Zanzibar Arts for Children's Eyesight Pilot Trial

NCT06469697 | Completed DMC

• 1 other identifier: MHLS 23_32
• Study Type: interventional
• Target: 1,295
• Locations: 1 country
• Sites: 1

Brief Summary

In Zanzibar, around 22,000 children (4% of those aged 6 to 12) need treatment for eye issues like conjunctivitis or require glasses. A 2017 study found that 42% of rural children needing glasses didn't have them. Many locals distrust Western medicine and prefer traditional remedies, rejecting public health efforts such as posters and brochures. Globally, eye health promotion has been underfunded and overlooked. Research suggests community-designed interventions and behavior change studies are needed to promote sustainable eye health practices. Arts-based interventions using traditional storytelling and performances have been effective in Africa, improving health outcomes in areas like food hygiene and mental health. Health campaigns in schools might be less effective since parents make health decisions for their children. This study aims to see how well using both traditional and modern music performances in an eye health education program can break down cultural barriers and increase children's use of eye health services in schools and communities. The investigators want to answer three main questions:

1. 1.How effective is a 6-month music-based eye health education program in schools and communities at improving eye health knowledge and service use among parents and children?
2. 2.What factors influenced the success of the 6-month music-based eye health education program?
3. 3.What are the costs and benefits of this 6-month program in increasing eye health service use among children in schools and communities?

Conditions

Myopia; Conjunctivitis; Hyperopia

Keywords

Arts; Health education; Refractive errors; Conjunctivitis

Outcome Measures

Primary Outcomes (1)

• Change in the proportion of children accessing eye health services

  Proportion of children who have gone for eye treatment at the referral sites over those who failed eye health screening and referred to the referral site; measured in percentage, the higher the percentage the better the referral rate

  Three months and six months after the intervention is implemented

Secondary Outcomes (6)

• Children spectacle compliance

  Three months and six months after the intervention is implemented

• Children eye drops usage compliance

  Three months and six months after the intervention is implemented

• Cost-benefit analysis

  Through study completion, 6 months after the intervention is implemented.

• Parents knowledge and attitude

  Three months and six months after the intervention is implemented

• Children's knowledge and attitude

  Three months and six months after the intervention is implemented

Study Arms (2)

Intervention

EXPERIMENTAL

Musical pieces developed by the Ministry of Education and Vocational Training will be played at intervention schools using compact discs. These will be broadcast once during morning assembly, once during recess, and once before school ends on Mondays and Fridays for 3 months. After this period, a popular local radio station will broadcast the music pieces three times a day during peak hours.

Behavioral: School music broadcast

Comparator

ACTIVE COMPARATOR

A popular local radio station will broadcast the music pieces three times a day during peak hours, coinciding with the times when the intervention group is receiving the same program (community broadcast).

Behavioral: Community music broadcast

Interventions

School music broadcast BEHAVIORAL

An arts-based eye health intervention featuring traditional and contemporary music pieces will be broadcasted at both school and community levels.

Intervention

Community music broadcast BEHAVIORAL

An arts-based eye health intervention featuring traditional and contemporary music pieces will be broadcasted at community levels.

Comparator

Eligibility Criteria

• Age: 6 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• primary and secondary schools with student school-going rates of approximately 75%
• schools with similar number of boys and girls
• schools within 5km of the nearest eye centres.
• school children who have either an obvious eye disease tested using a pen torch test and/or a presenting distance visual acuity ≤6/12 in either eye, and their parents.

You may not qualify if:

• primary and secondary schools with student school-going rates of less than 75%
• schools with imbalance number of boys and girls
• schools above 5km of the nearest eye centres.
• school children who do not have either an obvious eye disease tested using a pen torch test and/or a presenting distance visual acuity ≤6/12 in either eye, and their parents.

Sponsors & Collaborators

• Queen's University, Belfast: lead
• Ministry of Health and Social Welfare, Zanzibar: collaborator

Study Sites (1)

Ministry of Health

Zanzibar, Tanzania

Location

Related Publications (5)

• Hobday K, Ramke J, du Toit R. Eye health promotion in Western Pacific island countries. Clin Exp Ophthalmol. 2011 Aug;39(6):584-5. doi: 10.1111/j.1442-9071.2011.02514.x. No abstract available.

  PMID: 21631663 BACKGROUND

• Evans JR, Morjaria P, Powell C. Vision screening for correctable visual acuity deficits in school-age children and adolescents. Cochrane Database Syst Rev. 2018 Feb 15;2(2):CD005023. doi: 10.1002/14651858.CD005023.pub3.

  PMID: 29446439 BACKGROUND

• Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, Ah Tong BAM, Arunga S, Bachani D, Bascaran C, Bastawrous A, Blanchet K, Braithwaite T, Buchan JC, Cairns J, Cama A, Chagunda M, Chuluunkhuu C, Cooper A, Crofts-Lawrence J, Dean WH, Denniston AK, Ehrlich JR, Emerson PM, Evans JR, Frick KD, Friedman DS, Furtado JM, Gichangi MM, Gichuhi S, Gilbert SS, Gurung R, Habtamu E, Holland P, Jonas JB, Keane PA, Keay L, Khanna RC, Khaw PT, Kuper H, Kyari F, Lansingh VC, Mactaggart I, Mafwiri MM, Mathenge W, McCormick I, Morjaria P, Mowatt L, Muirhead D, Murthy GVS, Mwangi N, Patel DB, Peto T, Qureshi BM, Salomao SR, Sarah V, Shilio BR, Solomon AW, Swenor BK, Taylor HR, Wang N, Webson A, West SK, Wong TY, Wormald R, Yasmin S, Yusufu M, Silva JC, Resnikoff S, Ravilla T, Gilbert CE, Foster A, Faal HB. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health. 2021 Apr;9(4):e489-e551. doi: 10.1016/S2214-109X(20)30488-5. Epub 2021 Feb 16. No abstract available.

  PMID: 33607016 BACKGROUND

• McConnell BB. Music and health communication in The Gambia: A social capital approach. Soc Sci Med. 2016 Nov;169:132-140. doi: 10.1016/j.socscimed.2016.09.028. Epub 2016 Sep 19.

  PMID: 27721137 BACKGROUND

• Omar F, Othman OJ, Yong AC, Belluigi D, Graham C, Graham R, Mashayo E, Chan VF. Preliminary effectiveness of musical messaging to improve child eye health service uptake in Zanzibar: a pilot randomised trial. BMJ Open. 2025 Sep 23;15(9):e107348. doi: 10.1136/bmjopen-2025-107348.

  PMID: 40987737 DERIVED

MeSH Terms

Conditions

Myopia; Conjunctivitis; Hyperopia; Arts syndrome; Health Education; Refractive Errors

Condition Hierarchy (Ancestors)

Eye Diseases; Conjunctival Diseases; Adherence Interventions; Medication Adherence; Patient Compliance; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Officials

• Ving Fai Chan, PhD

  Queen's University, Belfast

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Masking Details: Care providers will not be able to know whether the children referred are from intervention not comparator group as they will only receive a generic referral form from the project.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Senior Lecturer

Model Details: This is pilot will be conducted in 9 schools where radio broadcasts and community broadcasts will be implemented (intervention) and 9 schools where only community broadcasts will be implemented (comparator).

Study Record Dates

• First Submitted: June 13, 2024
• First Posted: June 24, 2024
• Study Start: January 15, 2024
• Primary Completion: December 11, 2024
• Study Completion: December 11, 2024
• Last Updated: December 12, 2024

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

TA (1)