Prevalence and factors associated with visual impairment among high school students in Mbarara city, Southwestern Uganda: a cross‑sectional study

Abstract

Background: In most low-income countries, including Uganda, routine screening for Visual Impairment (VI) in schools is not conducted, despite the growing global trend of VI among young people, and its negative impacts on academic performance and social integration. Data on prevalence and factors associated with VI among students in Uganda are limited. We determined the prevalence of VI and identified associated factors among high school students in Mbarara City. Methods: We conducted a cross-sectional study among high school students in sampled high schools within Mbarara City, southwestern Uganda from September 19, 2023 to October 14, 2023. Participants were selected using multi-stage stratified cluster sampling. We obtained data on socio-demographics and behaviors through interview-administered questionnaires. Visual acuity (VA) was measured using Snellen’s chart at six meters. Participants were considered visually impaired if their VA in the better eye was < 6/12. Logistic regression analysis was used to identify factors associated with VI. Results: We enrolled 768 participants from four schools; most were males (56.4%), aged 18–24 years (50.3%). Median age was 18 (inter-quartile range [IQR]: 13–24) years. The prevalence of VI was 2.99% (n = 23; 95%CI 2.00–4.47%]. Age category 18–24 years (adjusted odds ratio [aOR] = 2.73, 95%CI 1.03–7.21, p = 0.043), obesity (aOR = 9.60, 95%CI 1.43–64.51, p = 0.020) and family history of VI (aOR = 7.09, 95%CI 2.87–7.51, p < 0.001), were independently associated with VI. Conclusion: The prevalence of VI among the high school students surveyed was low. However, targeted screening of older students, those with a family history of VI and obese students, could facilitate early detection and timely interventions in the region.