Email this article 
Hide
Show all
Original Research
Prevalence of visual impairment and refractive error in school-aged children in South Darfur State of Sudan
Submitted: 17 April 2016 | Published: 27 October 2016
About the author(s)
Saif H. Alrasheed, African Vision Research Institute, University of Kwa-Zulu Natal, South Africa; Faculty of Optometry and Visual Science, Al Neelain University, SudanKovin S. Naidoo, African Vision Research Institute, University of Kwa-Zulu Natal, South Africa; Brien Holden Vision Institute, Sydney, Australia
Peter C. Clarke-Farr, African Vision Research Institute, University of Kwa-Zulu Natal, South Africa; Department of Ophthalmic Sciences, Cape Peninsula University of Technology, South Africa
Abstract
Background: Global estimates suggest there are almost 19 million visually impaired children worldwide, the major cause being uncorrected refractive error (RE).
Aim: To assess the prevalence of visual impairment (VI) and RE among Sudanese school-aged children.
Setting: Eight randomly selected primary schools from 21 districts in South Darfur State of Sudan were involved.
Methods: A school-based cross-sectional study of RE and VI in primary schoolchildren from grades 1 to 8 (children aged 6–15 years) was investigated. A Refractive Error Study in Children (RESC) protocol was implemented to determine the prevalence of RE and VI in these schoolaged children. Participants were enrolled through stratified multistage cluster sampling of four all-male and four all-female primary schools from South Darfur State of Sudan. Examination procedures followed the RESC protocol, which included visual acuity (VA) measurements, binocular vision assessments, retinoscopy and autorefraction under cycloplegia, as well as examination of the external eye, anterior-segment, media and fundus.
Results: A total of 1775 children were invited to participate in the study and 1678 were examined resulting in a participation rate of 94.5%. The findings indicated that the prevalence of uncorrected, presenting and best-corrected VA of 6/12 or worse was 6.4% (95% confidence interval [CI], 4.9–7.9), 4.4% (95% CI, 2.9–5.9) and 1.2% (95% CI, 0.3–2.7) respectively. RE was the cause of VI in 57% of participants, retinal disorders in 13.1%, amblyopia in 5.6%, corneal opacity in 0.9%, cataract in 3.7%, with the causes of reduced vision undetermined in 10.3% and various other causes contributed 9.3%. External and anterior-segment abnormalities were observed in 10.2% of children. This was mainly allergic conjunctivitis (5.3%) followed by bacterial and viral conjunctivitis (4.2%). The prevalence of myopia (≥|-0.50 D|) in one or both eyes was 6.8% (95% CI, 5.3–8.3), hypermetropia (≥ 2 D) was noted in 1.9% (95% CI, 0.4–3.4) and astigmatism (≥|-0.75 D|) prevailed in 2.5% (95% CI, 1.0–4.0). Prevalence of VI among schoolaged children were associated with the children’s age and grade levels (p = 0.00) but was not correlated with gender (p = 0.224). Prevalence of RE among school-aged children was significantly correlated with age and grade levels (p = 0.00). No significant correlation was found between gender and prevalence of RE (p = 0.833). The prevalence of VI because of myopia was associated with increasing grade levels and also the childhood age (p = 0.023), but there was no significant difference in the prevalence of VI because of myopia between male and female children.
Conclusion: Uncorrected RE was a major cause of VI among children in the South Darfur State. There is thus a critical need for developing a comprehensive child eye care plan focusing on the reduction of uncorrected RE through collaboration between key stakeholders and government.
Keywords
Metrics
Total abstract views: 8993Total article views: 13590
Crossref Citations
1. Morphology and thickness of corneal endothelial cells in young Sudanese individuals with myopia
Raghda Faisal Mutwaly, Saif Hassan Alrasheed, Abd Elaziz Mohamed Elmadina, Sulaiman Aldakhil
Journal of Medicine and Life vol: 16 issue: 12 first page: 1808 year: 2023
doi: 10.25122/jml-2023-0251
2. Systematic review and meta-analysis of myopia prevalence in African school children
Godwin Ovenseri-Ogbomo, Uchechukwu L. Osuagwu, Bernadine N. Ekpenyong, Kingsley Agho, Edgar Ekure, Antor O. Ndep, Stephen Ocansey, Khathutshelo Percy Mashige, Kovin Shunmugan Naidoo, Kelechi C. Ogbuehi, Aleksandra Barac
PLOS ONE vol: 17 issue: 2 first page: e0263335 year: 2022
doi: 10.1371/journal.pone.0263335
3. Refractive errors among schoolchildren in the Middle East: A systematic review and meta-analysis
Zoelfigar D. Mohamed, Galal M. Ismail, Saif H. Alrasheed, Gopi S. Vankudre, Babu Noushad, Janitha P. Ayyappan
African Vision and Eye Health vol: 83 issue: 1 year: 2024
doi: 10.4102/AVEH.v83i1.940
4. Patterns of refractive errors and visual function in school-going children in South Africa
Rinkie M. Lekganyane, Nobukhosi Siziba, Musa T. Mabasa, Lebogang Matlala, Khutjo E. Machipi, Rangoaga G. Maditsi, Thuso Khohomela, Masego G. Ramonyai, Christina M.L. Segwati, Pheagane M.W. Nkoana
African Vision and Eye Health vol: 83 issue: 1 year: 2024
doi: 10.4102/AVEH.v83i1.845
5. Awareness and knowledge of myopia complications and control among myopic subjects in Saudi Arabia
Majid A. Moafa, Saif Hassan Alrasheed, Rakan Massad Almutairi, Muhammed S. Alluwimi, Waleed M. Alghamdi, Abdelaziz Mohamed Elmadina, Raghda F. Mutwali
International Ophthalmology vol: 45 issue: 1 year: 2025
doi: 10.1007/s10792-025-03639-7
6. Regional variations and temporal trends of childhood myopia prevalence in Africa: A systematic review and meta‐analysis
Emmanuel Kobia‐Acquah, Daniel Ian Flitcroft, Prince Kwaku Akowuah, Gareth Lingham, James Loughman
Ophthalmic and Physiological Optics vol: 42 issue: 6 first page: 1232 year: 2022
doi: 10.1111/opo.13035
7. Strabismus and amblyopia in Africa – a systematic review and meta-analysis
Prince Kwaku Akowuah, Samuel Adade, Andrews Nartey, Ebenezer Owusu, Richard Donkor, Stephen Ankamah-Lomotey, Asafo Agyei Frimpong, Joseph Adjei-Anang, Emmanuel Kobia-Acquah
Strabismus vol: 31 issue: 1 first page: 31 year: 2023
doi: 10.1080/09273972.2022.2157023
8. Prevalence of hyperopia in school-aged children in eastern Mediterranean region: A systematic review and meta-analysis
Saif H. Alrasheed, Naveen K. Challa
Saudi Journal of Ophthalmology vol: 38 issue: 3 first page: 243 year: 2024
doi: 10.4103/sjopt.sjopt_47_23
9. Demographic Characteristics and Causes of Visual Impairment in the White Nile State of Sudan: A Hospital-based Study
Abdelaziz M. Elmadina, Atif Babiker Ali, Saif H. Alrasheed, Sulaiman Aldakhil, Mohammed Alluwimi, Roghia Abdarshead Derar
Open Access Macedonian Journal of Medical Sciences vol: 10 issue: B first page: 1492 year: 2022
doi: 10.3889/oamjms.2022.9028
10. Characteristics of the retinal and choroidal thicknesses in myopic young adult males using swept-source optical coherence tomography
Saif Hassan Alrasheed, Yazan Gammoh
PeerJ vol: 13 first page: e19030 year: 2025
doi: 10.7717/peerj.19030
11. Sensitivity and Specificity of Sheard and Percival’s Criteria for the Diagnosis of Young People with Near-heterophoria
Saif Hassan Alrasheed , Amel Mohamed Yousif, Majid A. Moafa , Abd Elaziz Mohamed Elmadina, Mohammad Alobaid
Open Access Macedonian Journal of Medical Sciences vol: 9 issue: B first page: 1128 year: 2021
doi: 10.3889/oamjms.2021.6399
12. Effectiveness of treatment modalities for childhood esotropia: a systematic review
Saif Hassan Alrasheed, Naveen Kumar Challa, Saeed Aljohani, Nawaf M. Almutairi, Mohammed M. Alnawmasi
PeerJ vol: 13 first page: e19584 year: 2025
doi: 10.7717/peerj.19584
13. Prevalence, Causes, and Risk Factors of Visual Impairment: Evidence from Duhknah, a Rural Community in Saudi Arabia
Sulaiman Aldakhil
Healthcare vol: 13 issue: 15 first page: 1927 year: 2025
doi: 10.3390/healthcare13151927
14. Clinical features of Sudanese patients presenting with binocular vision anomalies: A hospital-based study
Saif Hassan Alrasheed, Tarteel Mohammed Osman, Saeed Aljohani, Saleh Alshammeri
Journal of Medicine and Life vol: 16 issue: 8 first page: 1251 year: 2023
doi: 10.25122/jml-2023-0132
15. Prevalence and causes of vision impairment in East Africa: A narrative review
Benedict Ayobi, Rekha Hansraj, Nishanee Rampersad, Gerard Urimubenshi
Journal of Public Health in Africa vol: 16 issue: 1 year: 2025
doi: 10.4102/jphia.v16i1.1273
16. Vision impairment in boys recruited to the iREAD study
Jonathan Levine, Ravid Doron, Lisa A. Ostrin, Einat Shneor
Israel Journal of Health Policy Research vol: 14 issue: 1 year: 2025
doi: 10.1186/s13584-025-00667-7
17. Evaluation of Visual Function Requirements for Public Jobs in Saudi Arabia
Majid A. Moafa, Waleed Alghamdi, Mohammed Alluwimi, Sulaiman Aldakhil, Ismail Abuallut, Mansour Alghamdi, Saif Alrasheed
Open Access Macedonian Journal of Medical Sciences vol: 9 issue: B first page: 608 year: 2021
doi: 10.3889/oamjms.2021.6394
18. Individual and school-level factors associated with suspected pediatric eye disorders and referral adherence in an enhanced school-based vision screening program in Ghana
Afua O. Asare, Priscilla Ablordeppey, Enoch Ansah-Asiedu, Emmanuel T. Doku, Gabriel K. Agbeshie, Seyram A. Gle, Nana Akwasi Owusu Mensah, Ruby E. Adikah, Christiana Nyarko Yeboah, Debora A. Baidoo, Christine K. Darko, Elisha E. Arkhurst, Melissa H. Watt, Eldrick A. Acquah, Hornametor Afake, Sylvia Agyekum, Kwadwo Owusu Akuffo, Julia Robinson
PLOS Global Public Health vol: 6 issue: 6 first page: e0006000 year: 2026
doi: 10.1371/journal.pgph.0006000
19. Childhood visual impairment in Qassim region of Saudi Arabia prevalence causes and risk factors
Saif Hassan Alrasheed, Muhammed S. Alluwimi, Saleh Alshammeri, Sulaiman Aldakhil, Majid A. Moafa, Waleed M. Alghamdi, Bandar M. Alenezi
Scientific Reports vol: 15 issue: 1 year: 2025
doi: 10.1038/s41598-025-20318-w
20. Analysis and applicability of protocols for the diagnosis of refractive errors in children
Laura Victoria Martín Algarra, Martha Fabiola Rodríguez Álvarez, Andrés Gené Sampedro
Ciencia & Tecnología para la Salud Visual y Ocular vol: 16 issue: 1 first page: 111 year: 2018
doi: 10.19052/sv.5063
21. Prevalence and risk factors of myopia amongst Grade 8 learners in the Vhembe district, South Africa
Shonisani E. Tshivhase, Ntsieni S. Mashau, Daphney Mathebula
African Vision and Eye Health vol: 80 issue: 1 year: 2021
doi: 10.4102/aveh.v80i1.640
22. Status of Childhood Eye Care Services in the Kingdom of Saudi Arabia: Eye Care Professionals’ Perspectives
Majid A. Moafa, Saif H. Alrasheed
The Open Ophthalmology Journal vol: 16 issue: 1 year: 2022
doi: 10.2174/18743641-v16-e2206200
23. Approaches for delivery of refractive and optical care services in community and primary care settings
Valerie Umaefulam, Sare Safi, Gareth Lingham, Iris Gordon, Andreas Mueller, Neha S. Krishnam, Vera L Alves Carneiro, Mitasha Yu, Jennifer R Evans, Stuart Keel
Cochrane Database of Systematic Reviews vol: 2024 issue: 5 year: 2024
doi: 10.1002/14651858.CD016043
24. Childhood visual impairment causes and barriers to accessing eye care: A suggested approach for Africa
Saif H. Alrasheed, Zoelfigar D. Mohamed, Muhammed S. Alluwimi
African Journal of Primary Health Care & Family Medicine vol: 16 issue: 1 year: 2024
doi: 10.4102/PHCFM.v16i1.4556
25. Impact of vision therapy on eye-hand coordination skills in students with visual impairment
JavadHeravian Shandiz, Abbas Riazi, AbbasAzimi Khorasani, Negareh Yazdani, MaryamTorab Mostaedi, Behrooz Zohourian
Journal of Ophthalmic and Vision Research vol: 13 issue: 3 first page: 301 year: 2018
doi: 10.4103/jovr.jovr_103_17
26. Normative values of accommodation functions in young Saudi adults in the Qassim region
Saif H. Alrasheed, Muhammed S. Alluwimi, Zoelfigar D. Mohamed
Saudi Journal of Ophthalmology vol: 39 issue: 4 first page: 389 year: 2025
doi: 10.4103/sjopt.sjopt_212_24
27. Correlation of anterior chamber parameters and intraocular pressure with white-to-white corneal diameter in myopic eyes
Saif Hassan Alrasheed, Azzam A. Alharbi, Muhammed S. Alluwimi, Norah M. Alawad, Hanin A. Alhudhayf
Graefe's Archive for Clinical and Experimental Ophthalmology vol: 264 issue: 5 first page: 1455 year: 2026
doi: 10.1007/s00417-025-07099-8