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首页> 外文期刊>Ophthalmology >Vernal keratoconjunctivitis in school children in rwanda: Clinical presentation, impact on school attendance, and access to medical care
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Vernal keratoconjunctivitis in school children in rwanda: Clinical presentation, impact on school attendance, and access to medical care

机译：卢旺达学龄儿童春季角膜结膜炎：临床表现，对上学率的影响以及就医机会

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Objective: We sought to describe the clinical presentation, effect on visual acuity, impact on school attendance, and access to appropriate eye care in children with vernal keratoconjunctivitis (VKC) in Rwanda (Central Africa). Design: Case-control study nested within a cross-sectional survey. Participants: We examined 3041 children; 121 had VKC. Methods: Primary schools were randomly selected and children were interviewed using a questionnaire on VKC-related symptoms. Data on health-seeking behavior and school attendance were recorded. Children received a full eye examination, including visual acuity using a LogMar E Chart. Main Outcome Measures: Description of the clinical findings, unaided visual acuity, prior attendance for medical eye care, and the impact of VKC on school attendance. Results: Of the 121 children with VKC, 119 (98.4%) had only limbal disease. Ocular itching (n = 101; 83.5%) was the predominant symptom and this was seasonal in 66 children (65.4%), constant but with variable intensity in 18 (17.8%), and constant with constant intensity in 17 children (16.8%). Children with VKC were >6 times more likely to have corneal astigmatism >2 diopters in their worse eye (odds ratio [OR], 6.31; 95% confidence interval [CI], 3.26-12.26; P<0.001) than controls. Eight affected eyes had astigmatism >4 diopters or irregular astigmatism incompatible with autokeratometry. Although 4 eyes (1.7%) had uncorrected low vision from VKC-induced corneal astigmatism or keratoconus, only 1 child was visually impaired in both eyes. School nonattendance for an ocular reason during the last 3 months was 5 times more likely in children with VKC (n = 44; 36.4%) than among those without (n = 297; 10.2%; OR, 5.04; 95% CI, 3.40-7.47; P < 0.001). Repeating a school year or having ever dropped out of school was not more common among children with VKC than those without. Medical eye care had been sought by 54 (44.6%) children with VKC. Conclusions: This survey of prevalence and treatment of VKC in an African community adds to the argument for better primary eye care, including a safe topical medication. Long-term follow-up of this cohort is required to ascertain the overall risk of sight-threatening complications. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
机译：目的：我们试图描述卢旺达（中部非洲）患有春季角膜结膜炎（VKC）的儿童的临床表现，对视力的影响，对上学率的影响以及获得适当的眼保健的机会。设计：病例对照研究嵌套在横断面调查中。参与者：我们检查了3041名儿童; 121有VKC。方法：随机选择小学，并使用有关VKC相关症状的问卷对儿童进行访谈。记录有关寻求健康行为和入学率的数据。儿童使用LogMar E Chart进行了全眼检查，包括视敏度。主要结果指标：描述临床发现，无辅助视敏度，医疗眼保健的就读率以及VKC对学校出勤率的影响。结果：在121名VKC儿童中，只有119名（98.4％）仅患有角膜缘疾病。眼部瘙痒（n = 101; 83.5％）是主要症状，这是季节性的，其中66例儿童（65.4％）为持续性，但强度持续变化的18例儿童（17.8％），17例持续恒定强度的儿童（16.8％）。 。与对照组相比，VKC儿童在其较差的眼睛中患角膜散光> 2屈光度的可能性高> 6倍（几率[OR]为6.31; 95％置信区间[CI]为3.26-12.26; P <0.001）。八只受影响的眼睛的散光> 4屈光度或与自动角膜测定法不兼容的不规则散光。尽管有4眼（1.7％）因VKC引起的角膜散光或圆锥角膜未矫正视力低下，但只有1名儿童的双眼视力受损。在过去3个月中，由于视觉原因导致的VKC儿童失学的可能性（n = 44; 36.4％）比没有VKC的儿童（n = 297; 10.2％; OR，5.04; 95％CI，3.40- 7.47; P <0.001）。患有VKC的孩子比没有孩子的孩子更重读一个学年或辍学。 54名（44.6％）患有VKC的儿童曾寻求医疗眼保健。结论：这项对非洲社区VKC患病率和治疗情况的调查为更好的初级眼保健（包括安全的局部用药）提供了依据。需要对该队列进行长期随访，以确定威胁视力的并发症的总体风险。财务披露：作者对本文讨论的任何材料均没有所有权或商业利益。

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