Meta-analysis of the prevalence and influencing factors of myopia in children and adolescents in mainland China

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Study design Systematic review and meta-analysis. Methods This study used computers to search multiple databases and include relevant literature. The search time limit was from January 1, 2013 to September 10, 2023. The cross-sectional study quality evaluation standards of the U.S. Agency for Healthcare Research and Quality (AHRQ) were used to evaluate included The quality of the literature was evaluated, and Stata16.0 software was used for Meta analysis. PROSPERO registration numbe CRD42023489155 Myopia Children and adolescents Prevalence. influencing factors Systematic review Figures Figure 1 Figure 2 Introduction Myopia is a refractive abnormality, which is a global public health problem. Myopia is increasing worldwide, and there has been a "global epidemic of myopia" [ 1 ] . A study by Brien A Holden [ 2 ] et al estimated that the prevalence of myopia and high myopia would increase significantly worldwide by 2050, affecting nearly 5 billion and 1 billion people, respectively. China is one of the countries with high prevalence of myopia among children and adolescents [ 3 ] , and the prevalence of myopia among children and adolescents in China has been increasing year by year. The prediction of myopia prevalence in students aged 6–18 years in the next ten years made by Chen Jun [ 4 ] et al pointed out that without intervention, the prevalence of myopia in China would continue to rise in the next ten years. Changes in China's domestic education methods, the popularization of teaching informatization, and the extended time children and adolescents are exposed to electronic screens may further increase the risk of myopia in children and adolescents. Research shows that myopia progression accelerated in children and adolescents during the COVID-19 pandemic lockdown [ 5 ] .The high rate of myopia in children and adolescents in China has become a serious social problem [ 6 ] . Existing research shows that the prevalence of myopia among Chinese children and adolescents has further increased compared with the past ten years. In order to understand and analyze the prevalence of myopia among children and adolescents in China in the past ten years, and to explore the influencing factors, this study selected provinces or municipalities directly under the central government as survey areas, and conducted a Meta-analysis. It is hoped that the results of this study can provide a reference for reducing the incidence of myopia in children and adolescents and promoting their healthy growth. Materials and method 2.1.Study design The protocol for this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. This protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) [ 7 ] (See list in online supplementary Additional file 1). The registration number is CRD42023489155. 2.2.search strategy PubMed, EmBase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Biology Medicine Disc were searched for studies on the incidence of myopia and influencing factors in Chinese children and adolescents published from 2013 to 2023. The search was performed by subject headings plus free words, and the included references were manually searched. The search strategy for PubMed is adjusted according to the specific syntax for each database, as outlined in Table 1 . Table 1 Search strategy used in PubMed No Search item #1 Myopia[Mesh] #2 ametropia[Title/Abstract] OR poor sight[Title/Abstract] OR low vision[Title/Abstract] OR poor eyesight[Title/Abstract] OR poor vision[Title/Abstract] #3 #1OR#2 #4 adolescent[Mesh] OR child[Mesh] #5 children and adolescents[Title/Abstract] OR primary and middle school students[Title/Abstract] OR students[Title/Abstract] #6 #4OR#5 #7 Incidence [Mesh] OR prevalence [Mesh] #8 Factor [Mesh] #9 Risk factor [Title/Abstract] OR factor [Title/Abstract] OR risk [Title/Abstract] OR influence [Title/Abstract] OR impact [Title/Abstract] OR effect [Title/Abstract] OR prevalence [Title/Abstract] OR frequency [Title/Abstract] OR related factors [Title/Abstract] OR associated factors [Title/Abstract] #10 #8OR#9 #11 #3AND#6AND#7AND#10 2.3.Study eligibility 2.3.1.Inclusion criteria 1. The subjects were children and adolescents, including junior high school and senior high school students. 2. The study area is mainland China. (3) Cross-sectional studies on the analysis of myopia influencing factors among Chinese children and adolescents published at home and abroad from 2013 to 2023; (4) the research was conducted at the municipal or provincial level; (5) clear definition criteria, that is, clear myopia judgment criteria; (6) Study content: Outcome measures reported the prevalence and risk factors of myopia. 2.3.2.Exclusion criteria 1. Study type: non-cross-sectional study; 2. The study areas were Hong Kong, Macao, and Taiwan; 3. articles unrelated to the purpose of the study; 4. Low quality articles; 5. The odds ratio (OR) and 95% confidence interval (CI) could not be provided for the outcome indicators; literature without effective statistical data. 6. literature without effective statistical data. 2.4.Data extraction The search results of different databases were imported into NoteExpress to remove duplicates. Two researchers independently screened and cross-checked the literature. The data extracted included: first author, publication year, survey time, survey area, sample size, myopia detection rate, and influencing factors. 2.5.Quality assessment Two researchers used AHRQ's quality evaluation criteria for cross-sectional studies to evaluate the included literature. For the literature in the same research area, the one with the highest quality was selected for inclusion. In case of disagreement, the third researcher assisted in the judgment. AHRQ had 11 items in total. According to the total score, the literatures were divided into low quality literatures (0–3 points), medium quality literatures (4–7 points) and high quality literatures (8–11 points). 2.6.Statistical analysis Stata16.0 software was used for meta-analysis to calculate the combined incidence and the effect size of the influencing factors. When I 2 ≥ 50% and P < 0.1, there was statistical heterogeneity among the literatures. Random effect model was used for combined analysis. When I 2 < 50% and P ≥ 0.1, there was little heterogeneity among the literatures, fixed effect model was used. Sensitivity analysis was performed by comparing the difference between the fixed effect model and the random effect model. Small changes indicated low sensitivity and the results were stable. Funnel plots and Egger's test were used to assess the presence of bias in the meta-analysis results. Results 2.7.1.Study selection According to the above search formula, a total of 3346 literatures were retrieved in Chinese and foreign databases, including 3190 literatures in Chinese and 156 literatures in English. After layer by layer screening of the literatures, a total of 19 literatures met the criteria were obtained (17 literatures in Chinese and 2 literatures in English). The literature screening process is shown in Fig. 1 . 2.7.2.Basic characteristics and quality evaluation The survey period was from 2013 to 2021. A total of 1329784 children and adolescents were investigated, and a total of 742649 children and adolescents were diagnosed with myopia. The survey areas of 19 studies included 4 municipalities directly under the Central government, 2 autonomous regions and 14 provinces in China, covering the east, west, south, north and central regions of China. A total of 15 influencing factors were involved, namely: The height of students' desks and chairs should be adjusted according to their height, the rest place after class, the use of lights when reading and writing at home after dark, gender, whether the continuous close use of eyes is longer than 1 hour, grade, whether they lie down or lie down to read or screen, whether they do eye exercises every day, whether they have outdoor activities for less than 1 hour every day, one parent is myopic, both parents are myopic, and the average daily sleep time is small In 8 hours, the average daily use of electronic equipment online ≥ 2 hours, the average daily homework time 1 - < 2 hours, the average daily homework time is more than 2 hours. The quality assessment criteria for cross-sectional studies of the Agency for Healthcare Research and Quality were used to assess the risk of bias of each included article. The average score of each article was more than 4 points, and all articles were of medium quality. The basic characteristics of the 19 included documents are in the online supplementary additional file 2. 2.7.3.Meta-analysis results of the prevalence of myopia in children and adolescents in mainland China The 19 included articles all reported the incidence of myopia in children and adolescents, and a total of 74 649 children and adolescents were included in the Meta analysis of the 19 articles. There was significant heterogeneity (I 2 = 100.0%,P < 0.001).,Using the random effect model, the total incidence of myopia in children and adolescents in the mainland of China was 60.0% [95%CI(0.56%,0.64%), P < 0.001], as shown in Fig. 2 . 2.7.4.Meta-analysis results of influencing factors of myopia in Chinese children and adolescents A meta-analysis was performed on the 16 included influencing factors: gender (male), whether the average daily sleep time is less than 8 hours, and whether the average daily use of electronic devices to surf the Internet is ≥ 2 hours. There is no significant heterogeneity among the three influencing factors in the literature. Using The fixed effects model was used for Meta analysis; there was significant heterogeneity among the relevant literature on the remaining 13 influencing factors, so the random effects model was selected for Meta analysis. Meta-analysis results show that gender (female), continuous close eye use for ≥ 1 hour, senior grade, often lying or lying down to read or screen, not doing eye exercises every day, outdoor activity time less than 1 hour every day, one parent with myopia, parents Both parties are myopic, the average sleep time is less than 8 hours a day, the average daily use of electronic devices to surf the Internet is ≥ 2 hours, the average daily homework time is more than 1 hour, the average daily homework time is more than 3 hours, are the risk factors for myopia in children and adolescents (P<0.05 );the height of student desks and chairs is regularly adjusted according to height., using roof lights and desk lamps while reading and writing at home after dark, and taking breaks outdoors are protective factors for myopia in children and adolescents (P<0.05), Details are provided in the online supplementary additional file 2. 2.8.Sensitivity analysis Sensitivity analyzes were conducted under the fixed effect model and the random effect model respectively, and the OR values and 95% CI of each influencing factor were calculated. The results showed that, except for the calculation results of grade, the OR values of the two models for other factors were significantly different. The 95% CIs are all close, indicating that the meta-analysis results of this study are relatively stable,Details are provided in the online supplementary additional file 2. 2.9.Publication bias assessment In this study, more than 10 articles were included in the two factors of one parent's myopia and whether the average homework time per day was more than 2 hours. Publication bias was evaluated on them.The results showed that the scatter points in the funnel plot of the two factors were almost evenly distributed.On both sides of the axis, seethe online supplementary additional file 2, the Egger's test results P>|t| indicators are 0.216 and 0.900 respectively, showing that there is no obvious publication bias (P<0.05). Discussion This study included 19 cross-sectional studies on the incidence of myopia and its influencing factors among Chinese children and adolescents since 2013. Meta-analysis results show that the incidence of myopia among children and adolescents in my country is 60.0%, which is higher than the study by scholar Liu Chang [ 27 ] .From 2018 to 2020, the overall prevalence rate of myopia among primary and secondary school students in my country was 49.25%. In recent years, with the improvement of people's economic level, this has led to an increase in the popularity of electronic products such as mobile phones, computers, and tablets among children and adolescents. Some studies have found that the frequency of use of electronic products by school-age children and adolescents increased during the COVID-19 epidemic [ 28 ] . Long-term use of electronic products is associated with an increased risk of myopia. The longer the use of electronic products, the higher the prevalence of myopia [ 29 ] . Myopia prevention and control awareness is an important issue. With the development of modern society, children and adolescents are facing more and more time using their eyes at close range. Parent's awareness of myopia prevention and control has not changed with the changing times, which may be the reason for the increase in the number of children and adolescents with myopia. The prevalence of myopia in China is higher than that in other East Asian countries (such as India and Nepal) [ 30 – 31 ] . The incidence of myopia among children and adolescents in my country is relatively high. Relevant government departments should pay more attention to the problem of myopia among children and adolescents and adopt active and effective prevention strategies to reduce the incidence of myopia. This can include publicity and education, reminding parents and schools to control the time and manner in which children use electronic products, encouraging outdoor activities, strengthening eye exercises. The results of this study show that parents with myopia or one parent with myopia are high-risk factors for myopia in children and adolescents. Many studies [ 32 – 34 ] have shown that parents with myopia may increase the possibility of myopia in children. The number of girls with myopia is higher than that of boys, which is consistent with previous studies [ 35 – 36 ] . This may be due to the fact that girls tend to read and write more, do less outdoor sports, and use their eyes longer for continuous myopia [ 37 – 38 ] . The prevalence of myopia increases as grades increase, and previous studies can support this conclusion [ 39 ] . Related literature mentions that learning intensity is closely related to the incidence of myopia, which can explain the high incidence of myopia in senior adolescents [ 40 ] . The increase in grade will bring heavy learning tasks and increase the time of eye use every day, which may also be related to the accumulation of myopia in the early stage. The risk of myopia for children and adolescents who often lie down or lie down to read books or screens is 1.33 times that of those who never lie down or lie down to read books or screens. The research results of Yang Lu [ 41 ] show that always looking at electronic screens in a bad posture is myopia. Risk factors are mainly due to abnormal eye angles, reading objects too close to each other, poor visual environment and strained eye adjustment(OR = 2.45, 95%CI:1.25ཞ4.80). Children and adolescents who do not do eye exercises and spend less than 1 hour outdoors are at a relatively high risk of developing myopia.Children and adolescents who use their eyes continuously at close range for ≥ 1 hour are more likely to develop myopia, which is consistent with previous research results [ 42 – 43 ] . This may be because continuous use of the eyes is prone to excessive fatigue of the accommodation function, increased intraocular pressure, and compression of the extraocular muscles. Children and adolescents whose average daily sleep time is less than 8 hours are risk factors for myopia, which is consistent with the conclusions drawn by domestic studies [ 44 ] . Studies [ 45 – 46 ] believe that lack of sleep leads to myopia by affecting the biological clock and thus the circadian rhythm of the eyes. Some studies have found that students who do homework for more than one hour have a higher risk of myopia than students who do homework for less than one hour, which is consistent with the research results of Chen Yanzhe [ 47 ] and Wang Huihui [ 48 ] . The study also found that regularly adjusting the height of studte's desks and chairs according to their height, using roof lights and table lamps while reading and writing at home after dark, and taking breaks outdoors during class are protective factors for children and adolescents from myopia. Strengths and limitations of this study A comprehensive search strategy across multiple databases and the use of a standardized quality assessment tool (AHRQ Cross-sectional Research Quality Criteria) ensured reliable and consistent data assessment. The research area was carried out across the entire province, and the sample size obtained was large enough to have high credibility. Two independent investigators participated in data extraction and quality assessment, while a third party performed a secondary check on the data, effectively reducing bias and improving the credibility of the study. Since no relevant research has been conducted in some areas of the country, some provinces and autonomous regions were not included in the study, which may lead to bias. This study may have been affected by publication bias, as well as differences in methodologies, diagnostic criteria, and assessment tools among the included studies, which may have led to overestimation of effect sizes and introduced heterogeneity. Conclusion The prevalence of myopia among children and adolescents in mainland China is at a relatively high level, which requires increased attention from relevant government departments. The relevant government departments should speed up the improvement of the myopia prevention and health care service system for children and adolescents. Declarations Patient and public involvement Patients and the public were not involved in this review. Ethics and communication Ethical approval and informed consent were not required for this review because the data used were obtained from publicly available published articles. The findings will be submitted to a peer-reviewed medical journal for publication to ensure that the findings are disseminated to the wider scientific community and healthcare professionals. Contributors QingWei Liu and Li Guo are the co-first authors.Li Guo received funding. Li QingWei Liu and Li Guo designed the study. Fan Gao and Shu Xin collected the data. QingWei Liu checked and analyzed the data. QingWei Liu drafted the manuscript. QingWei Liu and Li Guo contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript.All authors have read and approved the final manuscript. Funding This study was supported by the Shandong Provincial Humanities and Social Sciences Program (2023-JCXK-004). Project name: An empirical study on the effect of health education strategies based on TPB integration theory on poor eye behavior in children with early myopia. Conflict of interest All authors declare that they have no conflicts of interest. References Bremond-Gignac D. Myopie de l’enfant [Myopia in children]. Med Sci (Paris). 2020;36(8-9):763-768.10.1051/medsci/2020131. Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology.2016;123(5):1036-1042.10.1016/j.ophtha.2016.01.006. Wang NL, Li SM, Wei SF.Key points and difficulties in the prevention and control of myopia among children and adolescents in my country.Chinese Journal of Ophthalmology2021;57(04):241-244. 10.3760/cma.j.cn112142-20210123-00047. 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Chinese Journal of School Health2023；44(04):502-505+511.10.16835/j.cnki.1000-9817.2023.04.006. Wang HH, Zhang XH, Huo JF,et al..Analysis of the current status and influencing factors of myopia among primary school students in grades four to six in Shanxi Province.CHINESE JOURNAL OF HEALTH EDUCATION2022;38(06):483-486+490.10.16168/j.cnki.issn.1002-9982.2022.06.001. Additional Declarations No competing interests reported. Supplementary Files Additionalfile.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4002933","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":279260208,"identity":"7ee81caa-9d20-44d1-a391-0799038a54a7","order_by":0,"name":"Li Guo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzElEQVRIiWNgGAWjYBACfvn3Dx98qLCR42dvIFKLZEMOs+GMM2nGkj0HiNRi0JDDJs3Zdihxw40EYrUwnD0mzcB2IHHmzMcbbzDU2EQT1GLO2JdsXcBzx7hfOq3YguFYWm4DIS2WzQyGt2dIPJOdOTvHTIKx4TBhLQbHGAykeQwOM264eYZYLWd4jKR5Eg4rbrjBQ6QWyRlsyYYzDoACGeiXBGL8wi/BfPDBx3+gqDy88caHGhvCWlAcKZFAinKIFlJ1jIJRMApGwcgAAMHCQ++veVB6AAAAAElFTkSuQmCC","orcid":"","institution":"Shandong First Medical University","correspondingAuthor":true,"prefix":"","firstName":"Li","middleName":"","lastName":"Guo","suffix":""},{"id":279260209,"identity":"fbbda513-a6e5-4408-ae0e-02afd7f23775","order_by":1,"name":"QingWei Liu","email":"","orcid":"","institution":"Shandong First Medical University","correspondingAuthor":false,"prefix":"","firstName":"QingWei","middleName":"","lastName":"Liu","suffix":""}],"badges":[],"createdAt":"2024-03-01 10:50:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4002933/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4002933/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":52792888,"identity":"87bb7a8f-9408-4057-b46d-4d9a60a7ddca","added_by":"auto","created_at":"2024-03-15 20:25:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":118521,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of study selection\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4002933/v1/d469bb872d39c4f68b9116ff.png"},{"id":52792889,"identity":"5c2c4db0-dc70-47aa-80a2-05dbe31749e1","added_by":"auto","created_at":"2024-03-15 20:25:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":46735,"visible":true,"origin":"","legend":"\u003cp\u003eForest plot of the detection rate of myopia in children and adolescents in mainland China\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4002933/v1/afdafae257894051efef858f.png"},{"id":66941856,"identity":"8bf9cc16-1194-47af-94bf-5009c0d7eefa","added_by":"auto","created_at":"2024-10-18 09:02:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":593413,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4002933/v1/a7e620e3-dff2-4c78-8a08-7d4b1804a89a.pdf"},{"id":52792887,"identity":"66a15e7e-b193-42a0-99d6-0a67ff56c6f9","added_by":"auto","created_at":"2024-03-15 20:25:03","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":78227,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile.docx","url":"https://assets-eu.researchsquare.com/files/rs-4002933/v1/df6fc9a9324eded7f042dd4b.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Meta-analysis of the prevalence and influencing factors of myopia in children and adolescents in mainland China","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMyopia is a refractive abnormality, which is a global public health problem. Myopia is increasing worldwide, and there has been a \"global epidemic of myopia\"\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. A study by Brien A Holden\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e et al estimated that the prevalence of myopia and high myopia would increase significantly worldwide by 2050, affecting nearly 5\u0026nbsp;billion and 1\u0026nbsp;billion people, respectively. China is one of the countries with high prevalence of myopia among children and adolescents\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e, and the prevalence of myopia among children and adolescents in China has been increasing year by year. The prediction of myopia prevalence in students aged 6\u0026ndash;18 years in the next ten years made by Chen Jun\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e et al pointed out that without intervention, the prevalence of myopia in China would continue to rise in the next ten years. Changes in China's domestic education methods, the popularization of teaching informatization, and the extended time children and adolescents are exposed to electronic screens may further increase the risk of myopia in children and adolescents. Research shows that myopia progression accelerated in children and adolescents during the COVID-19 pandemic lockdown\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e.The high rate of myopia in children and adolescents in China has become a serious social problem\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. Existing research shows that the prevalence of myopia among Chinese children and adolescents has further increased compared with the past ten years. In order to understand and analyze the prevalence of myopia among children and adolescents in China in the past ten years, and to explore the influencing factors, this study selected provinces or municipalities directly under the central government as survey areas, and conducted a Meta-analysis. It is hoped that the results of this study can provide a reference for reducing the incidence of myopia in children and adolescents and promoting their healthy growth.\u003c/p\u003e"},{"header":"Materials and method","content":"\u003cdiv id=\"Sec3\"\u003e\n \u003ch2\u003e2.1.Study design\u003c/h2\u003e\n \u003cp\u003eThe protocol for this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. This protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO)\u003csup\u003e[\u003cspan\u003e7\u003c/span\u003e]\u003c/sup\u003e(See list in online supplementary Additional file 1). The registration number is CRD42023489155.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\"\u003e\n \u003ch2\u003e2.2.search strategy\u003c/h2\u003e\n \u003cp\u003ePubMed, EmBase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Biology Medicine Disc were searched for studies on the incidence of myopia and influencing factors in Chinese children and adolescents published from 2013 to 2023. The search was performed by subject headings plus free words, and the included references were manually searched. The search strategy for PubMed is adjusted according to the specific syntax for each database, as outlined in Table \u003cspan\u003e1\u003c/span\u003e.\u003c/p\u003e\n \u003cdiv\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv\u003eTable 1\u003c/div\u003e\n \u003cdiv\u003e\n \u003cp\u003eSearch strategy used in PubMed\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSearch item\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMyopia[Mesh]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eametropia[Title/Abstract] OR poor sight[Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003elow vision[Title/Abstract] OR poor eyesight[Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003epoor vision[Title/Abstract]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#1OR#2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eadolescent[Mesh] OR child[Mesh]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003echildren and adolescents[Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003eprimary and middle school students[Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003estudents[Title/Abstract]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#4OR#5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncidence [Mesh] OR prevalence [Mesh]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFactor [Mesh]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRisk factor [Title/Abstract] OR factor [Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003erisk [Title/Abstract] OR influence [Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003eimpact [Title/Abstract] OR effect [Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003eprevalence [Title/Abstract] OR frequency [Title/Abstract] OR\u003c/p\u003e\n \u003cp\u003erelated factors [Title/Abstract] OR associated factors [Title/Abstract]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#8OR#9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e#3AND#6AND#7AND#10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\"\u003e\n \u003ch2\u003e2.3.Study eligibility\u003c/h2\u003e\n \u003cdiv id=\"Sec6\"\u003e\n \u003ch2\u003e2.3.1.Inclusion criteria\u003c/h2\u003e\n \u003cp\u003e\u003cspan\u003e1. The subjects were children and adolescents, including junior high school and senior high school students.\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e2. The study area is mainland China.\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e(3) Cross-sectional studies on the analysis of myopia influencing factors among Chinese children and adolescents published at home and abroad from 2013 to 2023;\u003cp\u003e(4) the research was conducted at the municipal or provincial level;\u003c/p\u003e\n \u003cp\u003e(5) clear definition criteria, that is, clear myopia judgment criteria;\u003c/p\u003e\n \u003cp\u003e(6) Study content: Outcome measures reported the prevalence and risk factors of myopia.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec7\"\u003e\n \u003ch2\u003e2.3.2.Exclusion criteria\u003c/h2\u003e\n \u003cp\u003e\u003cspan\u003e1. Study type: non-cross-sectional study;\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e2. The study areas were Hong Kong, Macao, and Taiwan;\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e3. articles unrelated to the purpose of the study;\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e4. Low quality articles;\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e5. The odds ratio (OR) and 95% confidence interval (CI) could not be provided for the outcome indicators;\u003cbr\u003e\u003c/span\u003e \u003cspan\u003eliterature without effective statistical data.\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e6. literature without effective statistical data.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\"\u003e\n \u003ch2\u003e2.4.Data extraction\u003c/h2\u003e\n \u003cp\u003eThe search results of different databases were imported into NoteExpress to remove duplicates. Two researchers independently screened and cross-checked the literature. The data extracted included: first author, publication year, survey time, survey area, sample size, myopia detection rate, and influencing factors.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\"\u003e\n \u003ch2\u003e2.5.Quality assessment\u003c/h2\u003e\n \u003cp\u003eTwo researchers used AHRQ\u0026apos;s quality evaluation criteria for cross-sectional studies to evaluate the included literature. For the literature in the same research area, the one with the highest quality was selected for inclusion. In case of disagreement, the third researcher assisted in the judgment. AHRQ had 11 items in total. According to the total score, the literatures were divided into low quality literatures (0\u0026ndash;3 points), medium quality literatures (4\u0026ndash;7 points) and high quality literatures (8\u0026ndash;11 points).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\"\u003e\n \u003ch2\u003e2.6.Statistical analysis\u003c/h2\u003e\n \u003cp\u003eStata16.0 software was used for meta-analysis to calculate the combined incidence and the effect size of the influencing factors. When I\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;\u0026ge;\u0026thinsp;50% and P\u0026thinsp;\u0026lt;\u0026thinsp;0.1, there was statistical heterogeneity among the literatures. Random effect model was used for combined analysis. When I\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;\u0026lt;\u0026thinsp;50% and P\u0026thinsp;\u0026ge;\u0026thinsp;0.1, there was little heterogeneity among the literatures, fixed effect model was used. Sensitivity analysis was performed by comparing the difference between the fixed effect model and the random effect model. Small changes indicated low sensitivity and the results were stable. Funnel plots and Egger\u0026apos;s test were used to assess the presence of bias in the meta-analysis results.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003ch2\u003e2.7.1.Study selection\u003c/h2\u003e\u003cp\u003eAccording to the above search formula, a total of 3346 literatures were retrieved in Chinese and foreign databases, including 3190 literatures in Chinese and 156 literatures in English. After layer by layer screening of the literatures, a total of 19 literatures met the criteria were obtained (17 literatures in Chinese and 2 literatures in English). The literature screening process is shown in Fig. \u003cspan\u003e1\u003c/span\u003e.\u003c/p\u003e\u003ch2\u003e2.7.2.Basic characteristics and quality evaluation\u003c/h2\u003e\u003cp\u003eThe survey period was from 2013 to 2021. A total of 1329784 children and adolescents were investigated, and a total of 742649 children and adolescents were diagnosed with myopia. The survey areas of 19 studies included 4 municipalities directly under the Central government, 2 autonomous regions and 14 provinces in China, covering the east, west, south, north and central regions of China. A total of 15 influencing factors were involved, namely: The height of students' desks and chairs should be adjusted according to their height, the rest place after class, the use of lights when reading and writing at home after dark, gender, whether the continuous close use of eyes is longer than 1 hour, grade, whether they lie down or lie down to read or screen, whether they do eye exercises every day, whether they have outdoor activities for less than 1 hour every day, one parent is myopic, both parents are myopic, and the average daily sleep time is small In 8 hours, the average daily use of electronic equipment online ≥ 2 hours, the average daily homework time 1 - \u0026lt; 2 hours, the average daily homework time is more than 2 hours. The quality assessment criteria for cross-sectional studies of the Agency for Healthcare Research and Quality were used to assess the risk of bias of each included article. The average score of each article was more than 4 points, and all articles were of medium quality. The basic characteristics of the 19 included documents are in the online supplementary additional file 2.\u003c/p\u003e\u003ch2\u003e2.7.3.Meta-analysis results of the prevalence of myopia in children and adolescents in mainland China\u003c/h2\u003e\u003cp\u003eThe 19 included articles all reported the incidence of myopia in children and adolescents, and a total of 74 649 children and adolescents were included in the Meta analysis of the 19 articles. There was significant heterogeneity (I\u003csup\u003e2\u003c/sup\u003e = 100.0%,P \u0026lt; 0.001).,Using the random effect model, the total incidence of myopia in children and adolescents in the mainland of China was 60.0% [95%CI(0.56%,0.64%), P \u0026lt; 0.001], as shown in Fig. \u003cspan\u003e2\u003c/span\u003e.\u003c/p\u003e\u003ch2\u003e2.7.4.Meta-analysis results of influencing factors of myopia in Chinese children and adolescents\u003c/h2\u003e\u003cp\u003eA meta-analysis was performed on the 16 included influencing factors: gender (male), whether the average daily sleep time is less than 8 hours, and whether the average daily use of electronic devices to surf the Internet is ≥ 2 hours. There is no significant heterogeneity among the three influencing factors in the literature. Using The fixed effects model was used for Meta analysis; there was significant heterogeneity among the relevant literature on the remaining 13 influencing factors, so the random effects model was selected for Meta analysis. Meta-analysis results show that gender (female), continuous close eye use for ≥ 1 hour, senior grade, often lying or lying down to read or screen, not doing eye exercises every day, outdoor activity time less than 1 hour every day, one parent with myopia, parents Both parties are myopic, the average sleep time is less than 8 hours a day, the average daily use of electronic devices to surf the Internet is ≥ 2 hours, the average daily homework time is more than 1 hour, the average daily homework time is more than 3 hours, are the risk factors for myopia in children and adolescents (P\u0026lt;0.05 );the height of student desks and chairs is regularly adjusted according to height., using roof lights and desk lamps while reading and writing at home after dark, and taking breaks outdoors are protective factors for myopia in children and adolescents (P\u0026lt;0.05), Details are provided in the online supplementary additional file 2.\u003c/p\u003e\u003ch2\u003e2.8.Sensitivity analysis\u003c/h2\u003e\u003cp\u003eSensitivity analyzes were conducted under the fixed effect model and the random effect model respectively, and the OR values and 95% CI of each influencing factor were calculated. The results showed that, except for the calculation results of grade, the OR values of the two models for other factors were significantly different. The 95% CIs are all close, indicating that the meta-analysis results of this study are relatively stable,Details are provided in the online supplementary additional file 2.\u003c/p\u003e\u003ch2\u003e2.9.Publication bias assessment\u003c/h2\u003e\u003cp\u003eIn this study, more than 10 articles were included in the two factors of one parent's myopia and whether the average homework time per day was more than 2 hours. Publication bias was evaluated on them.The results showed that the scatter points in the funnel plot of the two factors were almost evenly distributed.On both sides of the axis, seethe online supplementary additional file 2, the Egger's test results P\u0026gt;|t| indicators are 0.216 and 0.900 respectively, showing that there is no obvious publication bias (P\u0026lt;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study included 19 cross-sectional studies on the incidence of myopia and its influencing factors among Chinese children and adolescents since 2013. Meta-analysis results show that the incidence of myopia among children and adolescents in my country is 60.0%, which is higher than the study by scholar Liu Chang\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e.From 2018 to 2020, the overall prevalence rate of myopia among primary and secondary school students in my country was 49.25%. In recent years, with the improvement of people\u0026apos;s economic level, this has led to an increase in the popularity of electronic products such as mobile phones, computers, and tablets among children and adolescents. Some studies have found that the frequency of use of electronic products by school-age children and adolescents increased during the COVID-19 epidemic\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e. Long-term use of electronic products is associated with an increased risk of myopia. The longer the use of electronic products, the higher the prevalence of myopia\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e. Myopia prevention and control awareness is an important issue. With the development of modern society, children and adolescents are facing more and more time using their eyes at close range. Parent\u0026apos;s awareness of myopia prevention and control has not changed with the changing times, which may be the reason for the increase in the number of children and adolescents with myopia. The prevalence of myopia in China is higher than that in other East Asian countries (such as India and Nepal)\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. The incidence of myopia among children and adolescents in my country is relatively high. Relevant government departments should pay more attention to the problem of myopia among children and adolescents and adopt active and effective prevention strategies to reduce the incidence of myopia. This can include publicity and education, reminding parents and schools to control the time and manner in which children use electronic products, encouraging outdoor activities, strengthening eye exercises.\u003c/p\u003e\n\u003cp\u003eThe results of this study show that parents with myopia or one parent with myopia are high-risk factors for myopia in children and adolescents. Many studies\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e have shown that parents with myopia may increase the possibility of myopia in children. The number of girls with myopia is higher than that of boys, which is consistent with previous studies\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e. This may be due to the fact that girls tend to read and write more, do less outdoor sports, and use their eyes longer for continuous myopia\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/sup\u003e. The prevalence of myopia increases as grades increase, and previous studies can support this conclusion\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/sup\u003e. Related literature mentions that learning intensity is closely related to the incidence of myopia, which can explain the high incidence of myopia in senior adolescents\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/sup\u003e. The increase in grade will bring heavy learning tasks and increase the time of eye use every day, which may also be related to the accumulation of myopia in the early stage. The risk of myopia for children and adolescents who often lie down or lie down to read books or screens is 1.33 times that of those who never lie down or lie down to read books or screens. The research results of Yang Lu\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/sup\u003e show that always looking at electronic screens in a bad posture is myopia. Risk factors are mainly due to abnormal eye angles, reading objects too close to each other, poor visual environment and strained eye adjustment(OR\u0026thinsp;=\u0026thinsp;2.45, 95%CI:1.25ཞ4.80). Children and adolescents who do not do eye exercises and spend less than 1 hour outdoors are at a relatively high risk of developing myopia.Children and adolescents who use their eyes continuously at close range for \u0026ge;\u0026thinsp;1 hour are more likely to develop myopia, which is consistent with previous research results\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/sup\u003e. This may be because continuous use of the eyes is prone to excessive fatigue of the accommodation function, increased intraocular pressure, and compression of the extraocular muscles. Children and adolescents whose average daily sleep time is less than 8 hours are risk factors for myopia, which is consistent with the conclusions drawn by domestic studies\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/sup\u003e. Studies\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e]\u003c/sup\u003e believe that lack of sleep leads to myopia by affecting the biological clock and thus the circadian rhythm of the eyes. Some studies have found that students who do homework for more than one hour have a higher risk of myopia than students who do homework for less than one hour, which is consistent with the research results of Chen Yanzhe\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e]\u003c/sup\u003e and Wang Huihui\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e]\u003c/sup\u003e. The study also found that regularly adjusting the height of studte\u0026apos;s desks and chairs according to their height, using roof lights and table lamps while reading and writing at home after dark, and taking breaks outdoors during class are protective factors for children and adolescents from myopia.\u003c/p\u003e\n"},{"header":"Strengths and limitations of this study ","content":"\u003cp\u003eA comprehensive search strategy across multiple databases and the use of a standardized quality assessment tool (AHRQ Cross-sectional Research Quality Criteria) ensured reliable and consistent data assessment.\u003c/p\u003e\n\u003cp\u003eThe research area was carried out across the entire province, and the sample size obtained was large enough to have high credibility.\u003c/p\u003e\n\u003cp\u003eTwo independent investigators participated in data extraction and quality assessment, while a third party performed a secondary check on the data, effectively reducing bias and improving the credibility of the study.\u003c/p\u003e\n\u003cp\u003eSince no relevant research has been conducted in some areas of the country, some provinces and autonomous regions were not included in the study, which may lead to bias.\u003c/p\u003e\n\u003cp\u003eThis study may have been affected by publication bias, as well as differences in methodologies, diagnostic criteria, and assessment tools among the included studies, which may have led to overestimation of effect sizes and introduced heterogeneity.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of myopia among children and adolescents in mainland China is at a relatively high level, which requires increased attention from relevant government departments. The relevant government departments should speed up the improvement of the myopia prevention and health care service system for children and adolescents.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003ePatient and public involvement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatients and the public were not involved in this review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics and communication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval and informed consent were not required for this review because the data used were obtained from publicly available published articles. The findings will be submitted to a peer-reviewed medical journal for publication to ensure that the findings are disseminated to the wider scientific community and healthcare professionals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQingWei Liu and Li Guo are the co-first authors.Li Guo received funding. Li QingWei Liu and Li Guo designed the study. Fan Gao and Shu Xin collected the data. QingWei Liu checked and analyzed the data. QingWei Liu drafted the manuscript. QingWei Liu and Li Guo contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript.All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Shandong Provincial Humanities and Social Sciences Program (2023-JCXK-004). Project name: An empirical study on the effect of health education strategies based on TPB integration theory on poor eye behavior in children with early myopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare that they have no conflicts of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBremond-Gignac D. Myopie de l\u0026rsquo;enfant [Myopia in children]. Med Sci (Paris). 2020;36(8-9):763-768.10.1051/medsci/2020131.\u003c/li\u003e\n\u003cli\u003eHolden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. 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Chinese Journal of School Health2023；44(04):502-505+511.10.16835/j.cnki.1000-9817.2023.04.006.\u003c/li\u003e\n\u003cli\u003eWang HH, Zhang XH, Huo JF,et al..Analysis of the current status and influencing factors of myopia among primary school students in grades four to six in Shanxi Province.CHINESE JOURNAL OF HEALTH EDUCATION2022;38(06):483-486+490.10.16168/j.cnki.issn.1002-9982.2022.06.001.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Myopia, Children and adolescents, Prevalence., influencing factors, Systematic review","lastPublishedDoi":"10.21203/rs.3.rs-4002933/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4002933/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSystematic review of the prevalence and influencing factors of myopia in children and adolescents in mainland China.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSystematic review and meta-analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study used computers to search multiple databases and include relevant literature. The search time limit was from January 1, 2013 to September 10, 2023. The cross-sectional study quality evaluation standards of the U.S. Agency for Healthcare Research and Quality (AHRQ) were used to evaluate included The quality of the literature was evaluated, and Stata16.0 software was used for Meta analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePROSPERO registration numbe\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCRD42023489155\u003c/p\u003e","manuscriptTitle":"Meta-analysis of the prevalence and influencing factors of myopia in children and adolescents in mainland China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-15 20:24:57","doi":"10.21203/rs.3.rs-4002933/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b7f35799-03d2-4881-a081-f9b99961e6c8","owner":[],"postedDate":"March 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-18T08:54:02+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-15 20:24:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4002933","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4002933","identity":"rs-4002933","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}