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. 2025 Jan 9;45(1):21.
doi: 10.1007/s10792-024-03370-9.

Prevalence and demographic profile of keratoconus among high school students in Kenya

Zahra Aly Rashid  1 , Khathutshelo Percy Mashige  2 , Vanessa Raquel Moodley  2
Affiliations

Prevalence and demographic profile of keratoconus among high school students in Kenya

Zahra Aly Rashid et al. Int Ophthalmol. .

Abstract

Purpose: To determine the prevalence and demographic profile of keratoconus (KC) among high school students in Nairobi County, Kenya.

Methods: In this population-based, prospective, cross-sectional study, multistage cluster sampling was used to select the participants. All students underwent visual acuity measurement, auto-refraction, retinoscopy and corneal topography. Students with a scissors reflex on retinoscopy or corneal topography patterns suspicious of KC were referred for corneal tomography.

Results: A total of 3051 students from 29 schools, with a mean age of 17.4 ± 1.6 years (range: 13-25 years) were screened. The prevalence of KC was 1.7% (n = 51) (95% CI, 1.2-2.2) and of KC suspects was 3.8% (n = 117) (95% CI, 3.2-4.6). There were no significant associations between the prevalence of KC and gender, age or ethnicity (all p > 0.05). In the KC group, 88.2% (n = 45) were unaware of their condition, 52.9% (n = 27) were treated for allergic conjunctivitis, 45.1% (n = 23) required spectacles, 11.8% (n = 6) were recommended contact lenses in at least one eye and 49.0% (n = 25) were recommended corneal cross-linking.

Conclusions: Among adolescents, the results of this study indicate a higher prevalence of KC compared to that reported in South Korea, Norway, Brazil and Caucasians in New Zealand, but less than that reported in some countries in the Middle East. Given the high prevalence revealed in this study, a national school screening program and clinical guidelines for screening, diagnosis and management of KC is recommended.

Keywords: Adolescents; Africa; High school; Kenya; Keratoconus; Prevalence.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Consent to participate: Permission was obtained from the Ministry of Education and Head teachers of participating schools. Written informed assent was obtained from all students before screening. For those under the age of 18 years, written informed consent from a parent/guardian was also required. Consent for publication: This study does not contain any individual person’s data. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Ethical approvals and research licenses were obtained from Amref Health Africa, Kenya (ESRC P1918/2021), the Biomedical Research Ethics Committee—University of KwaZulu-Natal (BREC/00001226/2020) and the National Commission for Science, Technology and Innovation, Kenya (NACOSTI/P/22/17767).

Figures

Fig. 1
Fig. 1
The process from selection to screening of students
See this image and copyright information in PMC

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