{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:20:01Z","timestamp":1789060801699,"version":"build-2803163510"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81273018"],"award-info":[{"award-number":["81273018"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81673224"],"award-info":[{"award-number":["81673224"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007128","name":"Natural Science Foundation of Shaanxi Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007128","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The present study was performed to detect the prevalence of myopia among primary-school students in Xi'an, north-western of China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study was a school-based study with students aged from 6 to 13 years old. All the individuals underwent ophthalmological examination and spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Myopia was defined as a SE of \u2264 -0.5 diopters (D), and further divided into three stratified groups based on SE: low myopia (\u2264 -0.5 to &amp;gt;-3.0 D), moderate myopia (\u2264 -3.0 to &amp;gt;-6.0 D), and high myopia (\u2264 -6.0 D). Relative risk factors, including age, sex, grade and ethnicity were investigated using questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4,680 individuals were eligible for this survey and 4,654 (99.4% participation rate) were finally included (51.2% boys). The mean age of participants was 8.756 \u00b1 1.727 years. The whole city-level prevalence of total myopia was 57.1% (95% CI: 55.7\u201358.6%). Additionally, the prevalence of low, moderate, and high myopia was 45.0% (95% CI: 43.5\u201346.4%), 11.1% (95% CI: 10.2\u201312.0%), and 1.0% (95% CI: 0.7\u20131.3%), respectively. Moreover, grade (education level) instead of age, sex and ethnicity was the most essential risk factor for prevalence of overall myopia (OR = 1.844, 95% CI: 1.605\u20132.119), and an increase of prevalence by 84.4% per grade was seen. Furthermore, similar associations of grade were significant with low myopia (OR = 1.613, 95% CI: 1.385\u20131.877) and moderate myopia (OR = 2.186, 95% CI: 1.693\u20132.823), meanwhile, prevalence of low myopia and moderate myopia demonstrated an increase of prevalence by 61.3 and 118.6% per grade, respectively. None of the factors included in the present study was significant risk factor for high myopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study investigated a non-negligible high prevalence of myopia among primary-school students in Xi'an, north-western of China, and a gradual increasing in proportion with education level.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.1070984","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T05:15:16Z","timestamp":1671426916000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Increasing prevalence of myopia and the impact of education in primary-school students in Xi'an, north-western of China"],"prefix":"10.3389","volume":"10","author":[{"given":"Lu","family":"Ye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-qi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guo-yun","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-jun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-xia","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing-zhou","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-jiao","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang-cai","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo-qi","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dang-xia","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1475-1313.2011.00884.x","article-title":"Worldwide prevalence and risk factors for myopia","volume":"32","author":"Pan","year":"2012","journal-title":"Ophthal Physiol Optics."},{"key":"B2","doi-asserted-by":"publisher","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":"Holden","year":"2016","journal-title":"Ophthalmology."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s12886-019-1281-0","article-title":"Prevalence of myopia and vision impairment in school students in Eastern China","volume":"20","author":"Wang","year":"2020","journal-title":"BMC Ophthalmol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.47102\/https:\/\/doi.org\/10.47102\/annals-acadmedsg.V33N1p27","article-title":"Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000","volume":"33","author":"Lin","year":"2004","journal-title":"Ann Acad Med Singapore."},{"key":"B6","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1097\/00006324-200104000-00012","article-title":"Does education explain ethnic differences in myopia prevalence? 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