Progression of Myopia and Associated Risk Factors among Pediatric Patients at a Tertiary Hospital in Northern Tanzania: A Cross-sectional Study
John Njelango *
Department of Ophthalmology, KCMC University, Moshi, Tanzania.
Andrew Makupa
Department of Ophthalmology, KCMC University, Moshi, Tanzania and Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Venkataramana Kalikivayi
School of Medical and Health Sciences, MNR University, Hyderabad, India.
Aimbora Kimaro
Department of Ophthalmology, KCMC University, Moshi, Tanzania and Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Kevin Rwegoshola
Kilimanjaro College of Health and Allied Sciences, Tanzania.
Mchikirwa Msina
Department of Ophthalmology, KCMC University, Moshi, Tanzania and Department of Ophthalmology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
*Author to whom correspondence should be addressed.
Abstract
Objective: To determine the proportion and factors associated with myopia progression among pediatric patients attending the Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania.
Methods: A hospital-based analytical cross-sectional study was conducted at the Pediatric Eye Clinic of KCMC from January 2022 to April 2024. Pediatric patients aged 4–18 years diagnosed with myopia (spherical equivalent ≤ –0.50D) and with follow-up refraction 11–13 months after baseline were included. Data were collected through clinical assessments and structured face-to-face interviews. Myopia progression was defined as an increase in spherical equivalent between visits. Generalized linear models with Poisson distribution and robust standard errors were used to estimate crude and adjusted prevalence ratios (PRs) with 95% confidence intervals (CIs).
Results: Of 201 eligible participants, 63.2% (n=127) demonstrated myopia progression. In unadjusted analyses, significant associations with progression were observed for male sex (PR=0.79; 95% CI: 0.63–0.98), non-spectacle wear (PR=1.37; 95% CI: 1.12–1.69), mobile device use (PR=1.49; 95% CI: 1.22–1.82), viewing television at ≤2 meters (PR=1.65; 95% CI: 1.33–2.06), prolonged near work (>2 hours/day) (PR=1.74; 95% CI: 1.42–2.14), reduced outdoor time (<1 hour/day) (PR=0.65; 95% CI: 0.45–0.92), and a positive family history of myopia (PR=1.80; 95% CI: 1.42–2.29). In adjusted analysis, four factors remained independently associated with progression: older age >13 years was protective (PR=0.64; 95% CI: 0.43–0.96), while near work >2 hours/day (PR=1.55; 95% CI: 1.23–1.94), television viewing distance ≤2 meters (PR=1.31; 95% CI: 1.07–1.62), and a positive family history (PR=1.53; 95% CI: 1.23–1.91) were associated with increased risk.
Conclusion: Myopia progression was notably prevalent. Younger age, prolonged near work, close television viewing, and a positive family history emerged as independent risk factors. These findings highlight the urgent need for early screening, behavior-focused education, and targeted interventions to address modifiable risk factors and mitigate the rising burden of myopia among pediatric populations in African settings.
Keywords: Myopia progression, children, near work, screen time, spectacle use, Tanzania