| Objective: Through a cross-sectional study of myopia among primary and secondary school students in Gansu Province in 2019,to understand the prevalence of myopia and its influencing factors,and to provide a scientific basis for the prevention and control of myopia in primary and secondary school students.Methods: A multi-stage stratified cluster random sampling survey method was adopted.The subjects were 14 cities and states in Gansu Province and Lanzhou New District,and a total of 14 districts and 12 counties were randomly selected,and 7 schools(2 primary schools,2 junior high schools,2 senior high schools,and 1 vocational high school)were randomly selected from each urban area.Five schools(2 primary schools,2 junior high schools,and 1 senior high school)were randomly selected in the suburbs/counties.The survey subjects were 80 students randomly selected from each school in the third grade(fourth,fifth,and sixth grades of primary school,junior high school,senior high school,and vocational high school).The survey was conducted in the whole class.A total of 45,010 students were surveyed.The selected students were examined for distance vision,refractive examination and questionnaire survey.Epi Data3.1 software was used to establish a database,double input data,and SPSS 23.0 statistical software was used to analyze the survey results.Chi-square test was used for univariate analysis,and binary logistic regression analysis was used for multivariate analysis.Results:(1)A total of 45,010 students were investigated in this study.The proportion of students in the three learning stages of primary school,junior high school and senior high school(including vocational high school)was between 32% and 35%.There were 23,069 boys and 21,941 girls,accounting for 51.3% and 48.7% respectively.The number of resident students was higher than that of non-resident students,and the number of Han students was higher than that of ethnic minorities.(2)The myopia detection rate of primary and middle school students in Gansu province was 70.5%.The prevalence of myopia was 73.7% in girls and 67.5% in boys.The prevalence of myopia in primary school students(grade 4-6),junior high school students and senior high school students was 53.4%,75.0% and 84.2%,respectively.The myopia detection rate was higher in girls than in boys,in urban areas than in rural areas,in boarding students than in nonboarding students,and in Han ethnic group than in minority ethnic groups(P<0.001).(3)The single factor results of myopia among primary and secondary school students in Gansu Province showed that: Different class,gender,district,living on campus or not,ethnic group,daily intake of sugar-sweetened beverages,frequency of eating sweets,frequency of eating fried foods,frequency of eating fresh vegetables and fruits,frequency of eating breakfast,and seat changes in school classes,The change of the height of desks and chairs,The Times of doing eye exercises,the time of homework after class every day,the time of attending cultural tutoring classes every week,the reading and writing posture,the time of watching TV and using computers,the habit of using eyes in near distance,the time of outdoor activities,and sufficient sleep,and the condition of parents’ myopia were the influencing factors of myopia(P<0.001).(4)The results of multiple factors of myopia in primary and secondary school students in Gansu province showed that the protective factors of myopia were: Class seats are changed once a week(OR=0.838,95%CI: 0.772~0.909),desks and chairs are changed once a year(OR=0.671,95%CI:0.632~0.713),and once a semester(OR=0.637,95%CI:0.597~0.680),outdoor activities during recess(OR=0.747,95%CI: 0.717~0.779),and always keeping eyes more than one foot away from a book when reading and writing(OR=0.770,95%CI: 0.694~0.855),teachers always(OR=0.505,95%CI: 0.461~0.554)remind you that your reading and writing posture is not correct,and never use the computer(OR=0.676,95%CI: 0.628~0.728)OR when using a computer,always(OR=0.670,95%CI: 0.614~0.731)distance between eyes and the computer display screen is more than 66 cm,and never watch TV(OR=0.692,95%CI: 0.633~0.757)OR watching TV/playing video games(OR=0.856,95%CI: 0.792~0.924),always keep the eye distance from the display screen of the TV(OR=0.856,95%CI: 0.792~0.924),and spend 3 or more hours outdoors during the day(OR=0.936,95%CI: 0.883~0.991),sleep duration of 7h-12 h per day(OR=0.344,95%CI: 0.325~0.364),sleep duration ≥12h per day(OR=0.259,95%CI: 0.189~0.356),parents without myopia(OR=0.503,95%CI: 0.479~0.528),etc.Possible risk factors for myopia include: Eating sweets once a day OR more(OR=1.177,95%CI: 1.068~1.298),never having breakfast(OR=1.824,95%CI: 1.466~2.270),and not doing eye exercises at school(OR=1.509,95%CI: 1.427~1.595),doing homework/reading and writing for more than 1 hour every day after school and attending cultural cram for more than 3 hours every week(OR=1.138,95%CI:1.043~1.241),using mobile electronic devices(OR=1.360,95%CI:1.300~1.422),often(OR=1.127,95%CI: 1.038~1.224)watching electronic screens after dark with lights off,always(OR=1.506,95%CI: 1.296~1.751)lying down or lying down to read a book or electronic screen,often(OR=1.177,95%CI: 1.053~1.315),reading a book OR electronic screen while walking or riding a car,taking a rest for more than 15 minutes when using the eyes in a near distance,having parents who were myopic(OR=1.483,95%CI: 1.347~1.633),etc.Conclusions:(1)There are significant differences in myopia among primary and middle school students in Gansu Province in different grades,genders,districts and counties,whether they live in school or not,and nationalities.The myopia rate of girls is generally higher than that of boys in different grades,and the myopia rate of primary and middle school students shows an increasing trend.(2)The risk factors for myopia among primary and secondary school students in Gansu Province may be related to diet and exercise behavior,eye environment inside and outside school,reading and writing posture,near eye use,electronic screen use,outdoor activities,sleep and genetics. |
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