Seroprevalence of Chlamydia trachomatis in Enugu, Nigeria

Background: Chlamydia infections in women cause pelvic inflammatory disease, which often results in devastating consequences of infertility, ectopic pregnancy, or chronic pelvic pain. The infection is largely asymptomatic.Objective: To determine the seroprevalence of Chlamydia trachomatis in Enugu, South Eastern Nigeria.Materials and Methods: A population-based prospective study comprising female residents of Enugu, South Eastern Nigeria. Indirect solid phase enzyme immunoassay of Chlamydia antibodies was done using ImmunoComb C. Trachomatis IgG Kit (Orgenics).Results: The population comprised 136 female undergraduate students and 150 non-student women. The overall prevalence of C. trachomatis in the population studied was 29.4%. The percentage of subjects who admitted to be having multiple sexual partners was higher among the student population (71.2%) compared to those from the nonstudent population (28.8%). The highest percentage of seroprevalence was 28 (33.3%) in the age group of 20-24 years for the student population and 18 (21.4%) in the age group of 25-29 years for the non-student population. The highest seroprevalence of C. trachomatis antibodies (69.0%) in both populations was observed in females without any history of infection. Females that had pelvic inflammatory disease, sexually transmitted infection, and secondary infertility assayed for C. trachomatis had seroprevalence levels of 19%, 9.5%, and 2.4%, respectively. There was a positive correlation between positive Chlamydia assay and the type of subject population (student or non-student) with r2 value of 1.55 at P < 0.01.Conclusions: C. trachomatis infection is largely underdiagnosed and remains a silent disease in the apparently healthy population of Enugu, South eastern Nigeria

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Pattern of Eye Disorders among Inmates of a Nigerian Prison

Aim: To determine the prevalence of eye disorders among the inmates of a Nigerian prison with a view to providing eye health care for the prisoners. Methods: A cross sectional survey of the ocular health status of the prisoners in a Nigerian prison was carried out using a pretested protocol designed for the study. Data was obtained on bio-data as well as anterior and posterior segment examinations. These were analyzed using EPI-INFO version 6.0. Results: Two hundred and sixty-nine (26.8%) out of the 1005 prisoners examined had eye disorders. The commonest ocular problems noted were presbyopia (21.5%), pterygium (19.3%) refractive error (15.6%) and allergic conjunctivitis (12.5%). One inmate (0.1%) was blind; 12 (1.2%) had monocular blindness while 5(0.5%) had low vision. Cataract was the commonest cause of monocular blindness and also the only cause of bilateral blindness. Conclusion: The prevalent eye diseases in the prison community are similar to the findings in the general population. There is a need to train the staff of the medical clinics in Nigerian prisons as integrated eye health workers to enable them meet the basic eye health needs of the prisoners.Keywords: Presbyopia, Refractive Error, Prisoner

Indications for Enucleation of the Eyes of Children in Eastern Nigeria

Objective: To determine the reason for enuleation of the eyes among children in eastern Nigeria as this should serve as a guide for initiating appropriate prevention measures where possible. Materials and Methods: A retrospective study of records of enucleated eyes from children aged 15 years or less received in a central laboratory service situation in Enugu, eastern Nigeria, over a 29-year period (20/2/70-19/2/99) was undertaken. Results: A total of 82 enucleated eyes were received. Retinoblastoma accounted for 36 (56.1%) enucleations, both sex being equally affected. Avoidable ocular problems resulting in enucleations such as panophthalmitis, endopphthalmitis, some staphyloma and others were noted in as high as 42.7% Trauma, measles and corneal ulcers of unknown aetiology preceded most of these. Conclusions: A significant proportion of enucleation among children in eastern Nigeria is due to avoidable causes, Health education and other positive measures to reduce the incidence of avoidable enucleations are advocated. KEY WORDS: Eye Enucleations, Children, retinoblastoma, Avoidable Enucleations [Nig. J. Ophthalmology Vol.10(1): 21-23

The outcome of complementary and alternative medicine use among pregnant women in South-East Nigeria: a multi-centre prospective study

There is a global increasing trend of complementary and alternative medicine (CAM) use among pregnant women. This study aimed at determining the maternal and perinatal outcome of CAM use among the pregnant women in South-East Nigeria. This was a prospective study in which self-administered semi-structured questionnaires were used to collate information from the consenting pregnant women who use CAM and those who did not use CAM from the gestational age of 36 weeks at four hospitals in South-East Nigeria. Both groups were matched for age, parity and address. Every participant was followed up until delivery. Data were analysed using SPSS version 23 (SPSS Inc., Chicago, IL). This study’s ethical clearance number was NHREC/05/01/2008B-FWA00002458-1RB00002323 and it was obtained at UNTH and on February 15 2019. CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of babies when compared with non-CAM users (p value= <.05). In conclusion, CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them.Impact Statement What is already known on this subject? There is an increasing trend of CAM use among pregnant women in the world. Pregnancy is associated with certain conditions that predispose women to CAM use. The clinical indications for CAM use by the pregnant women are nausea and vomiting, labour pain, induction of labour, pedal oedema and waist pain. What the results of this study add? CAM use in pregnancy was associated with low haemoglobin concentration, maternal complications, high caesarean section rate, low birth weight, low APGAR score, large placental weight and high hospital admission of the babies when compared with non-CAM users. What the implications are of these findings for clinical practice and/or further research? CAM use in pregnancy was associated with poor maternal and perinatal health indices, hence the need to implement policies aimed at reversing them