| Objective(s):To understand the current situation and cognition of myopia among primary and middle school students in Chenggong District of Kunming in2019-2021,and analyze the influencing factors of myopia,and to provide a scientific basis for the focus of the next phase of myopia prevention and control work.Methods:A stratified cluster random sampling method was used.From 2019to 2021,students from seven schools were selected in Chenggong District,Kunming City,Yunnan Province to conduct a survey,including 2 primary schools,2 junior high schools,2 senior high schools,and 1 vocational high school.Visual acuity was examined by professionals using a standard logarithmic visual acuity chart and refractive detector,and a questionnaire survey was conducted on the subjects.The questionnaire included basic information and eye-related information.The Epi Data3.1double entry and Excel software were used for data collation,and SPSS23.0 software were used to analyze the data.Theχ~2test was used to compare the differences between myopia and non-myopia students in gender,age,grade and nationality;The grade data using Linear trendχ2 Test.The Logistic regression was used to explore the influencing factors of myopia in primary and secondary school students,such as eye environment,reading and writing posture,electronic screen using times,near work activities,outdoor activities,sleeping times,and parental myopia.Based on the results of unconditional binary logistic regression analysis,and further draw the Nomogram using the rms and ggplot2 software packages in the MAC version of R Studio.Results:(1)A total of 7223 primary and middle school students in Ch enggong District of Kunming City from 2019 to 2021,including 3566 boys,(49.37%),and 3657 girls(50.63%).The overall prevalence of myopia was 56.29%from 2019 to 2021;According to the BMI classification standard of boys,194 were underweight,accounting for 5.44%,2614 were normal,accounting for73.3%,343 were overweight,accounting for 9.62%,and 415 were obese,a ccounting for 11.64%.According to the BMI classification standard of girls,152 were underweight,accounting for 4.16%,2761 were normal,accounting fo r 75.49%,397 were overweight,accounting for 10.86%,and 347 were obese,accounting for 9.49%.(2)the prevalence of myopia was 57.10%,55.83%,and 56.00%(trendχ~2=0.575,P=0.448)from 2019 to 2021,respectively.The prevalence of myopia in girls was higher than that in boys(31.08%vs 26.02%,χ~2=6.426,P<0.05),(60.37%vs 51.72%,χ~2=20.859,P<0.05),(58.67%vs 53.37%,χ~2=7.042,P<0.05).The prevalence of myopia increased with the grade level,and the p revalence of myopia in ordinary high school was as high as 89.07%(P<0.05).The higher the BMI of primary and middle school students in Chenggong Dis trict of Kunming City,the higher the detection rate of myopia.The myopia rat e was 51.16%when the BMI was low weight,55.16%when the BMI was normal,61.89%when the BMI was overweight,and 61.15%when the BMI was obese(χ~2=252.392,P<0.05).There was a statistically significant differenc e in the detection rate of myopia among primary and middle school students a t 6-18 years in Chenggong District in 2019(trendχ~2=504.998,P<0.05).There was a statistically significant difference in the detection rate of myopia a mong primary and middle school students at 6-18 years in Chenggong District in 2020(trendχ~2=642.458,P<0.05).There was a statistically significant d ifference in the detection rate of myopia among primary and middle school stu dentsat 6-18 years in Chenggong District in 2021(trendχ~2=61.492,P<0.05).There was a statistically significant difference 9 years(trendχ~2=15.627,P<0.05)、10 years(trendχ~2=3.930,P<0.05)between primary and middle sch ools in Chenggong District from 2019 to 2021.(3)Chi-square test analysis showed that girls were more likely to be myop ic than boys(χ~2=6.426,P<0.05)、(χ~2=20.859,P<0.05)、(χ~2=7.042,P<0.05),students with higher grades were more likely to be myopic(trendχ~2=350.401,P<0.05)、(trendχ~2=40.659,P<0.05)(trendχ~2=464.431,P<0.05),students with higher body mass index(BMI)were more likely to b e myopic(χ~2=448.734,P<0.05)、(χ~2=8.130,P<0.05)、(χ~2=13.365,P<0.05),students with myopic parents were more likely to be myopic(χ~2=33.245,P<0.05),students with shorter sleep time were more likely to be myopic(χ~2=47.196,P<0.05)(χ~2=35.794,P<0.05)(χ~2=81.107,P<0.05).(4)The results of Logistic stepwise regression analysis showed that the fre quency of adjusting the height of desks and chairs according to height(OR=0.60,95%CI,0.40～0.90),the regular exchange of class seats(OR=0.64,95%CI,0.48～0.87),the number of taking eye exercises(OR=1.84,95%CI,1.12～3.01),(OR=1.69,95%CI,1.07～2.68).The average daily homework time(OR=0.59,95%CI,0.39-0.99),the eye distance between reading and writing is more than 33cm(OR=0.63,95%CI,0.45～0.87)、(OR=0.55,95%CI,0.41～0.75),the eye distance between ches t reading and writing more than one punch(OR=1.37,95%CI,1.08～1.76),a wee k average daily TV watching time(OR=0.48,95%CI,0.27～0.84)、(OR=0.35,95%CI,0.16～0.78),a week average daily computer watching time(OR=12.16,95%CI,2.71～54.60),a week average using mobile devices time(OR=1.70,95%CI,1.04～2.78)、(OR=2.84,95%CI,1.53～5.26),average daily outdoor activity time(OR=0.51,95%CI,0.31～0.84),class break outdoor(OR=0.61,95%CI,0.47～0.79)、(OR=0.71,95%CI,,0.56～0.89)、(OR=0.69,95%CI,0.53～0.84),daily sleeping time(OR=0.61,95%CI,0.48～0.79)、(OR=0.60,95%CI,0.47～0.77)、(OR=0.62,95%CI,0.47～0.81)and parental myopia(OR=2.75,95%CI,1.60～4.70)were the influencing factors o f myopia(P<0.05).(5)Through the results of logistic regression analysis,a visual Nomogram model of the influencing factors of myopia in Chenggong primary and middlea ry school students in Kunming City in 2019、2020 and 2021 was constructed.Conclusion(s):(1)From 2019 to 2021,the overall detection rate of myopia among primary and middle school students in Chenggong District decreased slightly,especially in junior school,and the overall detection rate of myopia was lower than that in other regions of China.The detection rate of myopia increased with the increase of grade and age,and the detection rate of myopia in primary school was higher than that in other regions of China.The detection rate of myopia in girls is higher than that in boys,and girls should be taken as the key prevention and control population of myopia.The detection rate of myopia in overweight and obese students was higher,suggesting that the higher the BMI grade,the more likely to suffer from myopia.The dynamic change trend from 2019 to 2021 was statistically significant in the age groups of 9 and 10 years,suggesting that this age was an important learning period in primary schools,and the prevention and control of myopia at this age should be strengthened.(2)The risk factors affecting adolescent myopia in Chenggong District of Kunming include:the average daily watching TV time,doing the average daily doing homework,using mobile devices,the average daily playing computers times,parents’myopia,etc.,when reading and writing,the distance between the eyes and the book is more than 33cm,the desk and chair are adjusted according to height,the seat is adjusted regularly,there is no cram school,the average daily sleeping time is more than 6 hours,the daily average outdoor activity time is more than 1 hour and the break is outdoors. |
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