Regional Trends and Associated Factors of Childhood Visual Impairment: A Case Study in Shandong Province, China

Abstract

Background: Visual impairment is a common child health problem. We hopes to analyze the regional trend, related factors and spatial distribution of children's visual impairment in Shandong province, to explore the spatial changes brought by time and their influencing factors, so as to provide scientific basis for prevention of childhood visual impairment.Methods: This study covers five complete cross-sectional surveys (Physical examination data in Shandong province) from 2013 to 2017, involving about 29.24 million students. The 11th International Classification of Diseases was selected as the diagnostic standard. Spatial autocorrelation and hotspot analysis methods in ArcGIS software were used to analyze spatial features. The associated factors were analyzed by multinomial logistic regression.Results: The visual impairment prevalence showed a trend of decreasing first and then increasing from 2013-2017, with slight changes. In terms of regional spatial differences, Weihai and Yantai have the highest VI rates in all years, and there was a large-scale spatial aggregation phenomenon. The southern low-value clusters, however, showed a weakening year by year. Further exploration revealed that the per capita disposable income of rural households, the growth rate of gross domestic product, total retail sales of consumer goods and number of full-time teachers were verified as risk factors for regional visual impairment levels.Conclusions: The slight rebound of the prevalence of visual impairment and the high rate in the eastern and northern regions of Shandong province need more attention. It is suggested that relevant departments should focus on the influence of regional economic and educational factors when formulating relevant strategies.