BackgroundTo eliminate blinding trachoma, the World Health Organization emphasizes implementing the SAFE strategy, which includes annual mass drug administration (MDA) with azithromycin to the whole population of endemic districts. Prevalence surveys to assess impact at the district level are recommended after at least 3 years of intervention. The decision to stop MDA is based on a prevalence of trachomatous inflammation follicular (TF) among children aged 1–9 years below 5% at the sub-district level, as determined by an additional round of surveys limited within districts where TF prevalence is below 10%. We conducted impact surveys powered to estimate prevalence simultaneously at the sub-district and district in two zones of Amhara, Ethiopia to determine whether MDA could be stopped.MethodologySeventy-two separate population-based, sub-district surveys were conducted in 25 districts. In each survey all residents from 10 randomly selected clusters were screened for clinical signs of trachoma. Data were weighted according to selection probabilities and adjusted for correlation due to clustering.Principal FindingsOverall, 89,735 residents were registered from 21,327 households of whom 72,452 people (80.7%) were examined. The prevalence of TF in children aged 1–9 years was below 5% in six sub-districts and two districts. Sub-district level prevalence of TF in children aged 1–9 years ranged from 0.9–76.9% and district-level from 0.9–67.0%. In only one district was the prevalence of trichiasis below 0.1%.Conclusions/SignificanceThe experience from these zones in Ethiopia demonstrates that impact assessments designed to give a prevalence estimate of TF at sub-district level are possible, although the scale of the work was challenging. Given the assessed district-level prevalence of TF, sub-district-level surveys would have been warranted in only five districts. Interpretation was not as simple as stopping MDA in sub-districts below 5% given programmatic challenges of exempting sub-districts from a highly regarded program and the proximity of hyper-endemic sub-districts.
Background: Pseudoexfoliation syndrome is an age-related disorder characterized by the deposition of a distinct fibrillar extracellular material in various tissues and organs of the body. Glaucoma and cataract are the consistently reported clinical consequences of Pseudoexfoliation syndrome on the eye. This study aimed to estimate the proportion of pseudo-exfoliation syndrome and associated factors in Gondar university comprehensive specialized hospital tertiary eye care and training center. Methods and Materials: Institution-based cross-sectional study was conducted from January to March 2019 at Gondar university comprehensive specialized hospital tertiary eye care and training center among 295 patients. Consecutive 295 participants aged above 40 years were involved in the study. A structured questionnaire and ocular examination were used to collect the data. Data were entered into EPI-INFO 3.5.1 and exported to SPSS version 20 for analysis. Factors associated with pseudoexfoliation syndrome were ascertained by chi-square and independent t-test. Statistical significance was considered when p-value <0.05. Results: A total of 295 adults participated in the study with a response rate of 92.8%. The median (±IQR) age of study respondents was 64(±9) years and 67.8% were males. The proportion pseudoexfoliation syndrome was 34.6% [95% CI: 29.2-40.7%]. The mean IOP and mean age were significantly higher among patients with pseudoexfoliation syndrome. Age, sex, high IOP, glaucoma, outdoor work, and rural residence were significantly associated with the proportion of pseudoexfoliation syndrome. Conclusion:The proportion of pseudoexfoliation syndrome among participants aged ≥40 years was high. Age, sex, high IOP, glaucoma, outdoor work, and rural residence were factors having a significant association with the proportion of pseudoexfoliation syndrome.
Leishmaniasis is caused by unicellular eukaryotic obligate intracellular protozoa of the genus Leishmania that is endemic in over 98 countries in the world-most of which are developing countries including Ethiopia. It is transmitted by phlebotomine sandflies. The eye may be affected in cutaneous, mucocutaneous and Post Kala-Azar Dermal Leishmaniasis. We report a case of ocular leishmaniasis with eyelid and conjunctival involvement that had simulated ulcerative blepharoconjunctivitis not responding to conventional antibiotics. The patient was diagnosed by microscopy of a sample obtained via direct smear from the lesions. He was treated with systemic sodium stibogluconate (20 mg/kg/day) for 45 days and was clinically cured with this treatment.
Background: Strabismus has been defined as an intermittent or constant misalignment of the visual axes. Several studies have reported that strabismus affects about 1-6 % of the population across the world. This study aimed to assess the clinical profile of strabismus patients at the University of Gondar (UOG) tertiary eye care and training center. Material and Methods: A hospital-based cross-sectional study was conducted from April to October 2021 on all consecutive strabismus patients attending at UOG tertiary eye care and training center. Interviewer-administered questionnaires and clinical examinations were performed by residents and pediatric ophthalmologist for data collection. Results: A total of 258 strabismus patients with a median age of 8 (SD ±17.64) years old were enrolled in this study of whom 60.1% were esotropia (ET) and 32.6% were exotropia (XT). Accommodative-ET (AET) 46 (17.8%), constant type of XT 38 (14.7%), infantile ET 36 (14.0%) and acquired non-AET 34 (13.3%) were common sub-variants of strabismus. Having inferior oblique over action IOOA (AOR=7.6: 95% CI: 2.77 - 20.83) and being hyperopic in the left eye (AOR=8: 95% CI: 2.55-25) were significant factors associated with ET. Conclusion: Esotropia was the most common type of deviation accounting for more than half of the strabismus patients. Having IOOA and being hyperopic on the left eye were significant factors associated with ET.
Introduction Coping strategy is the mechanism by which patients adjust to the condition they face. It can be adaptive or maladaptive. A maladaptive coping strategy is a harmful and ineffective way of dealing with stress or anxiety. It is common among patients with chronic illnesses. Despite Ethiopia having a greater glaucoma prevalence, there was no evidence of patients with glaucoma using maladaptive coping mechanisms. Objective The main goal of this study was to evaluate the magnitude of maladaptive coping strategy use and the factors that associate with it among adult glaucoma patients enrolled in the Tertiary Eye Care and Training Center at the University of Gondar in Northwest Ethiopia in 2022. Methods and Materials At the University of Gondar, Tertiary Eye Care and Training Center, a facility-based cross-sectional study was carried out on a sample of 423 glaucoma patients chosen by a systematic random sampling technique from May 15 to June 30, 2022. Optometrists conducted an interview with the study subject and reviewed the medical record, and administered a pretested, structured questionnaire of the brief cope inventory assessment. In the multivariable logistic regression, binary logistic regression was performed to identify the related factors, and significance was taken into account when the p-value was less than 0.05 at the 95% confidence interval. Results The study found that among study participants 50.1% (95% CI: 45.1–54.5%) had a maladaptive coping strategy. Female sex (AOR=2.031, 95% CI:1.185–3.480), chronic medical illness (AOR=1.760, 95% CI:1.036–2.989), bilateral glaucoma (AOR=2.321, 95% CI: 1.328–4.055), receiving both drug and surgery treatment (AOR=1.895, 95% CI: 1.002–3.585), severe visual impairment (AOR=2.758, 95% CI:1.110–6.852), absolute glaucoma (AOR=2.543, 95% CI:1.048–6.169), duration of diagnosis >12 months (AOR=3.886, 95% CI: 2.295–6.580) were significantly associated with a maladaptive coping strategy. Conclusion and Recommendation Half of the participants had a maladaptive coping strategy. It is better to set and plan strategies that enable the integration of coping strategy care into the current treatment of patients with glaucoma to encourage positive coping strategies instead of maladaptive ones.
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