%respectively,with a statistically significant difference(P<0.001).The detection rate of resident students(64.8%)was higher than that of non-resident students(54.5%),and the difference was statistically significant(P<0.001).3.The results of univariate analysis showed that gender,economic level,urban and rural areas,learning stage,accommodation,space for activities between classes,frequency of seat rotation,frequency of table and chair adjustment,completion of eye health exercises,use of lamps and lanterns,daily homework time,weekly TV watching time,weekly computer use time,sleep time,daytime outdoor activities time,eyes more than one foot away from books when reading and writing,fingers one inch away from the pen tip when reading and writing The teacher reminded us to pay attention to the learning posture,reading in direct sunlight,watching the electronic screen in the dark environment,reading lying or lying down,reading while walking or riding,parents’myopia and depression had statistical significance on the detection rate of myopia among students(all P<0.05).4.Multi-factor logistic regression analysis showed that students in suburban counties(OR=0.870,95%CI:0.808～0.938),high frequency of seat rotation(1 semester rotation OR=0.813,95%CI:0.727～0.909;1 semester rotation≥2 times OR=0.809,95%CI:0.706～0.927),table and chair adjustment≥2 times in a school year(OR=0.797,95%CI:0.708～0.896),eye health exercises≥2 times a day(OR=0.788,95%CI:0.718～0.868)At the same time,the use of desk lamp ceiling lamp(OR=0.865,95%CI:0.782～0.958),sleep time≥8 hours(OR=0.618,95%CI:0.578～0.660),outdoor activity time≥2 hours in the daytime(OR=0.771,95%CI:0.705～0.842),and eyes more than one inch away from the book when reading and writing(OR=0.895,95%CI:0.836～0.957)are the protective factors for students’myopia(all OR<1);Gender:female(OR=1.424,95%CI:1.330～1.524),from a region with medium economic level(OR=1142,95%CI:1.004～1.299),higher learning stage(junior high school OR=1.523,95%CI:1.396～1.627;senior high school OR=2.176,95%CI:1.911～2.459),longer homework time("1～2(excluding 2)hours":OR=1.105,95%CI:0.935～1.306,"≥2 hours":OR=1.176,95%CI:1.028～1.344);Use the computer for≥3 hours a day(OR=1.078,95%CI:1.030～1.189),watch the electronic screen in the dark environment(OR=1.812,95%CI:1.157～1.325),read while lying or lying down(OR=1.085,95%CI:0.981～1.198),neither parent is short-sighted(one parent is short-sighted OR=1.269,95%CI:1.157～1.393;both parents are short-sighted OR=2.137,95%CI:1.958～2.331),Risk factors of myopia in students with depression(OR=1.110,95%CI:1.017～1.212)(all OR>1).Conclusion:The detection rate of myopia among primary and secondary school students in Shanxi Province is 58.6%,which is lower than most regions of the country,but still at a high level.The detection rate of myopia in students shows an upward trend with the increase of learning stage,among which the detection rate of myopia in primary school students is 43.1%,and the trend of myopia is obvious.The causes of students’myopia are complex and there are many influencing factors,including gender,economic level,urban and rural areas,learning stage,accommodation,seat rotation frequency,table and chair adjustment frequency,completion of eye exercises,lamp use,close eye use time,sleep time,daytime outdoor activity time,eye use habits,myopia of parents and depression.