Prevalence of myopia and its socio-demographic distribution amongst secondary school going adolescents in Lurambi Sub-County, Kakamega, Kenya

Background: Globally the prevalence of myopia has increased alarmingly and is expected to affect an estimated 2.56 billion people in the world by the end of 2020. It is believed to be the leading cause of visual impairment in Kenya, contributing 59.5% of all causes of visual impairment. Still, agreement on the exact prevalence in Kenya and whether socio-demographic factors have an influence on myopia is unknown. This study was aimed at evaluating the prevalence of myopia and its socio-demographic distribution amongst randomly selected school-going adolescent. This study was conducted in Lurambi Sub-County in Kakamega, Kenya. Material and methods: The study adopted a school-based cross-sectional descriptive study design. Using a multi-stage sampling technique, 733 participants from a population of 7,400 secondary school students within Lurambi Sub-County were randomly selected. A standard optometric vision-assessment protocol was applied to those who met the inclusion criteria and cycloplegic refraction was conducted to elicit those who had myopia. Results: The prevalence of myopia was found to be 7.5% of which 29 (52.7%) were male while 26 (47.3%) were female and there was no association between gender and myopia (p = 0.572). Myopia was found to be more prevalent in urban 49 (87.3%) as compared to rural 7 (12.7%) areas and there was no association between place of residences and myopia (p = 0.381). Similarly, 15–18 years was the dominant age group 39 (70.9%) and there was no association between age and having myopia (p = 0.926). The study also found that there was no association (p = 0.207) between school class of the participants and having myopia, although most myopic cases were in the form four class 15 (27.3%). Conclusion: Myopia was found to be mostly prevalent in the urban setting and upper classes as compared to rural and lower classes. This may link myopia to other risk factors such as near work and outdoor activities, but more research needs to be done in these areas.

Impact of surface treatments on the sorption and solubility of a heat-cured denture base material

Removable dentures fabricated from polymethylmethacrylate material are the most common prostheses used to treat edentulism worldwide. This research aimed to compare the sorption and solubility characteristics of a mechanically polished heat-cured acrylic denture material and a light-cured varnished material against non-treated material, all of which were soaked in distilled water. A total of 45 specimens were prepared and tested according to the ISO Standard 20795-1: 2013 (E) to test for sorption and solubility. The data were analysed through one-way analysis of variance (ANOVA) and Tukey-Kramer multiple comparison test

Factors associated with uncorrected refractive errors in school-going adolescents in Kakamega County, Kenya

Background: Uncorrected refractive errors (URE) present an enormous burden on children in Kenya. The study investigated factors associated with URE in school-going adolescents in Kakamega County, Kenya. Material and methods: An observational, cross-sectional study with multistage sampling was conducted with randomly selected secondary school students in forms one to four. Comprehensive clinical examinations conducted by optometrists were used to determine participants’ URE types and dioptric strength. Structured pre-validated questionnaires were administered to participants to elicit information on their sociodemographic and socioeconomic statuses. Results: A total of 165 students, aged 17.45 ± 1.44 years, with URE classified into myopia, hyperopia, and astigmatism, participated in the study. There were more males (57%) than females in this study, and most participants had astigmatism (52%). The study found no-to-weak association between predefined factors and URE. While males had decreased odds [odds ratio (OR): 0.557, 95% confidence interval (CI): 0.211–1.470] for myopia than astigmatism, the converse was true for hyperopia (OR: 1.165, 95% CI: 0.385–3.524) compared with astigmatism. Even though participants from families with lower affluence and living in rural settings had up to 18 times increased odds (OR: 18.699, 95% CI: 0.840–416.442) for myopia than astigmatism and hyperopia, significant dioptric power was less likely to be present in those with myopia (OR: 0.529, 95% CI: 0.165–1.698) and hyperopia (OR: 0.011, 95% CI: 0.001–0.192). Conclusions: URE may not be significantly associated with school-going adolescents’ sociodemographic and socioeconomicstatuses. However, myopia and astigmatism are increasingly likely to be present among participants from families with lower affluence and living in rural settings

Emerging technologies in artificial ocular devices: A systematic review

Background: Recent developments in vision restoration include visual prostheses designed to electrically stimulate artificial vision in those who have lost their sight. Major efforts in this area include multi-electrode arrays surgically implanted at various placement areas throughout the visual pathway. Visual prosthetic devices are named according to these placement areas (cortical, optic nerve, sub-retinal and epiretinal). These devices attempt to restore sight for retinal degenerative diseases such as Retinitis Pigmentosa (RP) and Age-related Macular Degeneration (AMD). Aim: To summarise the emerging technologies in the development of artificial ocular devices. Methods: The search methodology comprised seven databases for articles published between January 2000 and March 2017. Outcome data were analysed descriptively with results summarised in a Microsoft Excel database. Both quantitative and qualitative methodologies were used, and the main findings are discussed in a narrative format. Results: Eighty-nine full-text articles were included in this systematic review. Conclusion: The primary goal of these artificial devices is to provide functional vision in order to perform normal daily activities. Even though recent clinical trials in certain countries have shown advances in the development of various vision-restoring devices, they do not produce the same experience for the majority of patients and are unable to completely restore normal vision. The most common type of device according to its placement is the epiretinal device which is also the most successful device as determined in the majority of clinical trials

Biomarkers as a predictor for diabetic retinopathy risk and management: A review

Background: The systemic and ocular manifestations of diabetes are an increasing burden on both private and public healthcare systems. The ability to accurately predict patient susceptibility and prognostic implications of the disease is essential to its optimal management and planning. Aim: The purpose of this paper was to review alternative biomarkers to those currently in use regarding the diagnosis and prognosis of diabetes and the ocular effects of the disease. Current biomarkers include Fasting Plasma Glucose (FPG), Oral Glucose Tolerance Test (OGTT) and Glycolated Haemoglobin (HbA1c). Methods: The research strategy comprised of a comprehensive literature review of articles from Mendeley, Cochrane and Elsevier with additional input from experts in the field serving as co-authors. Results: The review found that there are alternative biomarkers to those currently utilised. These include adiponectin, apolipoprotein B, C-reactive protein and ferritin. Fructosamine, while useful where whole blood is available, is unreliable as a diagnostic biomarker resulting in a 10% variation coefficient. Post-prandial glucose (PPG) measurement most closely predicted HbA1c. Conclusion: With prediction of risk for diabetes in individuals, a value combination, expressed as either a numerical score or a percentage, consisting of adiponectin, apolipoprotein B, C-reactive protein and ferritin, almost doubled the relative risk of contracting the disease. Eye care practitioners need to question diabetic patients about their FPG and HbA1c levels and encourage them to have the relevant tests regularly, including PPG. The importance of biomarkers should be emphasised and used as an educational tool to facilitate better diabetes management and treatment adherence

Building consensus for the development of child eye care services in South Darfur State of Sudan using the Delphi technique

Background: Global estimates suggest there are almost 19 million visually impaired children worldwide, most of whom reside in poor countries, with the major cause being treatable. Aim: To determine the barriers to accessing childhood eye care services and to develop an eye care plan for children in South Darfur State, Sudan. Setting: The study took place in South Darfur State, Sudan. Methods: The classical Delphi technique was used to build consensus on a list of statements, which were generated based on the themes established by the experts, as well as on an extensive literature review. Results: Response rates ranged from 90% in the first round (n = 18), 100% in the second round (n = 18) to 89% in the third and final round (n = 16). The total number of statements recommended by the Delphi panellists for development of the paediatric eye care plan, was 60 based on a consensus level of 80% agreement or more. The expert’s consensus on the following key elements for promotion and improvement of child eye care: The main barriers to accessing child eye care were high poverty rate, unavailability of child eye services and a lack of community awareness. The challenges facing visually impaired children were an absence of paediatric ophthalmologists, low vision and orthoptic services. Conclusion: The main barriers to accessing child eye care services were financial, clinical access and lack of knowledge. There should be greater collaboration between the Ministries of Health, Education and non-governmental organisations (NGOs), to work together in addressing these barriers

Genetic perturbation of PU.1 binding and chromatin looping at neutrophil enhancers associates with autoimmune disease.

Neutrophils play fundamental roles in innate immune response, shape adaptive immunity, and are a potentially causal cell type underpinning genetic associations with immune system traits and diseases. Here, we profile the binding of myeloid master regulator PU.1 in primary neutrophils across nearly a hundred volunteers. We show that variants associated with differential PU.1 binding underlie genetically-driven differences in cell count and susceptibility to autoimmune and inflammatory diseases. We integrate these results with other multi-individual genomic readouts, revealing coordinated effects of PU.1 binding variants on the local chromatin state, enhancer-promoter contacts and downstream gene expression, and providing a functional interpretation for 27 genes underlying immune traits. Collectively, these results demonstrate the functional role of PU.1 and its target enhancers in neutrophil transcriptional control and immune disease susceptibility

Twenty-first century glacier slowdown driven by mass loss in High Mountain Asia

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Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p