COVID-19 疫情與臺灣國小學童視力之影響評估

Abstract

台灣一直是全球年度近視率最高的地區之一。儘管自2011年至2015年在國小推行每日120分鐘戶外活動後，近視率曾穩定下降，但目前尚無研究分析 COVID-19 疫情對台灣國小學生近視率的影響。鑑於其他國家的研究顯示兒童近視率有所上升，本研究旨在檢驗以下假設：台灣兒童近視率在疫情期間及之後顯著增加。 本研究以視力不良率作為近視率的替代指標。研究將透過台灣教育部取得2011年至2023年間台灣國小學生年度視力不良（定義為視力低於0.9）盛行率的公開彙總資料，以及學生註冊統計數據。在2011年至2023年間，每年有超過110萬名國小學生接受篩檢，且篩檢覆蓋率超過在學學生的99%。 研究結果顯示，2011年至2020年間，台灣國小學生視力不良的盛行率每年下降0.713%（SE = 0.05，t = -14.26，p < 0.001）；然而在2020年出現立即上升1.56%（SE = 0.43，t = 3.64，p < 0.05），並在2020年至2023年間持續以0.90%（SE = 0.18，t = 5.00，p < 0.001）的速度上升。近視率在女性、年齡較高，以及私立學校學生中較高。 研究結果支持本研究假設，即台灣國小學生的近視率在疫情後顯著上升。結合其他研究指出台灣兒童螢幕使用時間增加的情況，這些結果可作為學校限制螢幕使用時間的依據。

Taiwan consistently has one of the highest annual myopia rates in the world. While implementation of 120 minutes of outdoor time in elementary schools led to a steady decrease in myopia rates from 2011-2015, there is no study analyzing the COVID-19 pandemic’s effect on myopia rates among elementary students in Taiwan. With evidence from other countries that pediatric myopia rates increased, this study aims to test the hypothesis that Taiwan’s pediatric myopia rate significantly rose during and after the COVID-19 pandemic. Reduced visual acuity rate was used as a proxy for myopia rates. Publicly available aggregate data on annual reduced visual acuity (defined as less than 0.9) prevalence rates among Taiwanese elementary school students as well as enrollment statistics from 2011-2023 was obtained through the Taiwanese Ministry of Education. From 2011-2023, over 1.1 million elementary school students were screened each year, with more than 99% of enrolled students screened. From 2011-2019, the prevalence of reduced visual acuity among elementary students in Taiwan was decreasing by 0.713% (SE = 0.05, t = -14.26, p < 0.001), followed by an immediate 1.56% (SE = 0.43, t = 3.64, p < 0.05) increase at 2020, and a 0.90% (SE = 0.18, t = 5.00, p < 0.001) increase from 2020-2023. Myopia rates were higher among with female sex, older age, and private school students. The results are consistent with our hypothesis that Taiwan’s myopia rate for elementary schoolers significantly increased after the COVID-19 pandemic. With other studies reporting increased screen time among children in Taiwan, these results may serve as evidence for limiting screen time in schools.