深圳市宝安区外地与本地小学生视力低下多水平模型分析

Comparison of eyesight dysfunction between migrant and local schoolchildren in Shenzhen Baoan District: multilevel models analysis

目的 比较外地学生与本地学生视力低下的差异,分析人口流动状态与视力低下的关系。方法 以学校为基础采用分层整群抽样方法选取深圳市宝安区4所外来务工子弟小学和4所公立小学,对三至六年级学生进行问卷调查与视力检测;应用多水平模型分析数据。结果 实际有效调查4 661人,外地学生2 357人（50.6%）,本地学生2 304人（49.4%）,外地小学生视力低下患病率为29.6%,低于本地学生的33.6%（P=0.003）;调整相关混杂后,外地学生视力低下患病风险仍低于本地学生（OR=0.84,95%CI：0.74~0.95,P=0.006）,视力低下进展加深的风险也低于本地学生（OR=0.85,95%CI：0.75~0.96,P=0.009）;多水平模型显示,调整家庭、个人及学校视力相关因素后,人口流动状态与视力低下并无关联（P=0.327）。结论 本地学生视力低下状况较外地学生严峻,提示针对特定人群应采取针对性的视力防控措施。

Objective To compare eyesight dysfunction （ED） between migrant and local school-age children, and to examine the association of migratory status and ED among children in South China. Methods A school-based cross-sectional, stratified-cluster sample study was conducted. Students from 4 private migrant primary schools and 4 urban public schools in grade 3 to 6 were enumera- ted. All eligible participants finished questionnaires and implemented eye examination. Multi-level models were conducted to analyze data. Results Of 4 661 eligible participants, 2 357 （50. 6% ） were migrant children and 2 304 （49. 4% ） were locals. Prevalence of ED among migrant children was 29. 6%, which was lower than locals with 33.6% （ P = 0. 003）. After adjustment, the risk of ED in migrant group was also lower than that in locals （ OR =0. 84,95% CI：0. 74-0. 95 ,P =0. 006）. The progress vision in locals was more severe than that in migrants （OR = 0. 85,95% CI：0. 75-0. 96, P = 0. 009）. Multilevel models showed that migrant population in itself has no statistically significant impact on ED after controlling for family, individual and school characteristics. Conclusions Locals have worse vision than migrants, which indicates that specific measures should be addressed to prevent and control progress of ED.