The aim of this review is to evaluate the prevalence of and factors associated with keratoconus in Africa. Method: A systematic online literature search was conducted for articles on keratoconus in Africa. Meta-analysis was performed to estimate the prevalence of keratoconus in Africa. The Freeman-Tukey double arcsine transformation was used to minimize the effects of studies with extremely high or low prevalence estimates on the overall pooled estimates. Leave-one-out sensitivity analysis was used to assess the robustness of the pooled effects and potential outliers. Meta-regression was performed to explore associations between keratoconus, gender and age. Results: Twelve studies were included in the review; 5 from Egypt, 2 from South Africa, 2 from Kenya, 1 from Sudan, 1 from Ghana and 1 from Nigeria. Two studies were conducted in allergic conjunctivitis patients, 4 in keratoconus patients, 1 in contact lens service seekers, 1 in pre-LASIK patients, 1 in refractive patients and 1 in a student population. Eight studies were included in the meta-analysis. The overall prevalence estimate of keratoconus in Africa was 7.9% (95% CI: 2.5%-16.0%). The prevalence of keratoconus among males and females in Africa was estimated to be 9.3% (95% CI: 2.5%-19.5%) and 5.8% (95% CI: 1.5%-12.7%) respectively. The estimated prevalence of unilateral and bilateral keratoconus was 2.6% (95% CI: 0.4%-6.5%) and 5.8% (95% CI: 1.6%-12.3%), respectively. The estimated prevalence of mild keratoconus was 2.2% (95% CI: 0.7%-4.7%), moderate keratoconus was 3.5% (95% CI: 0.0%-11.8%) and severe keratoconus was 4.0% (95% CI: 0.0%-19.6%). There was no significant association between gender and the prevalence of keratoconus in Africa (p = 0.63), and age and the prevalence of keratoconus in Africa (p = 0.78). Conclusion:The estimated prevalence of keratoconus reported here is higher than prevalence values reported in other meta-analyses or different geographical locations. This is mainly because studies included in this meta-analysis were either conducted on a cohort at high risk of keratoconus or a population with high possibility of finding keratoconus patients. There is a dearth of well-designed population-based studies on keratoconus in Africa, resulting in a lack of epidemiological information. This highlights the urgent need for research on keratoconus in Africa.

The aim of the study was to determine the barriers to utilization of eye care services in the Upper East region of Ghana. A descriptive cross-sectional study in which 350 participants were randomly sampled from 8 district capitals and one settlement. These locations were selected for the study because an eye care facility was located in each of them. Interview of participants was conducted using structured questionnaires. Majority (53.71%) of the participants were females. Forty percent (40.00%) of the participants had not sought eye care in the last three years. There was no statistically significant difference in gender utilization of eye care services (p=0.204). The major barriers to utilization of eye care services identified were social engagement/other priorities, ability to perform daily task despite condition, cost of service and transportation, distance to eye care facility and the lack of knowledge of the availability of eye care services and treatment. This finding suggests that attitude, poverty and lack of awareness are major barriers to eye care utilization in the Upper East region. The importance of public education in the region and a health insurance with a wider coverage cannot be overemphasized.

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e increasing prevalence of childhood obesity and overweight is considered a public health issue in both developed and developing countries. is systematic review and meta-analysis estimates the prevalence of childhood obesity and overweight in Ghana. A multiple database search was conducted for articles published between January 1, 2001, and October 31, 2019, reporting the prevalence of childhood obesity and overweight in Ghana. Databases searched include PubMed, Google Scholar, Scopus, Cochrane Library, World Health Organization (WHO) Library Information System, and Africa Journals Online. Data were pooled from the articles to calculate an overall estimate of childhood obesity and overweight using a random-effects model after variance stabilization with Freeman-Tukey double arcsine transformation. is review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixteen studies with a combined sample size of 29,160 were included in the review. Analysis indicates that approximately 19% of children in Ghana either have obesity or are overweight. e prevalence of childhood obesity and overweight was 8.6% (95% CI: 4.8%-13.4%) and 10.7% (95% CI: 5.9%-16.6%), respectively. Although not significant, higher obesity (4.6% vs. 2.6%) and overweight (11.0% vs. 7.2%) prevalence were estimated for females than for males. ere was a significantly higher obesity prevalence estimate (17.4% vs. 8.9%) in rural settings than in urban settings (p � 0.0255). e high prevalence of childhood obesity and overweight estimated in this review is of worrying concern. It is a significant public health problem that has implications on the health of present and future generations in Ghana and as such calls for proactive measures to be put in place. Also, the driving forces behind the increasing prevalence of childhood obesity in Ghana need to be investigated.

SIGNIFICANCE Dry eye disease is a significant public health problem globally. The magnitude of the dry eye disease problem in Africa is, however, unknown. This study provides important and lacking information on dry eye disease in Africa. PURPOSE This study aimed to estimate the prevalence of dry eye disease in Africa. METHODS A systematic online literature search was conducted for articles on dry eye disease in Africa. Meta-analysis was conducted to estimate the prevalence of dry eye disease in Africa and meta-regression to explore the association between dry eye and sex, age, study population, country of study, and type of study. RESULTS The overall prevalence estimate of dry eye disease in Africa was 42.0% (95% confidence interval [CI], 30.7 to 53.8%). The prevalence rates of dry eye disease in male and female individuals were 42.1% (95% CI, 28.5 to 56.3%) and 44.4% (95% CI, 30.2 to 59.0%), respectively; in South Africa, Ghana, Nigeria, and Egypt, the rates were 54.9% (95% CI, 39.0 to 70.4%), 38.3% (95% CI,17.7 to 61.4%), 41.4% (95% CI, 20.1 to 64.5%), and 34.9% (95% CI, 13.2 to 60.6%) respectively; and in school, hospital, and population-based studies, the rates were 51.6% (95% CI, 40.6 to 62.6%), 38.7% (95% CI, 21.9 to 57.0%), and 37.4% (95% CI, 27.4 to 48.0%). respectively. The prevalence rates of dry eye disease were 36.9% (95% CI, 26.7 to 51.1%) in a “normal” population and 44.2% (95% CI, 18.0 to 67.9%) in a population with known risk conditions. There were no associations between dry eye disease prevalence and sex (P = .88), type of study (P = .42), country of study (P = .33), study population (P = .59), and the diagnostic criteria used (P = .36). CONCLUSIONS There seems to be a significant dry eye disease burden in Africa. This may pose an important public health problem that requires immediate attention and action. More epidemiological studies in Africa are needed to fully understand this problem to inform policy decisions.

Background. The purpose of the study was to determine the prevalence of computer vision syndrome (CVS) and poor sleep quality among university students and assess the relationship between digital device usage, CVS, and sleep quality. Methods. A cross-sectional study including undergraduate students was conducted in Ghana between January–March 2020. Information on digital device use and CVS symptoms was collected using a structured questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to determine the relationship between CVS and digital device use behavior, and linear regression analysis was used to explore the association between sleep quality and digital device use behavior. Statistical significance was set at p  < 0.05. Results. Mean (SD) age of participants was 20.95 (1.68) years and most (54.97%) of them were females. The prevalence of CVS was 64.36%. Factors associated with CVS included hours of digital device use per day (OR = 4.1, p  < 0.001), years of digital device use (OR = 3.0, p  < 0.001), adjustment of digital device screen contrast to the surrounding brightness (OR = 1.95, p  = 0.014), and presence of glare (OR = 1.79, p  = 0.048). Prevalence of poor sleep quality was 62.43%. There was a significant association between poor sleep quality and number of years participants had used a digital device ( p  = 0.015) and the number of hours they used a digital device per day ( p  = 0.005). Conclusion. There is a high prevalence of both CVS and poor sleep quality among undergraduate students in Ghana. This represents a significant public health issue that needs attention.

Mice fed a high fat diet (HFD) ab libitum show corneal dysregulation, as evidenced by decreased sensitivity and impaired wound healing. Time-restricted (TR) feeding can effectively mitigate the cardiometabolic effects of an HFD. To determine if TR feeding attenuates HFD-induced corneal dysregulation, this study evaluated 6-week-old C57BL/6 mice fed an ad libitum normal diet (ND), an ad libitum HFD, or a time-restricted (TR) HFD for 10 days. Corneal sensitivity was measured using a Cochet-Bonnet aesthesiometer. A corneal epithelial abrasion wound was created, and wound closure was monitored for 30 h. Neutrophil and platelet recruitment were assessed by immunofluorescence microscopy. TR HFD fed mice gained less weight (p < 0.0001), had less visceral fat (p = 0.015), and had reduced numbers of adipose tissue macrophages and T cells (p < 0.05) compared to ad libitum HFD fed mice. Corneal sensitivity was reduced in ad libitum HFD and TR HFD fed mice compared to ad libitum ND fed mice (p < 0.0001). Following epithelial abrasion, corneal wound closure was delayed (~6 h), and neutrophil and platelet recruitment was dysregulated similarly in ad libitum and TR HFD fed mice. TR HFD feeding appears to mitigate adipose tissue inflammation and adiposity, while the cornea remains sensitive to the pathologic effects of HFD feeding.

Purpose To provide contemporary and future estimates of childhood myopia prevalence in Africa. Methods A systematic online literature search was conducted for articles on childhood (≤18 years) myopia (spherical equivalent [SE] ≤ −0.50D; high myopia: SE ≤ −6.00D) in Africa. Population‐ or school‐based cross‐sectional studies published from 1 Jan 2000 to 30 May 2021 were included. Meta‐analysis using Freeman–Tukey double arcsine transformation was performed to estimate the prevalence of childhood myopia and high myopia. Myopia prevalence from subgroup analyses for age groups and settings were used as baseline for generating a prediction model using linear regression. Results Forty‐two studies from 19 (of 54) African countries were included in the meta‐analysis (N = 737,859). Overall prevalence of childhood myopia and high myopia were 4.7% (95% CI: 3.3%–6.5%) and 0.6% (95% CI: 0.2%–1.1%), respectively. Estimated prevalence across the African regions was highest in the North (6.8% [95% CI: 4.0%–10.2%]), followed by Southern (6.3% [95% CI: 3.9%–9.1%]), East (4.7% [95% CI: 3.1%–6.7%]) and West (3.5% [95% CI: 1.9%–6.3%]) Africa. Prevalence from 2011 to 2021 was approximately double that from 2000 to 2010 for all studies combined, and between 1.5 and 2.5 times higher for ages 5–11 and 12–18 years, for boys and girls and for urban and rural settings, separately. Childhood myopia prevalence is projected to increase in urban settings and older children to 11.1% and 10.8% by 2030, 14.4% and 14.1% by 2040 and 17.7% and 17.4% by 2050, respectively; marginally higher than projected in the overall population (16.4% by 2050). Conclusions Childhood myopia prevalence has approximately doubled since 2010, with a further threefold increase predicted by 2050. Given this trajectory and the specific public health challenges in Africa, it is imperative to implement basic myopia prevention programmes, enhance spectacle coverage and ophthalmic services and generate more data to understand the changing myopia epidemiology to mitigate the expanding risk of the African population.