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Individual and School-Level Factors Associated with Pediatric Eye Disorders and Referral Adherence in an Enhanced School-Based Vision Screening Program in Ghana

Article scientifique 2026 Anglais

Résumé

Background: Evidence on how social and school-level contexts shape pediatric vision screening outcomes is limited, particularly in sub-Saharan Africa. We examined the association between individual and contextual factors and vision screening outcomes in a pilot enhanced school-based vision screening program (ESVSP) in Kumasi, Ghana. Methods: We conducted a cross-sectional study using data from an ESVSP to detect eye disorders in schoolchildren aged 4 to 22 years. Outcomes were the presence of eye disorders and referral adherence. Exposure variables were individual [(age, sex, socioeconomic status (SES)], and contextual [school type (public vs private)] factors. Logistic regression was used to estimate unadjusted (OR) and adjusted (aOR) odds ratios with 95% confidence intervals (CI). Results: We analyzed data for 1,123 children screened and 299 referred. The average age was 10.2 (±2.6) years. Overall, 34% (n=382) had suspected eye disorders, and 32.8% (n=98) adhered to the referral. After adjusting for key variables, children attending public (32.2%) compared to private (67.8%) schools had 45% lower odds of identified eye disorders (aOR= 0.55; 95% CI 0.37, 0.83). Children with low (13.3%) compared to high (28.6%) SES had 70% lower odds of referral adherence (aOR= 0.30; 95% CI 0.12, 0.80). Conclusion: In this pilot school-based program, school context and socioeconomic status were associated with suspected pediatric vision and eye disorders, and referral adherence, respectively. These findings highlight equity-relevant gaps in referral adherence and underscore the need for context-specific strategies to strengthen referral pathways in low-resource settings.

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Asare, A., Ablordeppey, P., Asiedu, E., Doku, E., Agbeshie, G., Gle, S., Mensah, N., Adikah, R., Yeboah, C., Baidoo, D., Darko, C., Arkhurst, E., Watt, M., Acquah, E., Afake, H., Agyekum, S., Akuffo, K. (2026). Individual and School-Level Factors Associated with Pediatric Eye Disorders and Referral Adherence in an Enhanced School-Based Vision Screening Program in Ghana. https://doi.org/10.64898/2026.02.02.26345428

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Auteur(s)

Afua Oteng Asare Priscilla Ablordeppey Enoch A. Asiedu Emmanuel T. Doku Gabriel Kwaku Agbeshie Seyram A. Gle Nana Akwasi Owusu Mensah Ruby E. Adikah Christine N. Yeboah Diana Baidoo Christine Darko Elisha Eric Arkhurst Melissa H. Watt Eldrick Adu Acquah Hornametor Afake Sylvia Agyekum Kwadwo Owusu Akuffo

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