Are West Africans more likely to be myopic even iff little
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Executive summary
Available systematic reviews show childhood myopia prevalence in Africa is generally low compared with Asia: pooled childhood myopia in Africa ~4.7% (overall) and ~3.5% in West Africa (95% CI 1.9%–6.3%) [1]. Other African meta‑analyses report roughly one in twenty schoolchildren affected (~4.2% with cycloplegic refraction) and note significant heterogeneity and likely under‑ascertainment in some settings [2].
1. A simple answer: West Africans are not shown to be more myopic
Large, peer‑reviewed meta‑analyses of African childhood data do not find higher myopia in West Africa; estimated childhood myopia prevalence was lowest in West Africa at about 3.5% (95% CI 1.9%–6.3%), compared with North (6.8%), South (6.3%) and East (4.7%) Africa in the Ophthalmic & Physiological Optics review [1]. A separate pooled analysis of African schoolchildren reports ~4.2% prevalence when strict cycloplegic refraction is used [2].
2. Why the headline numbers are cautious: measurement and study bias
Both reviews warn that methods matter and studies vary. Non‑cycloplegic refraction overestimates myopia versus cycloplegic testing (6.4% vs 4.2% in one African pooled analysis) and studies come from different years, urban/rural mixes and sampling frames [2]. The Ophthalmic & Physiological Optics review found regional differences were not statistically significant on meta‑regression (p = 0.36), signalling uncertainty around small regional contrasts [1].
3. Urbanisation and lifestyle: the environmental context that drives change
Global and African analyses emphasise environment over immutable racial categories. Urban living and lifestyle shifts (less time outdoors, more near work) are strongly tied to rising myopia; models anticipate Africa’s prevalence may rise as urbanisation increases, even if current rates are lower than in East Asia [1] [3]. The 2016 and later global projections also frame rising myopia as an environmental epidemic rather than primarily genetic [4] [5].
4. Heterogeneity within regions: pockets and outliers matter
Even within Africa, some local studies report much higher rates — the reviews note estimates “as high as 40%” in particular populations — so national or subpopulation studies can deviate sharply from the pooled regional average [1]. The pooled figures mask wide heterogeneity driven by study location, age distribution, urban/rural mix and testing methods [6].
5. Competing perspectives in the literature
Most contemporary reviews converge: Africa’s childhood myopia prevalence is lower now than in East Asia and Western high‑income regions but is increasing in some settings [1] [5]. Emerging meta‑analyses and conference reports (IMC/Fricke updates) suggest Sub‑Saharan Africa’s prevalence may be rising faster than earlier models predicted, though those are preliminary and regionally uneven [7] [5].
6. What these findings do and do not show about “West Africans”
Available sources report regional prevalence estimates for West Africa (≈3.5%) and pooled African schoolchildren (~4.2% with cycloplegia) but do not support a blanket biological claim that “West Africans are more likely to be myopic.” The literature emphasizes environmental drivers and methodological caveats and notes that differences across African regions were not statistically significant in meta‑regression [1] [2].
7. Practical takeaway for readers and policymakers
Treat regional averages as baseline signals, not definitive individual risk. Public health planning should prioritise standardized measurements (cycloplegic refraction), surveillance in rapidly urbanising areas, and preventive strategies (outdoor time, myopia control where needed) because projections foresee increases if urban lifestyles spread [1] [5].
Limitations: the reviewed sources focus on childhood prevalence and pooled studies through mid‑2023; they report heterogeneity and methodological biases and caution against overinterpreting small regional differences [1] [2]. Available sources do not mention individual genetic subgroups within West Africa beyond broad regional aggregation.