Background/AimGlaucoma accounts for 8% of global blindness and surgery remains an important treatment. We aimed to determine the impact of adding simulation-based surgical education for glaucoma.MethodsWe designed a randomised controlled, parallel-group trial. Those assessing outcomes were masked to group assignment. Fifty-one trainee ophthalmologists from six university training institutions in sub-Saharan Africa were enrolled by inclusion criteria of having performed no surgical trabeculectomies and were randomised. Those randomised to the control group received no placebo intervention, but received the training intervention after the initial 12-month follow-up period. The intervention was an intense simulation-based surgical training course over 1 week. The primary outcome measure was overall simulation surgical competency at 3 months.ResultsTwenty-five were assigned to the intervention group and 26 to the control group, with 2 dropouts from the intervention group. Forty-nine were included in the final intention-to-treat analysis. Surgical competence at baseline was comparable between the arms. This increased to 30.4 (76.1%) and 9.8 (24.4%) for the intervention and the control group, respectively, 3 months after the training intervention for the intervention group, a difference of 20.6 points (95% CI 18.3 to 22.9, p<0.001). At 1 year, the mean surgical competency score of the intervention arm participants was 28.6 (71.5%), compared with 11.6 (29.0%) for the control (difference 17.0, 95% CI 14.8 to 19.4, p<0.001).ConclusionThese results support the pursuit of financial, advocacy and research investments to establish simulation surgery training units and courses including instruction, feedback, deliberate practice and reflection with outcome measurement to enable trainee glaucoma surgeons to engage in intense simulation training for glaucoma surgery.Trial registration numberPACTR201803002159198.

Background: Glaucoma is a global public health problem and it is the leading cause of irreversible blindness worldwide. Even though public knowledge of glaucoma is a key for early case identification and prevention of blindness, it is unknown in the study area, making provision of interventions difficult. Therefore, this study was intended to assess knowledge of glaucoma and associated factors among adults in Gish Abay town, Northwest Ethiopia, 2018. Methods: A Community based cross-sectional design study with systematic random sampling technique was used to select 630 adults. The study was conducted from April to May, 2018. Data was entered into Epi Info version 7 and was analysed by Statistical Package for Social Sciences version 23. Binary logistic regression model and adjusted odds ratio with 95% confidence level was used to identify the significant factors associated with knowledge of glaucoma. Variables with P-value ≤0.05 was considered statistically significant. Results: About 594 adults were participated with a response rate of 94%. Above half of (52%) the participants were females with median age of 28 years. The proportion of good knowledge was demonstrated in 16.8% [95% CI; 14.0, 19.9]. Educational status: primary education [

BackgroundRubella virus infection in early pregnancy lead to serious multi-organ birth defects known as congenital rubella syndrome (CRS). The incidence of CRS varies in different populations and the highest burden is found in developing countries in which rubella vaccination is not included in their national immunization programs. In Ethiopia, there is scarcity of data about congenital rubella syndrome. Therefore, the aim of this study was to determine the burden of CRS-related birth defects and its incidence in the pre-vaccine era in Amhara Regional State, Ethiopia.Materials and methodsA cross sectional study was conducted in Dessie, Felege-Hiwot and University of Gondar Referral Hospitals, from December 2015 to August 2017. After getting informed assent from each parent/guardian, blood was collected from infants < 1 year of age for laboratory determination of anti-rubella virus antibodies. Their socio-demographic data and clinical information compatible with congenital rubella syndrome were collected using WHO guideline.ResultsDuring the study period, a total of 50 infants suspected for congenital rubella syndrome were included in the study. All infants suspected for CRS were tested against rubella specific IgM and IgG [for infants ≥ 6 months of age] antibodies using ELISA method. Of these, 9/50 (18%) and 4/14 (28.6%) of them were laboratory confirmed and potential CRS cases, respectively. In the present study, the most common laboratory confirmed defect was ocular manifestations 6 (66.7%) followed by heart related problems 5 (55.6%). In the present study, most of the laboratory confirmed cases (66.7%) were reported among 1–5 months of age infants. In addition, 5 (55.6%) of the infants with laboratory confirmed CRS cases were male and 6 (66.7%) of them were from urban settings. In this study, the incidence of CRS was 0.4 per 1000 live births.ConclusionIn this study, nearly one fifth of the infants had laboratory confirmed congenital rubella syndrome and most of them had multiple rubella associated congenital defects at a time. Most of these congenital anomalies were reported among infants ≥ 1 month of age. Based on our result, the incidence of the CRS was line with the global incidence of the CRS in the pre-vaccine era. Therefore, establishing strong rubella/CRS surveillance system as well as introducing the rubella containing vaccine in the national immunization program might be important to reduce the burden of rubella and CRS in the country.

BackgroundAzithromycin mass distribution was given to residents of Gurage zone Cheha district in 2004, 2005 and 2006 for three consecutive years with more than 90% coverage. The effect of treatment in the study community was not yet determined. The present study was therefore designed to assess the effect of azithromycin on the prevalence of active trachoma two years after three rounds of mass treatment of the community at Cheha district, Gurage zone.MethodsA multistage stratified cluster random survey was employed to determine the prevalence of active trachoma among children aged 1 to 9. Selected children were examined for trachoma using the simplified WHO grading system and their households were assessed for trachoma risk factors.ResultsThis survey demonstrated that the prevalence of active trachoma in the study community was 22.8% (95% CI 18.24% - 27.36%) that was lower than that of Southern Nations, Nationalities, and People's Regional prevalence (33.2%) in 2006. Only 27.6% (95% CI 25.7% - 30.1%) of the study population had a safe and clean water supply, whereas 42.7% (95% CI 39.8% - 46.2%) of the visited households had simple pit latrines.ConclusionThis survey demonstrated that despite repeated mass oral azithromycin distributions, the prevalence of active trachoma was still high. Therefore, the other components of the SAFE strategy such as fly control program, improving the water sources, measures to improve face washing and construction of utilizable latrines that are being implemented through the health extension package have to be integrated with mass azithromycin treatment to eliminate active trachoma in the district.

Orbital pseudotumor is a rare, idiopathic, inflammatory process within the orbit. Early diagnosis is essential to prevent corneal, retinal and extraocular muscle damage. This article describes the presentation and clinical course of a 3-year-old male with bilateral orbital pseudotumor.