Prevalence of Refractive Error and Spectacle Coverage in Zoba Ma'ekel Eritrea: A Rapid Assessment of Refractive Error

Purpose: To determine the prevalence of refractive error and spectacle coverage in Zoba Ma'ekel, Eritrea in order to assist in planning for refractive services and blindness prevention strategies. Methods: A community-based cross-sectional study using multistage cluster sampling was conducted. A total of 3200 participants aged 15-50 years were enumerated and examined using the Rapid Assessment of Refractive Error (RARE) protocol. Results: The response rate was 99.1%. The prevalence of refractive error was 6.4% (95% confidence interval [CI], 5.6-7.2%). Spectacle coverage for refractive error was 22.2% (95% CI 16.7-28.5%). It was higher among males than females (Fisher's exact test, p = 0.028), and highest in those who had completed secondary school (48.6%, 95% CI 31.9-65.6%) and those who resided in Asmara (Fisher's exact test, p < 0.002). The prevalence of presbyopia was 32.9% (95% CI 30.3-35.7%) with 94.9% correctable. Spectacle use for presbyopia was 9.9% (95% CI 7.2-13.4%), which was lowest in those with no formal schooling but highest in those who had completed secondary school (chi(2) test, p < 0.001) and those persons who resided in Asmara (Fisher's exact test, p < 0.001). Respondents expressed different barriers to uptake of services. A total of 128 subjects were aware of the problem but did not feel the need for consultation while 83 subjects stated they could not afford the cost of examination and spectacles. Conclusion: The study provides helpful findings to assist with the development of appropriate refractive service planning in Zoba Ma'ekel. Uncorrected refractive error is of public health importance and prompt measures are needed to address the problem.