Prevalence of visual impairment in school-aged children (6–16 years) with special educational needs in Northern Mozambique: a cross-sectional study

This cross-sectional study investigated the prevalence and associated risk factors of visual impairment (VI) in school-age children with special educational needs in northern Mozambique. A total of 142 children, both with ( n = 64) and without ( n = 78) disabilities, aged 6 to 16 years and enrolled in grades 1 to 12, were recruited at the Josina Machel Inclusive Education Resource Center (CREI) between January and June 2019. Comprehensive eye examinations, including visual acuity (VA) testing,cycloplegic and subjective refraction, and anterior and posterior segment examinationt, were conducted. Visual Impairment (VI) was defined based on presenting VA in the better eye and categorised into mild (VA between < 6/12 and 6/18), moderate (VA between < 6/18 and 6/60), severe (VA between < 6/60 and 3/60) VI, Blindness was defined as VA < 3/60.Demographic information and medical history of the participants were recorded. Multivariable analysis using bivariate logistic regression were performed to determine associations between variables. The level of statistical significance was set at 5%. The prevalence of VI was significantly higher in children with disabilities (25.0%) than in those without (2.6%; p < 0.001). Refractive errors (68.8%) and ocular anomalies (20.3%) were also more common in children with disabilities. Refractive error was a significant predictor of VI in this group ( p < 0.001; AOR = 10.91, 95% CI 4.73–25.15), with hyperopia being the most prevalent type. The study found that children with special needs in northern Mozambique have a significantly higher prevalence of VI, with refractive error being the most significant factor . These findings emphasize the critical need for periodic vision screening programs in schools catering to children with disabilities for early detection and management of refractive errors to prevent or minimize VI.