Corneal diameters in infants born in two hospitals in Ibadan, Nigeria

Objectives: To measure the horizontal corneal diameters in infants at birth and compare with values reported in other studies. Design: A cross-sectional hospital based study. Subjects: All the healthy infants born within the period of one month in these hospitals were eligible for enrolment into the study. Horizontal corneal diameter measurements were performed with indirect caliper in both eyes of each of the 342 healthy full term infants and 25 preterm healthy infants born in these two hospitals. These results were evaluated according to the age of the infants Results: The corneal diameter in term infants was found to range from 9.00 mm to 12.50 mm during the first week of life with a mean of 10.26 mm (SD ± 0.59 mm, n = 64). This is higher than what was reported for Caucasian infants (P < 0.01). Mean horizontal corneal diameter in all male infants aged 1-238 days was 11.06 mm (SD 0.75 mm, n = 187), slightly higher than 10.93 mm (SD 0.22 mm, n = 154) in all females, though this difference was not statistically significant. Horizontal corneal diameter increased progressively with age, from a mean value (SD) of 10.26 mm (0.72) to a mean value (SD) of 12.0 mm at 34 weeks of age. There was no significant difference in the mean corneal diameter of the right and left cornea. A few infants had corneal diameters of 12.50 mm and had no congenital glaucoma. Mean corneal diameter in preterm infants less than 37 weeks of gestation was 8.90 mm at birth (SD 1.25 mm, n = 25). Conclusion: The horizontal diameter increased with age from birth to the 34 weeks of age. Changes after this period were not studied. The values obtained in these African infants were slightly higher than those reported from other populations. The East African Medical Journal Vol. 83 (11) 2006: pp. 631-63

Adapted motivational interviewing to improve the uptake of treatment for glaucoma in Nigeria: study protocol for a randomized controlled trial.

BACKGROUND: Glaucoma is a chronic eye disease associated with irreversible visual loss. In Africa, glaucoma patients often present late, with very advanced disease. One-off procedures, such as laser or surgery, are recommended in Africa because of lack of or poor adherence to medical treatment. However, acceptance of surgery is usually extremely low. To prevent blindness, adherence to treatment needs to improve, using acceptable, replicable and cost-effective interventions. After reviewing the literature and interviewing patients in Bauchi (Nigeria) motivational interviewing (MI) was selected as the intervention for this trial, with adaptation for glaucoma (MIG). MI is designed to strengthen personal motivation for, and commitment to a specific goal by eliciting and exploring a person's reasons for change within an atmosphere of acceptance and compassion. The aim of this study is to assess whether MIG increases the uptake of laser or surgery amongst glaucoma patients where this is the recommended treatment. The hypothesis is that MIG increases the uptake of treatment. This will be the first trial of MI in Africa. METHODS: This is a hospital based, single centre, randomized controlled trial of MIG plus an information sheet on glaucoma and its treatment (the latter being "standard care") compared with standard care alone for glaucoma patients where the treatment recommended is surgery or laser.Those eligible for the trial are adults aged 17 years and above who live within 200 km of Bauchi with advanced glaucoma where the examining ophthalmologist recommends surgery or laser. After obtaining written informed consent, participants will be randomly allocated to MIG plus standard care, or standard care alone. Motivational interviewing will be delivered in Hausa or English by one of two MIG trained personnel. One hundred and fifty participants will be recruited to each arm. The primary outcome is the proportion of participants undergoing laser or surgery within two months of the date given to re attend for the procedure. MIG quality will be assessed using the validated MI treatment integrity scale. DISCUSSION: Motivational interviewing may be an important tool to increase the acceptance of treatment for glaucoma. The approach is potentially scalable and may be useful for other chronic conditions in Africa. TRIAL REGISTRATION: ISRCTN79330571 (Controlled-Trials.com)

Experience with argon laser trabeculoplasty in Nigerians

Aim: To report the safety and efficacy of Argon Laser Trabeculoplasty (ALT) in reducing intraocular pressure (IOP).Settings and Design: This was a retrospective study performed on 25 eyes of 25 patients.Methods and Materials: Consecutive patients who met the inclusion criteria for ALT were recruited from the ophthalmic clinic of the University College Hospital Ibadan, Nigeria and followed up for a minimum period of six months. Two criteria were used to define successful response. Criterion 1 was defined as IOP reduction of 3mmHgor more without additional intervention while criterion 2 was IOP reduction of 20% or more from the pretreatment IOPStatistical Analysis: Data was analyzed using SPSS version 16. Frequencies and means were generated to observe patterns of variable distribution among the patients. P value &lt; 0.05 was considered significant.Results: The mean pretreatment IOP was 19.9 ±3.1mmHg, (range of 16 to 26 mmHg). Mean post treatment IOP at 6 months was 14.9 ±2.2 mmHg, (range of 11 to 19 mmHg). Mean IOP reduction at one year was 4.6 mmHg, representing a 22.3% drop. There was a statistically significant greater IOP reduction in eyes (P&lt;0.001) with higherpretreatment IOP. Based on criterion 1 and 2, 84.0% of the patients had successful outcome at six months while at one year, 76.9% were successful based on criterion one.Conclusion: To the best of our knowledge, this is the first study to report the efficacy of ALT in Nigerians. ALT is safe and effective in reducing IOP in Nigerians.Key messages: ALT is safe and effective in reducing intraocular pressure in this population of NigeriansFunding: The present study did not receive any fundsKeywords: Argon laser trabeculoplasty, Nigerians, Primary open angle glaucoma, intraocular pressure, outcom

Biodeterioration of the African star apple (Chrysophylum albidum) in storage and the effect on its food value

The biodeterioration of the African star apple fruits in storage was investigated at Ibadan, southwestern Nigeria. Eight fungal isolates were found associated with the deteriorating fruits. The fungi are Botryodiplodia theobromae, Rhizopus stolonifer, Aspergillus niger, A. tamarii, A. flavus, Fusarium spp, Penicilium spp and Trichoderma spp. All the fungal isolates were pathogenic on the star apple fruits with the exception of Trichoderma spp. The African star apple fruits stored for up to 5 days were associated with severe fungal infections and had significantly reduced crude protein, crude fat and moisture content while dry matter, potassium, calcium and sodium increased compared to the freshly harvested fruits. (African Journal of Biotechnology: 2003 2(3): 56-59

Genome-wide association study of primary open-angle glaucoma in continental and admixed African populations.

Primary open angle glaucoma (POAG) is a complex disease with a major genetic contribution. Its prevalence varies greatly among ethnic groups, and is up to five times more frequent in black African populations compared to Europeans. So far, worldwide efforts to elucidate the genetic complexity of POAG in African populations has been limited. We conducted a genome-wide association study in 1113 POAG cases and 1826 controls from Tanzanian, South African and African American study samples. Apart from confirming evidence of association at TXNRD2 (rs16984299; OR[T] 1.20; P = 0.003), we found that a genetic risk score combining the effects of the 15 previously reported POAG loci was significantly associated with POAG in our samples (OR 1.56; 95% CI 1.26-1.93; P = 4.79 × 10-5). By genome-wide association testing we identified a novel candidate locus, rs141186647, harboring EXOC4 (OR[A] 0.48; P = 3.75 × 10-8), a gene transcribing a component of the exocyst complex involved in vesicle transport. The low frequency and high degree of genetic heterogeneity at this region hampered validation of this finding in predominantly West-African replication sets. Our results suggest that established genetic risk factors play a role in African POAG, however, they do not explain the higher disease load. The high heterogeneity within Africans remains a challenge to identify the genetic commonalities for POAG in this ethnicity, and demands studies of extremely large size

Pre-harvest deterioration of Sour sop (Annona muricata) at Ibadan Southwestern Nigeria and its effect on nutrient composition

The etiology of pre-harvest deterioration of Soursop (Annona muricata) fruit in Ibadan, southwestern Nigeria and the effects on its nutrient composition was investigated. Four fungal pathogens including Botryodiplodia theobromae, Fusarium sp., Rhizopus stolonifer and Aspergillus niger were found associated with the pre-harvest deteriorating soursop . B. theobromae was the most prevalent and the most pathogenic inducing rot of 75 mm in diameter within four days of inoculation. There was a remarkable reduction in carbohydrate and protein contents of the fungal infected fruits while all other nutrients and mineral assayed were higher in the infected fruits than the non-infected ones. (African Journal of Biotechnology: 2003 2(1): 23-25

Demographic and clinical profile of patients with juvenile onset open angle glaucoma in southwestern Nigeria

Background: This was a non-comparative, retrospective review of patients diagnosed with juvenile open angle glaucoma (JOAG) in the eye clinic of a tertiary hospital in southwestern Nigeria.Objective: To document the demographic characteristics, clinical features and treatment outcome of the patients diagnosed with JOAG.Materials and Methods: Data were extracted from the clinical record of patients diagnosed with JOAG in the eye clinic of the University College Hospital, Ibadan, Nigeria, between January 2001 and December 2005. Such data included the basic demographic data, the clinical characteristic of the patients and the outcome of their treatment.Results: Twenty-nine patients were reviewed, which represents 3.4% of all newly diagnosed glaucoma patients seen in the out-patient section of the eye clinic of the University College Hospital, Ibadan, over the period reviewed. Eight (27.6%) patients were aged 20 years and below. The mean age was 25.1 &plusmn; SD 6.0 years. Eighteen (62.1%) had visual acuity of 6/18 or worse in the better eye at the time of presentation. The mean intraocular pressure (IOP) of the patients at presentation was 32.3 &plusmn; SD 15.2 mmHg. Eight (27.6%) patients defaulted within 6 months of presentation. The mean IOP for the 21 patients who were followed up on treatment for a mean period of 9.6 months was 17.0 &plusmn; SD 6.0 mmHg.Conclusion: Most patients with JOAG in this review presented with advanced form of the disease. Early detection through parent-driven school eye health program and community-based case detection could help in reducing the scourge arising from JOAG among our population

Effect of cold temperature storage on the quality attributes of pawpaw and guava leathers

The effect of cold temperature storage on the quality attributes of pawpaw and guava leathers was evaluated. Pawpaw leather was significantly higher than guava leather in calorific content, water activity, pH and total mould count throughout the duration of storage. However Guava leather was higher in texture. Sensory scores in relation to period of storage showed that Guava leather gave better result in overall acceptability at zero, one and two months of storage at 8 ± 10C. Guava leather also gave better sensory qualities in fruitiness, smell, chewiness, toughness, colour, and overall acceptability when varietal influence is considered. Guava leather is better accepted. (African Journal of Biotechnology: 2002 1(2): 61-63

Challenges of Loss to Follow-up in Tuberculosis Research.

In studies evaluating methods for diagnosing tuberculosis (TB), follow-up to verify the presence or absence of active TB is crucial and high dropout rates may significantly affect the validity of the results. In a study assessing the diagnostic performance of the QuantiFERON®-TB Gold In-Tube test in TB suspect children in Tanzania, factors influencing patient adherence to attend follow-up examinations and reasons for not attending were examined. In 160 children who attended and 102 children who did not attend scheduled 2-month follow-up baseline health characteristics, demographic data and risk factors for not attending follow-up were determined. Qualitative interviews were used to understand patient and caretakers reasons for not returning for scheduled follow-up. Being treated for active tb in the dots program (OR: 4.14; 95% CI:1.99-8.62;p-value<0.001) and receiving money for the bus fare (OR:129; 95% CI 16->100;P-value<0.001) were positive predictors for attending follow-up at 2 months, and 21/85(25%) of children not attending scheduled follow-up had died. Interviews revealed that limited financial resources, i.e. lack of money for transportation and poor communication, were related to non-adherence. Patients lost to follow-up is a potential problem for TB research. Receiving money for transportation to the hospital and communication is crucial for adherence to follow-up conducted at a study facility. Strategies to ensure follow-up should be part of any study protocol

Non-Surgical Management of Congenital Eversion of the Eyelids

Purpose: To report the effectiveness of non-invasive management of congenital eversion of the eyelids, a rare condition associated with serious socio-psychological consequences. Case Report: Three neonates with congenital eversion of the eyelids and secondary conjunctival chemosis and prolapse were managed with 5% hypertonic normal saline, lubricants, antibiotics, and padding. Complete eye opening was achieved by the 10th day of presentation and the condition resolved. Conclusion: Non-invasive management of congenital eyelid eversion was found to be effective with no need for surgical management. All health care workers should be informed that this condition is amenable to conservative treatment if started early, so that prompt referral for expert management can be offered