KNOWLEDGE, ATTITUDE AND FACTORS INFLUENCING THE UPTAKE OF MYOPIA CONTROL STRATEGIES AMONG TEENAGERS AND EYECARE PRACTITIONERS IN LURAMBI CONSTITUENCY, KENYA.

Abstract

The global rise in myopia has emerged as a significant public health issue, with 27% of the world population affected by 2020, and projections indicate that by 2050, nearly half of the global population will be myopic. Despite the increasing prevalence and the availability of effective myopia control strategies such as combination treatments, children with progressive myopia are often still prescribed single vision (SV) spectacles, which offer minimal to no control over myopia progression. This study aimed to evaluate the knowledge, attitude, and factors influencing the uptake of myopia control strategies among teenagers and Eye Care Practitioners (ECPs) in Lurambi Constituency, Kenya. An analytical cross-sectional design was employed, with 115 myopic teenagers and 22 ECPs purposively selected from 12 eye clinics in Lurambi Constituency participating. Teenagers completed a questionnaire assessing their knowledge, attitudes, and factors affecting the adoption of myopia control strategies, while ECPs responded to a questionnaire on their strategies and attitudes toward myopia management. The uptake of myopia control strategies among teenagers was 55.7%, with SV spectacles being the most commonly used at 70.3%, while none had used Ortho-K. Among ECPs, 86.36% had adopted effective myopia control strategies, with 84.2% prescribing SV spectacles, and Ortho-K was not prescribed. Knowledge of myopia control strategies was reported by 69.8% of teenagers and 100%of ECPs, with a significant relationship observed between knowledge and the uptake of myopia control strategies among teenagers (p-value <0.001). Good attitudes toward myopia control were reported by 48.3% of teenagers and 95.45% of ECPs. Cost emerged as the most influential factor in the uptake of myopia control strategies, affecting 79.7% of teenagers and 54.5% of ECPs. Increased cost was associated with a decreased likelihood of adopting myopia control strategies among teenagers, with an odds ratio of1.367 (95% CI [1.013-1.845]). Additionally, refractive error significantly influenced the uptake of myopia control strategies, with a p-value of 0.010 for teenagers and 0.031 for ECPs. The criteria for selecting an initial myopia control strategy in young myopes showed significant relationships with binocular vision status and other unspecified factors (p-values of 0.002 and 0.010, respectively). In conclusion, despite high levels of knowledge and positive attitudes toward myopia control strategies among both teenagers and ECPs, the actual uptake of effective myopia control strategies remains relatively low. The study found a significant relationship between knowledge and the uptake of myopia control strategies among teenagers (p-value ≤0.001) and identified cost as a critical barrier, decreasing the likelihood of adopting these strategies. Given these findings, the Ministry of Health of Kenya (Ophthalmic Division) is advised to develop a pediatric management guideline to support the utilization of myopia control strategies by ECPs in Kenya.