Estimating Need for Glasses and Hearing Aids in The Gambia: Results from a National Survey and Comparison of Clinical Impairment and Self-Report Assessment Approaches.

Few estimates are available of the need for assistive devices (ADs) in African settings. This study aimed to estimate population-level need for glasses and hearing aids in The Gambia based on (1) clinical impairment assessment, and (2) self-reported AD awareness, and explore the relationship between the two methods. The Gambia 2019 National Eye Health Survey is a nationally representative population-based sample of 9188 adults aged 35+ years. Participants underwent standardised clinical vision assessments including the need for glasses (distance and near). Approximately 25% of the sample underwent clinical assessment of hearing and hearing aid need. Data were also collected on self-reported awareness, need and access barriers to vision and hearing ADs. Overall, 5.6% of the study population needed distance glasses (95% CI 5.0-6.3), 45.9% (95% CI 44.2-47.5) needed near glasses and 25.5% (95% CI 22.2-29.2) needed hearing aids. Coverage for each AD was very low (<4%). The agreement between self-report and clinical impairment assessment for AD need was poor. In conclusion, there is high prevalence and very low coverage for distance glasses, near glasses and hearing aids in The Gambia. Self-report measures alone will not provide an accurate estimate of AD need

The Gambia National Eye Health Survey 2019: survey protocol.

Two national surveys of vision impairment and blindness were undertaken in The Gambia in 1986 and 1996. These provided data for the inception of The Gambia's National Eye Health Programme (NEHP) within the Ministry of Health and Social Welfare. There have been important developments in the eye health services provided by the NEHP in the last 20 years. At the same time, the population has also undergone major demographic changes that may have led to substantial changes in the burden of eye disease. We conducted a National Eye Health Survey of vision impairment, blindness and its comorbidities in adults in The Gambia in 2019. We examined a nationally representative population-based sample of adults 35 years and above to permit direct comparison with the data available from the previous surveys. Alongside a comprehensive vision and eye examination, the survey provides nationally representative data on important comorbidities in this population: diabetes, hypertension, obesity, hearing impairment, disability and mental health. Secondly, it estimates access to assistive technologies and eye health services. Thirdly, it is powered to allow a five-year follow up cohort study to measure the incidence and progression of eye disease

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Sefer ha-ʻIṭur /

וו/11ב־ ע 1860 XXVCPLSHThis book is from the private library of Mattityahu Strashun.BSLW YIVOL Clean-up ProjectDigital imag

Co-infections and antimicrobial resistance profile of Mycobacterium tuberculosis and Streptococcus pneumoniae among patients with pulmonary infections attending tertiary health facilities in Makurdi, Nigeria

Background: Pulmonary infections (Pls) cause mortality in elderly patients that have co-morbidities. These infections are life-threatening in the younger population, especially in infants and children. Co-infection with Mycobacterium tuberculosis and Streptococcus pneumoniae occurring concurrently may lead to undiagnosed Streptococcus pneumoniae leading to inadequate treatment. Aim: The study investigates the co-infection and antimicrobial resistance profile of Mycobacterium tuberculosis and Streptococcus pneumoniae in Makurdi, Nigeria. Materials and methods:  A total of 273 sputum samples were collected from patients with pulmonary infection attending chest clinics in tertiary health institutions in Makurdi and analysed. Genexpert was used for Mycobacterium tuberculosis while Streptococcus pneumoniae isolates were identified using Gram-staining reaction, optochin and bile solubility tests. The susceptibility test for Streptococcus pneumoniae was performed using Kirby-Bauer method. Results: Out of the 273 sputum samples, the percentage occurrence of mono-infections with Mycobacterium tuberculosis was 14(5.13%) while that with rifampicin resistance was 1(0.37%). The occurrence of mono-infection with Streptococcus pneumoniae was 11(4.03%). The resistance profile showed trimethoprim/sulphamethoxazole (septrin) with the highest resistance 6(54.55%) and vancomycin 5(45.45%) while amoxicillin/clavulanic acid and ceftriaxone had zero resistance (0.0%). There was the occurrence of co-infections in 3(1.10%) out of the 273 patients sampled. There was no significant association (p > 0.05) between Mycobacterium tuberculosis, Streptococcus pneumoniae, their co-infections and the variables analyzed. Conclusion: The occurrence rate of Streptococcus pneumoniae and Mycobacterium tuberculosis co-infections is low among suspected pulmonary infection cases with an occurrence rate of 1.10%. Early detection and proper management of co-infections are recommended

Shaʻare Dura ha-niḳra isur ṿe-heter /

VCPLSHThis book is from the private library of Mattityahu Strashun.BSLW YIVOL Clean-up ProjectDigital imag

Sefer Shaʻare Dura, ha-niḳra, Isur ṿe-heter /

VCPLSHThis book is from the private library of Mattityahu Strashun.BSLW YIVOL Clean-up ProjectDigital imag