武汉市学龄前儿童近视及其影响因素的城乡差异研究OA

Objective:To evaluate the prevalence of myopia among preschool children in Wuhan,and to explore its influencing factors and compare the urban-rural differences.Methods:Using a cluster sampling method,all preschool children in kindergartens affiliated with 13 primary-level myopia prevention and control stations in Wu-han City,Hubei Province,were selected as study subjects.The refraction was tested and questionnaires were ad-ministered to collect information on children's basic characteristics,daily living habits,screen exposure and di-etary habits.Univariate analysis,and multivariate logistic regression analysis were used to explore influencing factors for myopia in preschool children and compare urban-rural differences.The Shapley value analysis was fur-ther employed to calculate the contribution degree of different influencing factors.Results:A total of 7,352 pre-school children were recruited in this study,among whom 420 were identified with myopia,resulting in an over-all myopia prevalence of 5.71%.The numbers of myopic children were 185 in urban areas and 235 in rural areas,with myopia prevalence rates of 7.61%and 4.78%,respectively.In the urban area,parental myopia(OR=5.58,P＜0.01)and parental astigmatism(OR=1.81,P=0.02)were risk factors for myopia in children,whereas correct pen-holding and reading/writing posture(OR=0.68,P=0.02)was a protective factor;while in the rural area,older age(OR=1.55,P＜0.01),parental myopia(OR=3.05,P＜0.01),and prolonged eye use at a close distance(OR=1.80,P＜0.01),and frequent television viewing(OR=1.90,P=0.02)were risk factors for children's myopia,whereas matching of desk and chair to height(OR=0.27,P＜0.01),and correct pen-holding and reading/writing posture(OR=0.68,P=0.01)were protective factors for children's myopia.Shapley value analysis indicated that the primary contributing factor to myopia among preschool children in urban areas was parental myopia(77.25%),whereas in rural areas,lifestyle behaviors accounted for the largest proportion(43.62%).Conclusion:The prevalence rate of myopia in preschool children in Wuhan in this study is generally moderate,with a higher rate in children in urban areas than in rural areas.The influencing factors affecting myopia in children differs be-tween urban and rural areas,and interventions should be targeted separately.