title: Assessing the accuracy and feasibility of a refractive error screening program conducted by school teachers in pre-primary and primary schools in Thailand.
abstract: BACKGROUND
  As part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers.
  
  
  OBJECTIVE
  To assess the accuracy and feasibility of screening by teachers.
  
  
  METHODS
  A cross-sectional descriptive and analytical study was conducted in 17 schools in four provinces representing four geographic regions in Thailand. A two-staged cluster sampling was employed to compare the detection rate of refractive error among eligible students between trained teachers and health professionals. Serial focus group discussions were held for teachers and parents in order to understand their attitude towards refractive error screening at schools and the potential success factors and barriers.
  
  
  RESULTS
  The detection rate of refractive error screening by teachers among pre-primary school children is relatively low (21%) for mild visual impairment but higher for moderate visual impairment (44%). The detection rate for primary school children is high for both levels of visual impairment (52% for mild and 74% for moderate). The focus group discussions reveal that both teachers and parents would benefit from further education regarding refractive errors and that the vast majority of teachers are willing to conduct a school-based screening program.
  
  
  CONCLUSIONS
  Refractive error screening by health professionals in pre-primary and primary school children is not currently implemented in Thailand due to resource limitations. However, evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs.
authors.affiliation: Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand; Department of Ophthalmology, Samut Prakan Hospital, Samut Prakan, Thailand.
authors.forename: Kanlaya
authors.initials: K
authors.lastname: Teerawattananon
authors.affiliation: Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand.
authors.forename: Chaw-Yin
authors.initials: CY
authors.lastname: Myint
authors.affiliation: Department of Pediatric Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
authors.forename: Kwanjai
authors.initials: K
authors.lastname: Wongkittirux
authors.affiliation: Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand.
authors.forename: Yot
authors.initials: Y
authors.lastname: Teerawattananon
authors.affiliation: Department of Ophthalmology, Surat Thani Hospital, Surat Thani, Thailand.
authors.forename: Bunyong
authors.initials: B
authors.lastname: Chinkulkitnivat
authors.affiliation: Department of Ophthalmology, Lamphun Hospital, Lamphun, Thailand.
authors.forename: Surapong
authors.initials: S
authors.lastname: Orprayoon
authors.affiliation: Department of Ophthalmology, Nakhon Phanom Hospital, Nakhon Phanom, Thailand.
authors.forename: Suwat
authors.initials: S
authors.lastname: Kusakul
authors.affiliation: Department of Ophthalmology, Prince of Songkla University, Songkla, Thailand.
authors.forename: Supaporn
authors.initials: S
authors.lastname: Tengtrisorn
authors.affiliation: Faculty of Optometry, Rangsit University, Bangkok, Thailand.
authors.forename: Watanee
authors.initials: W
authors.lastname: Jenchitr
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D012030:Refractive Errors / Q000175:diagnosis*; D012572:School Health Services; D012574:Schools; D013334:Students; D013785:Thailand; D015351:Vision Screening / Q000379:methods*; D015354:Vision, Low / Q000175:diagnosis*