{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:54:02Z","timestamp":1793361242224,"version":"4.5.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T00:00:00Z","timestamp":1660780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Globally, the prevalence of refractive error was 12%, and visual impairment due to refractive error was 2.1%. In sub-Saharan Africa, the prevalence of refractive error and visual impairment due to refractive error was 12.6% and 3.4%, respectively. In Ethiopia, the prevalence of visual impairment due to refractive error varies from 2.5% in the Gurage zone to 12.3% in Hawassa city. Hence, this Meta-analysis aimed to summarize the pooled prevalence of visual impairment due to refractive error in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of the literature was conducted by the authors to identify all relevant primary studies. All articles on the prevalence of visual impairment due to refractive error in Ethiopia were identified through a literature search. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and grey literature was searched on Google until December 15, 2021. In this meta-analysis, the presence of publication bias was evaluated using funnel plots and Begg\u2019s tests at a significance level of less than 0.05. The sensitivity analysis was conducted to check for a single study\u2019s effect on the overall prevalence of refractive error.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      About 1664 studies were retrieved from initial electronic searches using international databases and google searches. A total number of 20,088 children and adolescents were included in this meta-analysis. The pooled prevalence of visual impairment due to refractive error in Ethiopia using the random effects model was estimated to be 6% (95% CI, 5\u20137) with a significant level of heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      = 94.4%; p &lt; 0.001). The pooled prevalence of visual impairment due to refractive was analyzed by subtypes, and pooled prevalence was estimated to be 4%, 5.2%, and 1% for myopia, hyperopia, and astigmatism, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pooled prevalence of visual impairment due to refractive error was high in Ethiopia. About one in twenty-five Ethiopian children and adolescents are affected by visual impairment due to myopia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0271313","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T13:47:23Z","timestamp":1660830443000},"page":"e0271313","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prevalence of visual impairment due to refractive error among children and adolescents in Ethiopia: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2968-4958","authenticated-orcid":true,"given":"Daniel","family":"Atlaw","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zerihun","family":"Shiferaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1114-4849","authenticated-orcid":true,"given":"Biniyam","family":"Sahiledengele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisay","family":"Degno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5351-8300","authenticated-orcid":true,"given":"Ayele","family":"Mamo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demisu","family":"Zenbaba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habtamu","family":"Gezahegn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-3942","authenticated-orcid":true,"given":"Fikreab","family":"Desta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wogene","family":"Negash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5474-0782","authenticated-orcid":true,"given":"Tesfaye","family":"Assefa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mujib","family":"Abdela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbul","family":"Hasano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gashaw","family":"Walle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chala","family":"Kene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-4887","authenticated-orcid":true,"given":"Degefa","family":"Gomora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9840-8335","authenticated-orcid":true,"given":"Vijay Kumar","family":"Chattu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"issue":"2","key":"pone.0271313.ref001","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1371\/journal.pone.0191199","article-title":"Knowledge, attitude, and associated factors among primary school teachers regarding refractive error in school children in Gondar city, Northwest Ethiopia","volume":"13","author":"AM Alemayehu","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"pone.0271313.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2415-14-95","article-title":"Uncorrected refractive error and associated factors among primary school children in Debre Markos District, Northwest Ethiopia","volume":"14","author":"SA Sewunet","year":"2014","journal-title":"BMC Ophthalmol"},{"key":"pone.0271313.ref003","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/bs.pmbts.2015.05.007","article-title":"Genetics of Refraction and Myopia","volume":"134","author":"Q. Zhang","year":"2015","journal-title":"Progress in Molecular Biology and Translational Science. Elsevier Inc."},{"issue":"1","key":"pone.0271313.ref004","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.joco.2017.08.009","article-title":"Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis","volume":"30","author":"H Hashemi","year":"2018","journal-title":"J Curr Ophthalmol"},{"issue":"12","key":"pone.0271313.ref005","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1136\/bjophthalmol-2019-315217","article-title":"Prevalence and causes of vision loss in sub-Saharan Africa in 2015: Magnitude, temporal trends and projections","volume":"104","author":"K Naidoo","year":"2020","journal-title":"Br J Ophthalmol"},{"issue":"3","key":"pone.0271313.ref006","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/OPX.0000000000000796","article-title":"Global vision impairment and blindness due to uncorrected refractive error, 1990Y2010","volume":"93","author":"KS Naidoo","year":"2016","journal-title":"Optom Vis Sci"},{"issue":"4","key":"pone.0271313.ref007","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1111\/cxo.12689","article-title":"Prevalence of refractive errors in children in India: a systematic review","volume":"101","author":"S Sheeladevi","year":"2018","journal-title":"Clin Exp Optom"},{"issue":"1","key":"pone.0271313.ref008","doi-asserted-by":"crossref","first-page":"533","DOI":"10.4314\/ahs.v20i1.60","article-title":"Visual impairment and associated factors among primary school children in gurage zone, Southern Ethiopia","volume":"20","author":"GG Woldeamanuel","year":"2020","journal-title":"Afr Health Sci"},{"issue":"3","key":"pone.0271313.ref009","article-title":"A cross-sectional analysis of refractive error prevalence and associated factors among elementary school children in Hawassa, Ethiopia","volume":"49","author":"KD Alem","year":"2021","journal-title":"J Int Med Res"},{"issue":"1","key":"pone.0271313.ref010","first-page":"2","article-title":"Vision 2020: the right to sight","volume":"2","author":"OK Malla","year":"2004","journal-title":"Kathmandu Univ Med J (KUMJ)"},{"issue":"5","key":"pone.0271313.ref011","doi-asserted-by":"crossref","first-page":"432","DOI":"10.4103\/0301-4738.100543","article-title":"Uncorrected refractive errors","volume":"60","author":"KS Naidoo","year":"2012","journal-title":"Indian J Ophthalmol"},{"issue":"10","key":"pone.0271313.ref012","doi-asserted-by":"crossref","first-page":"4171","DOI":"10.18203\/2394-6040.ijcmph20204392","article-title":"Epidemiology of visual impairment: focus on Delta State, Nigeria","volume":"7","author":"JE Moyegbone","year":"2020","journal-title":"Int J Community Med Public Heal"},{"key":"pone.0271313.ref013","doi-asserted-by":"crossref","first-page":"100852","DOI":"10.1016\/j.eclinm.2021.100852","article-title":"Global economic productivity losses from vision impairment and blindness","volume":"35","author":"AP Marques","year":"2021","journal-title":"EClinicalMedicine"},{"issue":"5","key":"pone.0271313.ref014","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"BA Holden","year":"2016","journal-title":"Ophthalmology"},{"issue":"4","key":"pone.0271313.ref015","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/IEB.0b013e318156abdc","article-title":"Economic impact of visual impairment and blindness in the United States","volume":"8","author":"JD Stein","year":"2007","journal-title":"Evidence-Based Ophthalmol"},{"issue":"2","key":"pone.0271313.ref016","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4103\/0301-4738.111207","article-title":"Impact of low vision care on reading performance in children with multiple disabilities and visual impairment","volume":"62","author":"KK Ramani","year":"2014","journal-title":"Indian J Ophthalmol"},{"key":"pone.0271313.ref017","doi-asserted-by":"crossref","first-page":"205031211984976","DOI":"10.1177\/2050312119849769","article-title":"Prevalence of visual impairment among school children in three primary schools of Sekela Woreda, Amhara regional state, north-west Ethiopia","volume":"7","author":"M Zelalem","year":"2019","journal-title":"SAGE Open Med"},{"key":"pone.0271313.ref018","first-page":"117","article-title":"prevalance of refractive error in preschool and school childern of Debark and Kola Diba towns,Northwest Ethiopia","author":"T Kassa","year":"2000","journal-title":"Ethiopian Journal of Health Development"},{"key":"pone.0271313.ref019","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1155\/2017\/9326108","article-title":"The Prevalence of Visual Acuity Impairment among School Children at Arada Subcity Primary Schools in Addis Ababa, Ethiopia","volume":"2017","author":"HF Darge","year":"2017","journal-title":"J Ophthalmol"},{"key":"pone.0271313.ref020","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6934013","article-title":"Visual Impairment among Primary School Children in Gondar Town, Northwest Ethiopia","volume":"2020","author":"AT Ferede","year":"2020","journal-title":"J Ophthalmol"},{"key":"pone.0271313.ref021","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2147\/OPTO.S293446","article-title":"Prevalence and Associated Factors of Amblyopia Among School Age Children at Bahir Dar City, Northwest Ethiopia: A Community-Based Cross-Sectional Study","volume":"13","author":"MM Tegegne","year":"2021","journal-title":"Clin Optom"},{"issue":"4","key":"pone.0271313.ref022","doi-asserted-by":"crossref","first-page":"372","DOI":"10.4103\/0974-9233.102742","article-title":"Prevalence of refractive errors among school children in Gondar town, northwest Ethiopia","volume":"19","author":"AW Yared","year":"2012","journal-title":"Middle East Afr J Ophthalmol"},{"key":"pone.0271313.ref023","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.2147\/OPTH.S135011","article-title":"Prevalence and factors associated with childhood visual impairment in Ethiopia","volume":"11","author":"L Bezabih","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"pone.0271313.ref024","doi-asserted-by":"crossref","first-page":"767","DOI":"10.2147\/OPTH.S245675","article-title":"Prevalence of visual impairment and associated factors among primary schoolchildren in Addis Ababa, Central Ethiopia","volume":"14","author":"Y Hailu","year":"2020","journal-title":"Clin Ophthalmol"},{"issue":"1","key":"pone.0271313.ref025","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1444-0938.2012.00762.x","article-title":"Prevalence of refractive errors among schoolchildren in rural central Ethiopia","volume":"96","author":"ZA Mehari","year":"2013","journal-title":"Clin Exp Optom"},{"key":"pone.0271313.ref026","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2147\/OPTO.S213047","article-title":"Prevalence and associated factors of visual impairment among school-age children in Bahir Dar City, Northwest Ethiopia","volume":"11","author":"YA Merrie","year":"2019","journal-title":"Clin Optom"},{"issue":"4","key":"pone.0271313.ref027","doi-asserted-by":"crossref","first-page":"353","DOI":"10.4314\/ejhs.v24i4.11","article-title":"Prevalence of refractive error and visual impairment among rural school-age children of Goro District, Gurage Zone, Ethiopia","volume":"24","author":"J Kedir","year":"2014","journal-title":"Ethiop J Health Sci"},{"issue":"1","key":"pone.0271313.ref028","doi-asserted-by":"crossref","first-page":"1554832","DOI":"10.1080\/2331205X.2018.1554832","article-title":"Prevalence and causes of visual impairment among schoolchildren in Mekelle, Ethiopia","volume":"5","author":"U Dhanesha","year":"2018","journal-title":"Cogent Med"},{"issue":"2","key":"pone.0271313.ref029","first-page":"1","article-title":"Causes of severe visual impairment and blindness in students in schools for the blind in Northwest Ethiopia","volume":"2","author":"M Asferaw","year":"2017","journal-title":"BMJ Glob Heal"},{"issue":"9","key":"pone.0271313.ref030","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.trstmh.2011.04.007","article-title":"Magnitude and causes of childhood blindness and severe visual impairment in Sekoru District, Southwest Ethiopia: A survey using the key informant method","volume":"105","author":"BS Demissie","year":"2011","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"1","key":"pone.0271313.ref031","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4314\/ejhs.v24i1.9","article-title":"Patterns of Eye Diseases in Children Visiting a Tertiary Teaching Hospital: Ethiopia","volume":"24","author":"B Demissie","year":"2014","journal-title":"Ethiop J Heal Sci"},{"key":"pone.0271313.ref032","doi-asserted-by":"crossref","first-page":"11","DOI":"10.2147\/OPTO.S120485","article-title":"Prevalence and associated factors of myopia among high school students in Gondar town, northwest Ethiopia, 2016","volume":"9","author":"GT Belete","year":"2017","journal-title":"Clin Optom"},{"issue":"1","key":"pone.0271313.ref033","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12886-020-01457-2","article-title":"Prevalence of myopia among secondary school students in Welkite town: South-Western Ethiopia","volume":"20","author":"SA Gessesse","year":"2020","journal-title":"BMC Ophthalmol"},{"issue":"2","key":"pone.0271313.ref034","article-title":"Common eye diseases in children of rural community in Goro district, Central Ethiopia","volume":"19","author":"M Shaffi","year":"2005","journal-title":"Ethiop J Heal Dev"},{"issue":"1","key":"pone.0271313.ref035","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2415-14-50","article-title":"Pattern of childhood ocular morbidity in rural eye hospital, Central Ethiopia","volume":"14","author":"ZA Mehari","year":"2014","journal-title":"BMC Ophthalmol"},{"key":"pone.0271313.ref036","unstructured":"Joanna Briggs Institute. Checklist for Prevalence Studies. Checkl prevalance Stud [Internet]. 2016;7. http:\/\/joannabriggs.org\/assets\/docs\/critical-appraisal-tools\/JBI_Critical_Appraisal-Checklist_for_Prevalence_Studies.pdf."},{"issue":"3","key":"pone.0271313.ref037","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/XEB.0000000000000065","article-title":"Fixed or random effects meta-analysis? Common methodological issues in systematic reviews of effectiveness","volume":"13","author":"C Tufanaru","year":"2015","journal-title":"Int J Evid Based Healthc"},{"issue":"2","key":"pone.0271313.ref038","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/jrsm.12","article-title":"A basic introduction to fixed-effect and random-effects models for meta-analysis","volume":"1","author":"M Borenstein","year":"2010","journal-title":"Res Synth Methods"},{"issue":"May 2014","key":"pone.0271313.ref039","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","author":"M Egger","year":"1997","journal-title":"BMJ"},{"issue":"8","key":"pone.0271313.ref040","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1007\/s11606-018-4425-7","article-title":"Empirical Comparison of Publication Bias Tests in Meta-Analysis","volume":"33","author":"L Lin","year":"2018","journal-title":"J Gen Intern Med"},{"issue":"20","key":"pone.0271313.ref041","article-title":"Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study","author":"GBD 2019 Blindness and Vision Impairment Collaborators","year":"2020","journal-title":"Lancet Glob Heal"},{"issue":"1","key":"pone.0271313.ref042","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2471\/BLT.07.041210","article-title":"Global magnitude of visual impairment caused by uncorrected refractive errors in 2004","volume":"86","author":"S Resnikoff","year":"2008","journal-title":"Bull World Health Organ"},{"issue":"6","key":"pone.0271313.ref043","first-page":"1","article-title":"Measuring progress towards universal health coverage: National and subnational analysis in Ethiopia","volume":"4","author":"GT Eregata","year":"2019","journal-title":"BMJ Glob Heal"},{"issue":"4","key":"pone.0271313.ref044","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1590\/2176-9451.19.4.027-029.ebo","article-title":"How sample size influences research outcomes","volume":"19","author":"J Faber","year":"2014","journal-title":"Dental Press J Orthod"},{"issue":"4","key":"pone.0271313.ref045","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1177\/2168479015570332","article-title":"Sample Size and the Precision of the Confidence Interval in Meta-analyses","volume":"49","author":"XS Liu","year":"2015","journal-title":"Ther Innov Regul Sci"},{"issue":"4","key":"pone.0271313.ref046","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1136\/bjo.2006.105593","article-title":"An evaluation of optometrists\u2019 ability to correctly identify and manage patients with ocular disease in the accident and emergency department of an eye hospital","volume":"91","author":"SCH Hau","year":"2007","journal-title":"Br J Ophthalmol"},{"issue":"1","key":"pone.0271313.ref047","first-page":"13","article-title":"Reasons for Referrals by Optometrists to Ophthalmologists: An Audit of Ocular Disease Detection","volume":"63","author":"DM COCKBURN","year":"1980","journal-title":"Aust J Optom"},{"issue":"2","key":"pone.0271313.ref048","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1444-0938.1994.tb02374.x","article-title":"An audit of disease diagnoses made by optometrists","volume":"77","author":"DM Cockburn","year":"1994","journal-title":"Clin Exp Optom"},{"issue":"10","key":"pone.0271313.ref049","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1097\/00006324-200210000-00011","article-title":"Sensitivity and specificity of visual acuity screening for refractive errors in school children","volume":"79","author":"L Tong","year":"2002","journal-title":"Optom Vis Sci"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0271313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T13:48:25Z","timestamp":1660830505000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0271313"}},"subtitle":[],"editor":[{"given":"Consolato M.","family":"Sergi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,8,18]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0271313","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,18]]}}}