Purpose: To compare whether free spectacles or only a prescription for spectacles influences wearing rates among Tanzanian students with un/undercorrected refractive error (RE).
Design: Cluster randomised trial.
Setting: 37 secondary schools in Dar es Salaam, Tanzania.
Participants: Distance visual acuity was measured in 6,904 year-1 students (90.2% response rate; median age 14 years; range 11–25 years) using a Snellen E-chart. 135 had RE requiring correction.
Interventions: Schools were randomly allocated to free spectacles (arm A) or prescription only (arm B).
Primary outcome: Spectacle use at 3 months.
Results: The prevalence of un/undercorrected RE was 1.8% (95% CI: 1.5 to 2.2%). At 3 months, 27/58 (47%) students in arm A were wearing spectacles or had them at school compared with 13/50 (26%) in arm B (adjusted OR 2.4, 95% CI 1.0 to 6.7). Free spectacles and myopia were independently associated with spectacle use.
Conclusions: The low prevalence of un/undercorrected RE and poor uptake of spectacles, even when provided free, raises doubts about the value of vision-screening programmes in Tanzanian secondary schools. Policy decisions on school vision screening in middle- and low-income countries should take account of the cost-effectiveness as well as competing demands for scarce resources.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.