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Sherief ST, Muhe LM, Mekasha A, Demtse A, Ali A. Prevalence and causes of ocular disorders and visual impairment among preterm children in Ethiopia. BMJ Paediatr Open 2024; 8:e002317. [PMID: 38325900 PMCID: PMC10860044 DOI: 10.1136/bmjpo-2023-002317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVE The aim of this study was to determine the prevalence, causes of ocular disorders and visual impairment among preterm children previously admitted to neonatal intensive care units in Addis Ababa, Ethiopia. METHODS AND ANALYSIS A prospective screening survey was conducted from February to June 2019 at the paediatric eye clinic of Menelik II Hospital. Children who were preterm at birth and who attended the eye clinic were included in the study. Data on demographic and neonatal characteristics, neonatal and maternal comorbidities and ocular disorders were collected. OR and univariate analysis were used to identify predictors of ocular diseases and visual impairment. RESULTS There were 222 children included in the study with a mean age at presentation of 2.62 years (range 2.08-6.38 years), mean gestational age 34.11 weeks (range 30-36) weeks and mean birth weight 1941.72 g (range 953-3500 g). Nearly two-thirds had ocular disorders with refractive error (51.8%), strabismus (11.3%) and a history of retinopathy of prematurity (ROP) (7.2%) being more common. One-fourth of the children had visual impairment, and the prevalence of amblyopia was 40.1%. Uncorrected refractive errors, strabismus and ROP were causes for visual impairment. CONCLUSION Visual impairment and amblyopia are common in Ethiopia. There is a need to develop a screening protocol for ocular disorders for preterm children to enhance early detection and prevention of childhood visual impairment.
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Affiliation(s)
- Sadik Taju Sherief
- Department of Ophthalmology, Addis Ababa University, Addis Ababa, Ethiopia
- Child Health Evaluative Sciences Program and Centre for Global Child Health, SickKids Research Institute, Toronto, Ontario, Canada
| | - Lulu M Muhe
- Department of Pediatrics and Child Health, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Amha Mekasha
- Department of Pediatrics and Child Health, Addis Ababa University, Addis Ababa, Oromia, Ethiopia
| | - Asrat Demtse
- Paediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asim Ali
- Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
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Sherief ST, Tesfaye S, Eshetu Z, Ali A, Dimaras H. Exploring the knowledge, attitudes, and practice towards child eye health: A qualitative analysis of parent experience focus groups. PLoS One 2023; 18:e0293595. [PMID: 37922264 PMCID: PMC10624311 DOI: 10.1371/journal.pone.0293595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/17/2023] [Indexed: 11/05/2023] Open
Abstract
BACKGROUND The majority of childhood blindness causes in low-income countries are treatable or avoidable. Parents or guardians are responsible for making decisions regarding a child's eye care. Understanding parents' awareness and perception of eye problems in crucial in helping to know parents' eye care-seeking behavior. OBJECTIVE To determine parental knowledge, attitudes and practice regarding child eye health. METHODS Seven focus groups were carried out in Northwest Ethiopia on knowledge, attitude and practice of parents towards child eye health. Their responses were tape-recorded and later transcribed. A thematic phenomenological approach was used for the analysis. RESULT Seventy-one parents participated in the focus groups. Participants were aware of common eye problems like trachoma, trauma, and glaucoma. However, they were unaware of the causes and etiologies of childhood blindness. Participants perceived that eye problems could be treated with hygiene and food, and often held misconceptions about the cause of strabismus and utilization of wearing spectacles. CONCLUSION The study revealed that parents are often unaware of the causes and etiologies of common childhood eye diseases, which has downstream effects on health-seeking behavior. Health promotion efforts, potentially through mass and social media, could be helpful to raise awareness, coupled with training of health professionals at primary and secondary health facility levels.
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Affiliation(s)
- Sadik Taju Sherief
- Department of Ophthalmology, Addis Ababa University, Addis Ababa, Ethiopia
- Child Health Evaluative Sciences Program and Centre for Global Child Health, Sickkids Research Institute, Toronto, Canada
| | | | - Zelalem Eshetu
- Biruh Vision Speciality Eye Center, Addis Ababa, Ethiopia
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Canada
| | - Helen Dimaras
- Child Health Evaluative Sciences Program and Centre for Global Child Health, Sickkids Research Institute, Toronto, Canada
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Canada
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Sherief ST, Taye K, Teshome T, Demtse A, Gilbert C. Retinopathy of prematurity among infants admitted to two neonatal intensive care units in Ethiopia. BMJ Open Ophthalmol 2023; 8:e001257. [PMID: 37487673 PMCID: PMC10373681 DOI: 10.1136/bmjophth-2023-001257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE This study was conducted to determine the prevalence and risk factors for retinopathy of prematurity (ROP) in two neonatal intensive care units (NICUs) in Addis Ababa, Ethiopia. METHODS AND ANALYSIS A prospective screening survey was conducted from June 2019 to June 2020 in two level 3 public NICUs. Infants with a birth weight (BW) of ≤1500 g or gestational age (GA) of ≤32 weeks and those with a BW of >1500 g and GA of >32 weeks with an unstable clinical course were included. Data on demographic and neonatal characteristics, neonatal and maternal comorbidities, and therapeutic interventions were collected. Logistic regression analysis was used to identify predictors of ROP. RESULTS Two hundred and two infants were included: mean BW: 1658g (range: 700-2400 g) and mean GA: 32.4 weeks (range: 26-34 weeks). 32.2% had any stage of ROP, and 6.4% had Type 1 ROP. Lower BW, smaller GA and total days on oxygen were independent risk factors for severe ROP (Type 1 or worse). All 13 neonates with severe ROP were treated. CONCLUSION ROP is emerging as a concern in Ethiopia. ROP screening should include neonates with BW of <1800 g or GAs of ≤33 weeks, but further studies are needed in level 2 and private NICUs. Screening guidelines need to be developed and implemented in all hospitals with NICUs.
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Affiliation(s)
- Sadik Taju Sherief
- Department of Ophthalmology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Kalekirstos Taye
- Department of Ophthalmology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Tiliksew Teshome
- Department of Ophthalmology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Asrat Demtse
- Department of Paediatrics, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Clare Gilbert
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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Awoke N, Tekalign T, Teshome Guta M, Lenjebo TL, Dendir G, Obsa MS, Asinake G, Lambebo AA, Bekele ML. Visual impairment in Ethiopia: Systematic review and meta-analysis. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221145358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
WHO Prevention of Blindness Program launched ‘‘VISION 2020” in 1999 to reduce visual impairment and eradicate avoidable blindness by the year 2020. Ethiopia launched the “VISION 2020” initiative in 2002. This systematic review and meta-analysis aimed to present the national prevalence of visual impairment at the end of “VISION 2020”. Electronic search was conducted on the PubMed, SCOPUS, EMBASE, Web of Science, CINAHL, Google scholar databases for including articles. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Endnote reference manager was used for downloading, organizing, and citing articles. Methodological quality was assessed using the Joanna Briggs Institute (JBI) quality appraisal tool for prevalence studies. Statistical analysis was done using the STATA™ software version 14. In this systematic review and meta-analysis, 18 studies involving 14,953 participants were included. The pooled prevalence of visual impairment in Ethiopia after correction for publication bias by Duval and Tweedie’s trim and fill analysis was estimated to be 6.24% (95% confidence interval [CI] = [2.66, 9.82]). The pooled prevalence of visual impairment among school children and adults in Ethiopia was 6.13% (95% CI = [4.27, 7.98]) and 19.89% (95% CI = [10.85, 28.93]), respectively. The most common causes of visual impairment in decreasing order of prevalence were refractive error, cataract, trachoma, glaucoma, and corneal opacity. Amblyopia was the cause of visual impairment among school-age child. The prevalence of visual impairment in Ethiopia was still significant at the end of “VISION 2020” program. Therefore, the program of “VISION 2020” should be extended and other large-scale programs were needed to reduce the prevalence of vision impairment in Ethiopia.
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Abuga J, Mwangi L, Ndolo J, Kariuki S, Newton C. Healthcare utilization by children with neurological impairments and disabilities in rural Kenya: a retrospective cohort study combined with secondary analysis of audit data. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18405.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: There is a paucity of data on healthcare utilization by children with neurological impairments (NI) in sub-Saharan Africa. We determined the rate, risk factors, causes, and outcomes of hospital admission and utilization patterns for rehabilitative care among children with NI in a defined rural area in Kenya. Methods: We designed two sub-studies to address the primary objectives. Firstly, we retrospectively observed 251 children aged 6–9 years with NI and 2162 age-matched controls to determine the rate, causes and outcomes of hospitalization in a local referral hospital. The two cohorts were identified from an epidemiological survey conducted in 2015 in a defined geographical area. Secondly, we reviewed hospital records to characterize utilization patterns for rehabilitative care. Results: Thirty-four in-patient admissions occurred in 8503 person-years of observation (PYO), yielding a crude rate of 400 admissions per 100 000 PYO (95% confidence interval (Cl): 286–560). The risk of admission was similar between cases and controls (rate ratio=0.70, 95%CI: 0.10–2.30, p = 0.31). The presence of electricity in the household was associated with reduced odds of admission (odds ratio=0.32, 95% Cl: 0.10–0.90, p < 0.01). Seizures and malaria were the main causes of admission. We confirmed six (0.3%) deaths during the follow-up period. Over 93% of outpatient paediatric visits for rehabilitative care were related to cerebral palsy and intellectual developmental delay. Health education (87%), rehabilitative exercises (79%) and assistive technology (64%) were the most common interventions. Conclusions: Surprisingly, the risk of hospitalization was not different between children with NI and those without, possibly because those with severe NI who died before this follow-up were under seclusion and restraint in the community. Evidence-based and tailored rehabilitative interventions are urgently required based on the existing secondary data.
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Markos M, Kefyalew B, Tesfaye HB. Pooled prevalence of blindness in Ethiopia: a systematic review and meta-analysis. BMJ Open Ophthalmol 2022; 7:bmjophth-2021-000949. [PMID: 36161856 PMCID: PMC9171275 DOI: 10.1136/bmjophth-2021-000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Blindness is defined as presenting visual acuity worse than 3/60 in the better eye. Its highest proportion has been conforming to the developing countries such as Ethiopia. So, timely information is crucial to design strategies. However, the study on the magnitude of blindness in Ethiopia was outdated which means it was conducted in 2005–2006. Therefore, this study was proposed to estimate the pooled prevalence of blindness in Ethiopia. Databases like PubMed, Cochrane library, Google Scholar and references of retrieved articles were used to search for articles. A standard data extraction approach was employed and presented using Preferred Reporting of Items for Systematic Reviews and Meta-Analyses. The Newcastle-Ottawa Scale quality assessment tool was used to evaluate the quality of studies. Analysis held using STATA V.11. The funnel plot and Egger’s regression test were applied to check for the potential sources of bias. Heterogeneity among the studies was tested using I² statistics that have been calculated and compared with the standard. Meta-regression and subgroup analysis were done to identify the potential sources of heterogeneity. Estimation of blindness was carried out using Duval and Twee die’s trim and fill analysis. The pooled prevalence of blindness in Ethiopia is found to be 1.18% (95% CI 0.650% to 1.706%). Blindness is among the main public health difficulties in Ethiopia. So, it demands up-to-date strategies and its implementation, preventive and curative eye care service with affordable and accessible interventions, and evidence-based advocacy. The trial Registration Number is CRD42021268448.
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Affiliation(s)
- Merkineh Markos
- Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Biruktayit Kefyalew
- Department of Ophthalmology and Optometry, Hawassa University, Hawassa, Ethiopia
| | - Hana Belay Tesfaye
- Department of Early Childhood Care and Education, University of Gondar, Gondar, Ethiopia
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Adane F, Alamneh YM, Desta M. Computer vision syndrome and predictors among computer users in Ethiopia: a systematic review and meta-analysis. Trop Med Health 2022; 50:26. [PMID: 35331333 PMCID: PMC8943996 DOI: 10.1186/s41182-022-00418-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background A computer is one of the most widely used office tools. The leading occupational health problem of the twenty-first century is computer vision syndrome (CVS). Research findings across Ethiopia on the magnitude and predictors of CVS among computer users are highly variable and inconsistent. Therefore, this study aimed to estimate the overall prevalence of CVS and its predictors among computer users in Ethiopia. Methods We searched articles in all databases and other sources. Cochrane Q test statistics and I2 tests were used. A random-effect meta-analysis model was used. In addition, the association between risk factors and CVS among computer users was examined. Results Eight eligible studies were included. The pooled prevalence of CVS among computer users in Ethiopia was 73.21% (95% CI 70.32–76.11). Sub-group analysis by profession has shown that the highest prevalence of CVS was observed in bank employees [73.76% (95% CI 70.40–77.13)]. The most common reported symptoms of CVS were blurred vision (34.26%; 95% CI 22.08, 46.43). The previous history of eye disease (95% CI 2.30, 5.47), inappropriate sitting position (95% CI 1.76, 3.22), the frequent use of a computer (95% CI 2.04, 3.60), and using eyeglass/spectacles (95% CI 1.10, 3.91) were significantly associated with CVS among computer users in Ethiopia. Conclusions According to this study, computer vision syndrome was high among computer users in Ethiopia. Computer vision syndrome (CVS) was significantly associated with a previous history of eye disease, inappropriate sitting position, frequent use of a computer, and the use of spectacles. Based on the findings, it is suggested that efforts be made to optimize computer exposure time. It is also worth noting that employees should be properly seated when using a computer. Furthermore, people with vision problems should be extra cautious when using a computer. Finally, community awareness of the safety precautions that can be taken to reduce CVS is critical.
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Affiliation(s)
- Fentahun Adane
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia.
| | - Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Abuga JA, Kariuki SM, Abubakar A, Nyundo C, Kinyanjui SM, Van Hensbroek MB, Newton CRJC. Neurological impairment and disability in children in rural Kenya. Dev Med Child Neurol 2022; 64:347-356. [PMID: 34536290 PMCID: PMC9292953 DOI: 10.1111/dmcn.15059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 01/02/2023]
Abstract
AIM To investigate geographical change over time in the burden of neurological impairments in school-aged children in a demographic surveillance area. METHOD We investigated changes in neurological impairment prevalence in five domains (epilepsy and cognitive, hearing, vision, and motor impairments) using similar two-phase surveys conducted in 2001 (n=10 218) and 2015 (n=11 223) and determined changes in location-level prevalence, geographical clustering, and significant risk factors for children aged 6 to 9 years (mean 7y 6mo, SD 1y) of whom 50.4% were males. Admission trends for preterm birth, low birthweight (LBW), and encephalopathy were determined using admission data to a local hospital. RESULTS Overall prevalence for any neurological impairment decreased from 61 per 1000 (95% confidence interval [CI] 48.0-74.0) in 2001 to 44.7 per 1000 (95% CI 40.9-48.6) in 2015 (p<0.001). There was little evidence of geographical variation in the prevalence of neurological impairments in either survey. The association between neurological impairments and some risk factors changed significantly with year of survey; for example, the increased association of adverse perinatal events with hearing impairments (exponentiated coefficient for the interaction=5.94, p=0.03). Annual admission rates with preterm birth (rate ratio 1.08, range 1.07-1.09), LBW (rate ratio 1.08, range 1.06-1.10), and encephalopathy (rate ratio 1.08, range 1.06-1.09) significantly increased between 2005 and 2016 (p<0.001). INTERPRETATION There was a significant decline in the prevalence of neurological impairments and differential changes in the associations of some risk factors with neurological impairments over the study period. Limited geographical variation suggests that similar interventions are appropriate across the defined area.
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Affiliation(s)
- Jonathan A Abuga
- Department of Clinical Research (Neurosciences)Kenya Medical Research Institute‐Wellcome Trust Research ProgrammeKilifiKenya,Global Child Health GroupAcademic Medical CentreEmma Children’s HospitalUniversity of AmsterdamAmsterdamthe Netherlands
| | - Symon M Kariuki
- Department of Clinical Research (Neurosciences)Kenya Medical Research Institute‐Wellcome Trust Research ProgrammeKilifiKenya,Department of PsychiatryUniversity of OxfordOxfordUK
| | - Amina Abubakar
- Department of Clinical Research (Neurosciences)Kenya Medical Research Institute‐Wellcome Trust Research ProgrammeKilifiKenya,Institute for Human DevelopmentThe Agha Khan UniversityNairobiKenya
| | - Christopher Nyundo
- Department of Clinical Research (Neurosciences)Kenya Medical Research Institute‐Wellcome Trust Research ProgrammeKilifiKenya
| | - Samson M Kinyanjui
- Department of Clinical Research (Neurosciences)Kenya Medical Research Institute‐Wellcome Trust Research ProgrammeKilifiKenya,Nuffield Department of MedicineUniversity of OxfordOxfordUK
| | - Michael Boele Van Hensbroek
- Global Child Health GroupAcademic Medical CentreEmma Children’s HospitalUniversity of AmsterdamAmsterdamthe Netherlands
| | - Charles RJC Newton
- Department of Clinical Research (Neurosciences)Kenya Medical Research Institute‐Wellcome Trust Research ProgrammeKilifiKenya,Department of PsychiatryUniversity of OxfordOxfordUK
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Ezeh E, Nkanga E, Okonkwo S, Agweye C, Ibanga A, Nkanga D. Paediatric cataracts in a tertiary eye centre in South-South Nigeria: An initial audit of surgical outcome. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_40_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Limitations in cataract surgical services for children in Ethiopia: a nationwide survey of pediatric cataract surgeons. BMC Ophthalmol 2021; 21:437. [PMID: 34923960 PMCID: PMC8684671 DOI: 10.1186/s12886-021-02190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Bilateral cataract is a significant cause of blindness in children in Ethiopia. This study aimed to identify the resources available for cataract surgery in children, and to assess current surgical practices, surgical output and factors affecting the outcome of surgery in Ethiopia. Methods A Google Forms mobile phone questionnaire was emailed to nine ophthalmologists known to perform cataract surgery in young children (0–5 years). Results All nine responded. All but one had received either 12- or 3–5-month’s training in pediatric ophthalmology with hands-on surgical training. The other surgeon had received informal training from an experienced colleague and visiting ophthalmologists. The surgeons were based in seven health facilities: five in the capital (Addis Ababa) and eight in six public referral hospitals and one private center. Over 12 months (2017–2018) 508 children (592 eyes) aged 0–18 years (most < 15 years) were operated by these surgeons. 84 (17%) had bilateral cataract, and 424 (83%) had unilateral cataract mainly following trauma. A mean of 66 (range 18–145) eyes were operated per surgeon. Seventy-one additional children aged > 5 years were operated by other surgeons. There were substantially fewer surgeons per million population (nine for 115 million population) than recommended by the World Health Organization and they were unevenly distributed across the country. Methylcellulose and rigid intraocular lenses were generally available but less than 50% of facilities had a sharp vitrectomy cutter and cohesive viscoelastic. Mean travel time outside Addis Ababa to a facility offering pediatric cataract surgery was 10 h. Conclusion Despite the high number of cases per surgeon, the output for bilateral cataracts was far lower than required. More well-equipped pediatric ophthalmology teams are urgently required, with deployment to under-served areas.
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Kwarteng MA, Mashige KP, Naidoo KS, Boadi-Kusi SB, Govender-Poonsamy P. The prevalence and causes of low vision and blindness amongst learners at the Akropong School for the Blind in Ghana. AFRICAN VISION AND EYE HEALTH 2021. [DOI: 10.4102/aveh.v80i1.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Regassa TT, Daba KT, Fabian ID, Mengasha AA. Knowledge, attitude and practice of Ethiopian pediatricians concerning childhood eye diseases. BMC Ophthalmol 2021; 21:91. [PMID: 33596846 PMCID: PMC7890964 DOI: 10.1186/s12886-021-01842-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Eye examination and vision assessment are vital for the detection of conditions that result in blindness. Childhood blindness seriously impacts the development, education, and future employment opportunities of affected children. Pediatricians' knowledge of eye diseases is critical for the prevention of blindness through early diagnosis, allowing proper treatment and identification of conditions requiring referral to an ophthalmologist to preserve or restore vision. This study aimed to assess the knowledge, attitude, and practice of Ethiopian pediatricians concerning childhood eye diseases. METHODS We carried out a cross-sectional descriptive study of pediatricians working in various hospitals and clinics in Ethiopia. Participants were selected via a convenient sampling technique. Data were collected using both closed and open-ended semi-structured questionnaires. Responses were entered into EpiData 3.1 and transferred to SPSS version 21.0 software for analysis. RESULTS A total of 79 pediatricians participated in the study. Our findings showed that the attitude of all but 2 participants towards improving the management of childhood eye diseases was positive, even though this was not reflected in actual knowledge or practice. Even though attitudes were positive, knowledge was often poor and practice inadequate owing to barriers such as inadequate undergraduate training, lack of ophthalmology options during pediatric residency, and unavailability of ophthalmic equipment. CONCLUSIONS Participants' attitudes towards improving treatment for childhood eye diseases are positive, but their insufficient knowledge of eye diseases makes their practice poor in this respect.
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Affiliation(s)
| | | | - Ido Didi Fabian
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel and the International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
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Regassa TT, Daba KT, Fabian ID, Mengasha AA. Knowledge, attitude and practice of Ethiopian pediatricians concerning childhood eye diseases. BMC Ophthalmol 2021. [PMID: 33596846 DOI: 10.1186/s12886-021-01842-5.pmid:33596846;pmcid:pmc7890964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Eye examination and vision assessment are vital for the detection of conditions that result in blindness. Childhood blindness seriously impacts the development, education, and future employment opportunities of affected children. Pediatricians' knowledge of eye diseases is critical for the prevention of blindness through early diagnosis, allowing proper treatment and identification of conditions requiring referral to an ophthalmologist to preserve or restore vision. This study aimed to assess the knowledge, attitude, and practice of Ethiopian pediatricians concerning childhood eye diseases. METHODS We carried out a cross-sectional descriptive study of pediatricians working in various hospitals and clinics in Ethiopia. Participants were selected via a convenient sampling technique. Data were collected using both closed and open-ended semi-structured questionnaires. Responses were entered into EpiData 3.1 and transferred to SPSS version 21.0 software for analysis. RESULTS A total of 79 pediatricians participated in the study. Our findings showed that the attitude of all but 2 participants towards improving the management of childhood eye diseases was positive, even though this was not reflected in actual knowledge or practice. Even though attitudes were positive, knowledge was often poor and practice inadequate owing to barriers such as inadequate undergraduate training, lack of ophthalmology options during pediatric residency, and unavailability of ophthalmic equipment. CONCLUSIONS Participants' attitudes towards improving treatment for childhood eye diseases are positive, but their insufficient knowledge of eye diseases makes their practice poor in this respect.
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Affiliation(s)
| | | | - Ido Didi Fabian
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel and the International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
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Kletke SN, Soboka JG, Dimaras H, Sherief ST, Ali A. Development of a pediatric ophthalmology academic partnership between Canada and Ethiopia: a situational analysis. BMC MEDICAL EDUCATION 2020; 20:438. [PMID: 33198727 PMCID: PMC7670694 DOI: 10.1186/s12909-020-02368-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/09/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Educational capacity building in pediatric ophthalmology is necessary to address the burden of childhood blindness in Ethiopia. Residency and fellowship training at Addis Ababa University (AAU) have been enhanced with support from the University of Toronto (UofT), following the established Toronto Addis Ababa Academic Collaboration (TAAAC). Our aim was to assess the feasibility of implementing a pediatric ophthalmology fellowship at AAU with support from UofT, modeled by successful postgraduate medical education within TAAAC. METHODS A situational analysis, including a needs assessment, was conducted at Menelik II Hospital, Addis Ababa. Staff expertise, equipment and infrastructure were compared to International Council of Ophthalmology fellowship guidelines. Patient volumes were assessed through medical chart review. Local training needs were evaluated. A strategic working meeting facilitated program specification. RESULTS The faculty consisted of 11 ophthalmologists, including 2 pediatric specialists. Fourteen thousand six hundred twenty-seven medical and three thousand six hundred forty-one surgical pediatric cases were seen in the previous year. A 2-year fellowship incorporating anterior segment, retinoblastoma, strabismus, and retinopathy of prematurity modules was developed. Research collaborations, didactic teaching, and surgical supervision were identified as priorities requiring support. Quality standard indicators included faculty feedback, case log review and formal examination. Telemedicine, development of a larger eye hospital and partnerships to support equipment maintenance were identified as strategies to manage implementation barriers. CONCLUSIONS The situational analysis provided a way forward for the development of a pediatric ophthalmology fellowship, the first of its kind in Eastern Africa. Learning outcomes are feasible given high patient volumes, qualified staff supervision and sufficient equipment. Strategic partnerships may ensure resource sustainability.
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Affiliation(s)
- Stephanie N Kletke
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | - Jibat G Soboka
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia
- Department of Ophthalmology, Menelik II Hospital, Addis Ababa, Ethiopia
| | - Helen Dimaras
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada
- Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences Program, SickKids Research Institute, Toronto, Canada
- Department of Human Pathology, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Sadik T Sherief
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.
- Department of Ophthalmology, Menelik II Hospital, Addis Ababa, Ethiopia.
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Canada
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15
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Ong APC, Watson A, Subbiah S. Rubeola keratitis emergence during a recent measles outbreak in New Zealand. J Prim Health Care 2020; 12:289-292. [PMID: 32988451 DOI: 10.1071/hc20013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/27/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Measles is a highly contagious disease caused by the rubeola virus. It can result in ocular complications such as conjunctivitis and keratitis, which will be encountered in general practice. Cases usually resolve without sequelae, but may progress to corneal perforation if left untreated. AIM We present two cases of rubeola keratitis secondary to measles infection. METHODS This report is about a retrospective review of data from two patients who presented to the eye department with rubeola keratitis in the midst of the recent measles outbreak in New Zealand. RESULTS Both patients presented with decreased visual acuity approximately 2 weeks after being diagnosed with measles. One of them was unvaccinated, whereas the other had no documentation of previous vaccination. Both were healthy and immunocompetent individuals. There was no evidence of corneal perforation or retinopathy on examination. Both patients regained their baseline visual acuity after treatment with fluorometholone eye drops. DISCUSSION Despite the existence of a safe and effective vaccine, there were more than 2000 cases of measles in the recent outbreak in New Zealand. The lack of vaccination is one of the primary causes of rubeola keratitis. These cases highlight the effects of measles infection from an ophthalmology perspective and reinforce the paramount importance of getting vaccinated.
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Affiliation(s)
- Aaron P C Ong
- Department of Ophthalmology, Southern District Health Board, Dunedin, New Zealand; and Corresponding author.
| | | | - Shanu Subbiah
- Eye Institute, Auckland, New Zealand; and Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
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Asferaw M, Mekonen SY, Woodruff G, Gilbert CE, Tesfaye S. Outcome of paediatric cataract surgery in Northwest Ethiopia: a retrospective case series. Br J Ophthalmol 2018; 103:112-118. [PMID: 29669781 DOI: 10.1136/bjophthalmol-2017-311513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 11/04/2022]
Abstract
AIM To assess visual acuity outcomes, and factors associated with the outcome, of paediatric cataract surgery at the Child Eye Health Tertiary Facility, Gondar, Northwest Ethiopia. METHODS The medical records of children aged below 16 years who underwent cataract surgery between September 2010 and August 2014 were reviewed for preoperative, surgical and postoperative data. RESULTS One hundred and seventy-six eyes of 142 children (mean age 7.9 years±4.2 SD, 66% male) who had cataract surgery were included. Twenty-five per cent (35/142) of children had bilateral cataract, 18 (13%) had unilateral non-traumatic cataracts and 89 (63%) had unilateral traumatic cataracts. An intraocular lens was implanted in 93% of eyes. Visual acuities at last follow-up: bilateral cases in the better eye: good (≥6/18 or fix and follow) in 21/34 eyes (62%), borderline (<6/18-6/60) in 4 eyes (12%) and poor (<6/60) in 9 eyes (26%). In unilateral non-traumatic cases: good in 6 eyes (33%), borderline in 3 eyes (17%) and poor in 9 eyes (50%). In unilateral traumatic cases: good in 36 eyes (40%), borderline in 20 eyes (23%) and poor in 33 eyes (37%). In bilateral cataract, worse outcomes were associated with preoperative nystagmus/strabismus. In traumatic cases, worse outcomes were associated with the preoperative trauma-related complications. CONCLUSIONS Visual acuity improved significantly after surgery, with better outcomes in bilateral cases. Early detection and surgery by a trained surgeon with good follow-up and postoperative rehabilitation can lead to better visual outcomes.
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Affiliation(s)
- Mulusew Asferaw
- Department of Ophthalmology, University of Gondar, Gondar, Ethiopia
| | | | | | - Clare E Gilbert
- Clinical Research Department, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
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Malik ANJ, Mafwiri M, Gilbert C. Integrating primary eye care into global child health policies. Arch Dis Child 2018; 103:176-180. [PMID: 28988214 PMCID: PMC5865509 DOI: 10.1136/archdischild-2017-313536] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022]
Abstract
Globally, approximately 75% of blind children live in low-income countries (LICs). Almost half of blindness and low vision in LICs is due to avoidable causes such as corneal scarring from measles infection, vitamin A deficiency disorders, use of harmful traditional eye remedies, ophthalmia neonatorum and cataract.
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Affiliation(s)
- Aeesha Nusrat Jehan Malik
- Department of Clinical Research, International Centre of Eye Health, London School of Hygiene and Tropical Medicine, London, UK,Moorfields Eye Hospital, London, UK
| | - Milka Mafwiri
- Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dares Salaam, Tanzania, UK
| | - Clare Gilbert
- Department of Clinical Research, International Centre of Eye Health, London School of Hygiene and Tropical Medicine, London, UK
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Gilbert C, Bowman R, Malik ANJ. The epidemiology of blindness in children: changing priorities. COMMUNITY EYE HEALTH 2017; 30:74-77. [PMID: 29483749 PMCID: PMC5820629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Clare Gilbert
- Co-director: nternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Bowman
- Honorary Clinical Consultant: nternational Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Aeesha NJ Malik
- Clinical Research Fellow: International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
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