Prevalence and associated factors of amblyopia among children seeking eye services at Mulago Hospital

Abstract

Introduction: Amblyopia is the leading cause of visual impairment in children, with a worldwide prevalence ranging between 0.13% and 12.9%. The burden of amblyopia among children in Uganda is not well documented, and the consequences of amblyopia, which include poor stereovision, reductions in visual acuity, pattern recognition, contrast sensitivity, low sensitivity to motion, and consequently blindness, remain a challenge to society, hence this study. Study objectives: This study aimed to determine the prevalence and associated factors of amblyopia among children 17 years of age and below who attended the eye clinic of MNRH from March to May 2024. Specifically, the study determined the prevalence and the factors associated with amblyopia among children 17 years and below attending the eye clinic of MNRH from March to May 2024. Methods: This study was a cross-sectional study conducted among children below 17 years old attending the eye clinic at Mulago National Referral Hospital. Logistic regression was done to determine the factors associated with Amblyopia at a 5% significance level. Results: The average age of the children was 11.7 years (SD=3.6 years). Amblyopia was diagnosed in 8.7% (25 out of 288) of the children, with anisometropic amblyopia accounting for 52.0% (13 out of 25) and ametropic amblyopia accounting for 28.0% (7 out of 25) of cases. Children whose next of kin (NOK) were their fathers were 3.01 times more likely [AOR=3.01, CI=1.09-8.29, P=0.03] to be diagnosed with amblyopia compared to those whose NOK were mothers at a 95% confidence interval. Mothers who never consumed alcohol during pregnancy [AOR=0.38, CI=0.22-0.97, P<0.001] were 62% less likely to have their children diagnosed with amblyopia compared to those who consumed alcohol during pregnancy. Additionally, children with first-degree family members using spectacles [AOR=2.75, CI=1.97-7.41, P=0.02] were 2.75 times more likely to be diagnosed with amblyopia than those without. Furthermore, children who presented with photophobia [AOR=4.98, CI=1.38-9.94, P=0.014] were 4.98 times more likely to be diagnosed with amblyopia compared to those without. Conclusion: Amblyopia prevalence was high, with Anisometropic amblyopia being the most common type of amblyopia diagnosed among children. Amblyopia was associated with having photophobia, a family history of spectacle use, alcohol consumption during the child’s pregnancy, and having the next of kin as the father. Interventions to reduce the public health burden of amblyopia among children in the study area should deliberately address these factors.