Prevalence of Trachoma in Pre-validation Surveillance Surveys in 11 Evaluation Units (Covering 12 Districts) in Oromia Regional State, Ethiopia: Results from 2018−2020

PURPOSE: Interventions to reduce the prevalence of trachoma and transmission of ocular Chlamydia trachomatis have been implemented in Oromia Region, Ethiopia. Following an impact survey in which the trachomatous inflammation—follicular (TF) prevalence in 1–9-year-olds is <5%, a surveillance survey is recommended 2 years later, without additional antibiotic treatment. We report results of surveillance surveys in 11 evaluation units (EUs) covering 12 districts in Oromia Region, to plan whether future interventions are needed. METHOD: We use a two-stage cluster-sampling cross-sectional survey design. In each EU, 26 clusters (villages) were systematically selected with probability proportional to size; from each cluster, 30 households were selected using compact segment sampling. Water, sanitation and hygiene (WASH) access was assessed in all selected households. All residents of selected households aged ≥1 year were examined for TF and trachomatous trichiasis (TT) by certified graders. RESULT: Of 31,991 individuals enumerated, 29,230 (91% of) individuals were examined. Eight EUs had an age-adjusted TF prevalence in 1−9-year-olds of ≥5% and seven had a TT prevalence unknown to the health system among adults aged ≥15 years of ≥0.2%. About one-third of visited households had access to an improved water source for drinking, and 5% had access to an improved latrine. CONCLUSION: Despite TF reductions to <5% at impact survey, prevalence recrudesced to ≥5% in all but three of the 11 EUs. Operational research is needed to understand transmission dynamics and epidemiology, in order to optimise elimination strategies in high-transmission settings like these

Prevalence of Trachoma after Implementation of Trachoma Elimination Interventions in Oromia Regional State, Ethiopia: Results of Impact Surveys in 131 Evaluation Units Covering 139 Districts

PURPOSE: To determine the prevalence of trachomatous inflammation—follicular (TF), trachomatous trichiasis (TT), water, sanitation, and hygiene (WASH) access in 131 evaluation units (EUs) after implementation of trachoma elimination interventions in Oromia Region, Ethiopia. METHODOLOGY: A population-based cross-sectional survey was conducted in each EU using the World Health Organization-recommended two-stage cluster-sampling methodology. Twenty-six clusters, each with a mean of 30 households were enumerated in each EU. All residents aged ≥1 year in selected households were examined for TF and TT. Information on WASH access in surveyed households was also collected through questioning the household head and direct observation. RESULTS: A total of 419,858 individuals were enumerated in 131 EUs, of whom 396,134 (94%) were examined, 54% being female. Age-adjusted EU-level prevalence of TF in children aged 1–9 years ranged from 0.15% (95% confidence interval [CI]: 0.0–0.4) to 37.5% (95% CI: 31.1–43.7). The TF prevalence was <5% in 73/131 (56%) EUs. The EU-level age- and gender-adjusted prevalence of TT unknown to the health system among people aged ≥15 years ranged from 0.001% (95% CI: 0.00–0.02) to 2.2% (95% CI: 1.1–3.1) with 37/131 (28%) EUs having a prevalence <0.2%. Only 48% of all households surveyed had access to improved water sources for drinking. Approximately 96% of households did not have an improved latrine. CONCLUSION: Oromia is on the path towards elimination of trachoma as a public health problem

Blinding trachoma among refugees: complicating social disaster

Objective:: To determine the prevalence of blinding trachoma among refugees in South Western Ethiopia. Methods:: A cross-sectional outreach clinic based descriptive study was conducted on 1 054 refugees in Southwest Ethiopia. A basic eyelid and cornea examination for signs of trachoma was done by using 2.5× binocular magnifying loupe. The findings were classified by using the World Health Orgnization simplified trachoma grading system and data were analyzed by using SPSS version 16.0. Results:: A total of 1 054 refugee patients were examined for trachoma, 179 (16.98%) of them had clinical signs of trachoma. About 6 (3.35%) patients had active trachoma with trachomatous trichiasis (TT), 47 (26.26%) patients had TT only and the rest 126 (70.39%) patients had TT with trachomatous corneal opacity. All of the trachoma patients had blinding trachoma (TT with or without trachomatous corneal opacity), and about 60.89% of them had visual impairment. Blinding trachoma was significantly more common among females, patients in age group of 16-59 years, married patients, illiterates and Fugnido camp settlers (P<0.05). Conclusions:: There is a very high burden of blinding trachoma among refugees. Urgent surgical intervention is needed to prevent blindness and low vision in the study subjects, and targeted regular outreach-based eye care service should be commenced

Vision loss and psychological distress among Ethiopians adults: a comparative cross-sectional study.

BACKGROUND:Vision loss causes major changes in lifestyle and habits that may result in psychological distress and further reduction in the quality of life. Little is known about the magnitude of psychological distress in patients with vision loss and its variation with the normal. The aim of this study is, therefore, to investigate the psychological effects of vision loss and its determinants among Ethiopians. METHODS:A comparative cross-sectional study was conducted on adults attending the Eye clinic of Jimma University Hospital. One hundred fifteen consecutive adults with visual loss at least in one eye and 115 age-and sex-matched controls with normal vision were studied. The psychological distress was measured using standardized Self-Reporting Questionnaire (SRQ-20). Chi-square test and logistic regression were carried out and associations were considered significant at P<0.05. RESULTS:The overall prevalence of psychological distress was 33.4%. While psychological distress was found in 49.8% of patients who had loss of vision at least in one eye, only 18.3% of the controls had it. In the adjusted analysis, patients with vision loss had 4.6 times higher risk of suffering from psychological distress compared to patients with normal vision (AOR 4.56; 95% CI 2.16-9.62). Moreover, patients with vision loss in both eyes (AOR 4.00; 95% CI 1.453-11.015) and with worse visual acuity in the better eye (AOR 3.66; 95% CI 1.27-10.54) were significantly more likely to have psychological distress than those patients with vision loss in one eye only and good visual acuity in the better eye respectively. The cause of visual loss, pattern of visual loss, duration of visual loss and sociodemographic variables did not influence the likelihood of having psychological distress. CONCLUSION:Prevalence of psychological distress was significantly higher in patients with visual loss compared to patients with normal vision. There is a need for integration of psychosocial care into the current medical and surgical treatment of patients with vision loss

Clinical Presentation of Retinoblastoma in Ethiopia: A Case of Jimma University Medical Center Pediatric Oncology Unit, Southwest Ethiopia

BACKGROUND፡ Retinoblastoma (RB) is one of the most curable childhood cancers if early detected and treated. Late presentation complicates the management of RB results in dismal treatment outcome. Objective: The aim of this study is to report the clinical presentation pattern of retinoblastoma patients seen at Jimma University Medical center (JUMC).METHODS: The study was a retrospective review of retinoblastoma cases managed at JUMC between August 2016 and July 2020.RESULTS: Among pediatric oncology cases registered retinoblastoma, accounting 8.5 % (36/423) of all childhood cancer patients in the study period, 29 (90.6%) of them had unilateral retinoblastoma and 3(9.4%) of them had bilateral retinoblastoma. The average age at presentation for bilateral and unilateral retinoblastoma patients was 17 (range 3-30) months and 37.5 months (range 8-84) respectively. The first symptom observed by the family was leukocoria in 21 (65.6%) of the patients but 24(75%) of the patients presented with advanced stage (proptosis and fungating orbital mass) of the disease. The longest and the shortest lag time of presentation from the first symptom was 17 months and 2 weeks respectively with the mean lag time of 1.4 months in bilateral and 6 months in unilateralcases. Clinically, the majority of the eyes 24/35(68.6%) were extraocular tumors involving orbital tissues at presentation.CONCLUSION: Most of retinoblastoma patients presented at advanced stage of the disease and presented very late after the family observed the disease. Early detection strategies must be designed by the government and responsible stakeholders in mitigating the effects of late presentation

Crude and adjusted ratios of psychological distress, demographic characteristics and level of visual acuity.

<p>Abbreviations: COR, Crude Odd Ratio; AOR, Adjusted Odd Ratio</p

Correlation between psychological distress and clinical characteristics of visual loss.

<p>Abbreviations: COR, Crude Odd Ratio; AOR, Adjusted Odd Ratio</p

Incidence and geographic distribution of retinoblastoma in Ethiopia

Abstract Introduction Retinoblastoma is the most frequent intraocular malignancy of the eye in children, occurring in early childhood. Based on global estimates, Ethiopia is expected to observe over 200 new retinoblastoma cases per year, however without a cancer registry, this number is difficult to confirm. Therefore, the goal of the study was to determine the incidence and geographic distribution of retinoblastoma in Ethiopia. Methods A retrospective medical chart review of clinically diagnosed new retinoblastoma patients between January 1, 2017 - December 31, 2020, in four public Ethiopian tertiary hospitals was performed. The incidence of retinoblastoma was calculated by a birth-cohort analysis. Results There were 221 retinoblastoma patients observed in the study period. The incidence of retinoblastoma was found to be 1 in 52,156 live births. Incidence varied among different regions of Ethiopia. Conclusion The incidence of retinoblastoma observed in this study is likely an underestimate. It is possible that patients were undercounted because they were seen outside of the 4 main retinoblastoma treatment facilities included in this facility, or they experienced barriers to accessing care. Our study suggests a need for a nationwide retinoblastoma registry and more retinoblastoma treatment centers in the country

Prevalence of Trachoma after Implementation of Trachoma Elimination Interventions in Oromia Regional State, Ethiopia: Results of Impact Surveys in 131 Evaluation Units Covering 139 Districts

To determine the prevalence of trachomatous inflammation—follicular (TF), trachomatous trichiasis (TT), water, sanitation, and hygiene (WASH) access in 131 evaluation units (EUs) after implementation of trachoma elimination interventions in Oromia Region, Ethiopia. A population-based cross-sectional survey was conducted in each EU using the World Health Organization-recommended two-stage cluster-sampling methodology. Twenty-six clusters, each with a mean of 30 households were enumerated in each EU. All residents aged ≥1 year in selected households were examined for TF and TT. Information on WASH access in surveyed households was also collected through questioning the household head and direct observation. A total of 419,858 individuals were enumerated in 131 EUs, of whom 396,134 (94%) were examined, 54% being female. Age-adjusted EU-level prevalence of TF in children aged 1–9 years ranged from 0.15% (95% confidence interval [CI]: 0.0–0.4) to 37.5% (95% CI: 31.1–43.7). The TF prevalence was Oromia is on the path towards elimination of trachoma as a public health problem.</p