FACTORS INFLUENCING CONTACT LENSES UPTAKE AMONG SCHOOL GOING CHILDREN AND TEENAGERS WITH MYOPIA ATTENDING SELECTED EYE CLINICS IN KENYA

Abstract

Myopia affects about 22.9% of the global population while it’s prevalence in Africa and in Kenya have been reported to be 5.5% and 7% respectively. Myopia pandemic has been associated with sight threatening conditions. The commonly used single vision spectacles among school-going children and teenagers has been reported to increase the risk of myopia progression among users. Contact lens (CL) alternative on the other side, has been shown to have superior advantages over spectacles, yet in Kenya, uptake remains low. This study investigated the factors influencing the uptake of CL in school-going children and teenagers with myopia attending selected CL clinics in Kenya. Specifically, the study determined the factors hindering, and promoting CL uptake, including the roles of parent(s), and eye care practitioners (ECP) on CL uptake. A clinic-based observational, descriptive study design was employed to elicit data relevant to the objectives of this study. Selected participants were sub grouped into – user, parental, and ECP groups and administered with appropriate pre-validated semi-structured questionnaires. Data collected from participants were analyzed and then presented in proportions and in tables. The results showed 86 user-group participants aged 13.4±2.1, 86 accompanying parents, and 48 ECPs, from 13 CL clinics, participated in the study. Among the user group, factors found promoting CL uptake were mostly; complaints of the bulkiness of glasses compared to CL (71.8%) and felt reduced self-esteem with spectacle use (69.4%) – although not significant (P=0.12, and P=0.084 respectively). Conversely, even though most (60.0%, P˂0.01) user-group participants expressed fear of harm from CL, the concern about parental approval of their CL use was mostly associated with non-uptake of CL (Cramer’s V: 0.581, P˂0.01). For the parental group, while the child’s improved class performance with CL (OR: 106, 95% CI: 2.6 – 4290, P=0.01) mostly influenced CL uptake, felt concerns about their child not being careful enough to handle CL (OR: 84, 95% CI: 1.8 – 3834, P=0.02) had highest hindrance to uptake. Similarly, while the child’s motivation to wear CL had the highest likelihood (OR: 34, 95% CI: 1.35 – 878, P=0.03) to influence ECPs in fitting CLs, hence improved uptake, lack of adequate knowledge and skills-set required for CL fitting (OR: 77, 95% CI: 1.6 – 3690, P=0.03) mostly presented hindrance to them. Therefore, the study concludes that low uptake of CL among children and teenagers with myopia is evident in Kenya. Results show uptake is not only influenced by factors related to the users themselves, but also those associated with both concerns from their accompanying parent(s), and the experiences and skills-set of the ECPs. Thus, the study recommends improved user education to enhance proper awareness of parents and their children with myopia on the safety and benefits of CL, as well as improved practitioners’ CL-related education and skills. The findings from this study elicited relevant tools to inform effective public health strategies, particularly improving availability and access of service.