Eye health myths, misconceptions and facts: results of a cross-sectional survey among Nigerian school children

Background. Vision is critical in the development and performance of children. Factual knowledge of eye health is important for preventive and promotive eye health. Objectives. To identify eye health myths and misconceptions that are considered true in a population of Nigerian school children, with the aim of prioritizing eye health messages. Material and methods. In a cross-sectional survey, self-administered questionnaires were used to obtain pupils’ views, which were elicited using statements presented as 22 ocular health myths/misconceptions and three facts in two selected secondary schools in Enugu state, Nigeria in October 2014. Frequency counts and percentages were generated using SPSS v18. A p-value of <0.05 was considered statistically significant. Results. The sample comprised 404 males (48.5%) and 429 females (51.5%), age range 10–17 years, median 13–14 years; IQR –6). More pupils in the senior classes had previously listened to eye health talks. The most common beliefs concerned the statements “staying close to the television set will damage vision” 782 (93.9%), and “reading in dim light will damage vision” 758 (90.8%). The least commonly-held misconception was “children do not need regular eye checks” 119 (14.3%). The greatest amount of uncertainty concerned the statements “short-sightedness is worse than long-sightedness” 421 (51%), and “crossed-eye disorders cannot be corrected in children” 383 (46%). Conclusions. The majority of the children do not have information on eye health. Despite the persistence of these myths and misconceptions, this study has demonstrated that the children had a reasonable level of knowledge in terms of safe eye care practices. However, appropriate eye health messages still need to be provided

Technical capacities needed to implement the WHO's primary eye care package for Africa: results of a Delphi process.

OBJECTIVE: The aim of the study was to establish the technical capacities needed to deliver the WHO African Region's primary eye care package in primary healthcare facilities. DESIGN: A two-round Delphi exercise was used to obtain expert consensus on the technical complexity of each component of the package and the technical capacities needed to deliver them using Gericke's framework of technical feasibility. The panel comprised nine eyecare experts in primary eyecare in sub-Saharan Africa. In each round panel members used a 4-point Likert scale to indicate their level of agreement. Consensus was predefined as ≥70% agreement on each statement. For round 1, statements on technical complexity were identified through a literature search of primary eyecare in sub-Saharan Africa from January 1980 to April 2018. Statements for which consensus was achieved were included in round 2, and the technical capacities were agreed. RESULTS: Technical complexity statements were classified into four broad categories: intervention characteristics, delivery characteristics, government capacity requirements and usage characteristics. 34 of the 38 (89%) statements on health promotion and 40 of the 43 (93%) statements on facility case management were considered necessary technical capacities for implementation. CONCLUSION: This study establishes the technical capacities needed to implement the WHO Africa Office primary eye care package, which may be generalisable to countries in sub-Saharan Africa

Chlorproguanil−Dapsone−Artesunate versus Artemether−Lumefantrine: A Randomized, Double-Blind Phase III Trial in African Children and Adolescents with Uncomplicated Plasmodium falciparum Malaria

Chlorproguanil−dapsone−artesunate (CDA) was developed as an affordable, simple, fixed-dose artemisinin-based combination therapy for use in Africa. This trial was a randomized parallel-group, double-blind, double-dummy study to compare CDA and artemether−lumefantrine (AL) efficacy in uncomplicated Plasmodium falciparum malaria and further define the CDA safety profile, particularly its hematological safety in glucose-6-phosphate dehydrogenase (G6PD) -deficient patients

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Eye Injuries among Primary School Children in Enugu, Nigeria: Rural vs Urban

A cross-sectional survey of the prevalence of eye injuries among primary school children in two noncontiguous local government areas of Enugu State of Nigeria was undertaken. One of the local government areas was urban, while the other one was rural. Children who were <15 years in two randomly selected primary schools in the urban area and three randomly selected schools in the rural area were interviewed and examined with Snellen chart, pen torch, head loupe, and direct ophthalmoscope. The findings were recorded using a semi-structured questionnaire and the World Health Organization Programme for Prevention of Blindness (WHO/PBL) eye examination form. Training on visual acuity measurement was done for each of the class teachers. A total of 1,236 children <15 years of age were studied and analyzed. Slightly more females, 652 (52.8%), than males, 584 (47.2%), constituted the sample population giving a female/male ratio of 1.1:1. A total of 98 (7.93%) children had evidence of injury to the eye or its adnexa. Eyelid scar was the commonest (5.34%) followed by eyebrow scar (2.10%). Canthal scar was the next (0.32%). Two girls had monocular blindness from eye trauma (0.16%). One had leucoma, while the other had a dislocated lens. All the monocular blind children of this study were from the urban area. The home was the commonest environment for an eye injury (69.39%) followed by the school (20.41%). The farm was next in frequency (7.14%), especially among boys in the rural area. The church and the road/street constituted the remainder. Regarding persons causing the injury, the child's playmate was the commonest (55.10%) followed by self (27.55%). Parents and guardians were the next (9.18%). These were injuries associated with corporal punishment. Corporal punishment-related eye injury, according to this study, appears to be common in the rural area and affects boys predominantly. Other human intermediary agents that cause an eye injury include passersby (2.04%), RTA (2.04%), siblings (2.04%), and others (1.02%). The primary agents that caused an eye injury were sticks/wood, 29 (29.60%); stone, 21 (21.43%); pieces of metal, 19 (19.39%); fall, 10 (10.20%); fight/fist blow, 9 (9.918%); plastic, 2 (2.04%); fingernails, 2 (2.04%); farm tools/fruits, 2 (2.04%); and RTA, glass, and headbutt, each 1.02%. Farm implements/fruits as well as fingernails appear to be fairly common primary agents that cause an eye injury in the rural Enugu, Nigeria. In terms of prevalence, there was no significant difference between the urban and rural areas. The findings from this study showed a high prevalence of eye injury among primary school children. In terms of treatment, 58.16% of the children with an eye injury had no form of treatment for it. The children from this study with monocular blindness did not receive adequate medical treatment. Treatment of an eye injury, according to this study, was sought from chemists (19.39%), at hospital/health centers (16.33%), at home (3.06%), and from traditional healers (3.06%). The persons who treated an eye injury, as observed from this study, were doctors (14.29%), nurses (4.08%), chemists (17.35%), and traditional healers and fathers (3.06% each). The frequency of noninjury-related diagnosis made in this study was refractive error, 4.85%; allergic conjunctivitis, 1.94%; oculocutaneous albinism, 0.24%; prepapillary vascular loops, 0.40%; and then ptosis, exotropia, stye, corneal opacity, and retinitis pigmentosa, 0.08% each. The annual incidence of an eye injury according to this study was 3.48%. The majority of the causes of an eye injury, as per this study, were preventable. Appropriate promotion of preventive eye care among children may go a long way in reducing the burden of blindness from eye injuries

Visual acuity and refractive changes among pregnant women in Enugu, Southeast Nigeria

Introduction: Pregnancy has been associated with changes in the eye which could be physiological, pathological, or exacerbation of pre-existing ocular conditions. Visual acuity (VA) and refractive error (RE) changes are part of the physiological changes that may occur during pregnancy. Objective: The objective of the present study was to investigate changes in VA and RE across two different trimesters and six weeks postpartum among pregnant women in Enugu, southeast, Nigeria. Materials and Methods: A longitudinal study was adopted and pregnant women in their second trimester attending antenatal clinic at University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu were consecutively recruited. A questionnaire was used to obtain information on their sociodemographic and clinical characteristics. Visual acuity was measured and refractive error monitored in second and third trimesters and 6 weeks after delivery. Results: The mean age of women was 30.81 (±5.49) years and a majority of them were civil servants. There was a worsening of VA for distance in more women in the third trimesters compared to the second trimester. There was no significant change in VA for near throughout the study period. There was an increased myopic shift in more pregnant women during the third trimester (40; 40.0%) compared to second trimester (36; 36.0%). The most common refractive error found among the women was simple myopia. These changes resolved six weeks postpartum. Conclusion: Pregnancy worsened VA for distance and the most common RE in pregnant women was simple myopia. However, these changes resolved during the postpartum period

What happens after helping babies breathe training is complete? A prospective cohort study of Nigerian health care workers

Background: Neonatal mortality remains disturbingly high in Nigeria. Helping Babies Breathe (HBB) is an evidence- based neonatal resuscitation (NR) educational program designed to teach NR in resourcelimited areas. There is no information in Nigeria on what happens after health careworkers (HCWs) complete HBB training.Aim: To determine if HCWs who received HBB training utilized the acquired knowledge and skills (K&amp;S) and engaged in any ongoing peer training. In addition, we studied HCW turnover one year after HBB training completion.Subjects and Methods: Seventy-two HCWs were trained in HBB, and surveyed 1 year later using a 10-item questionnaire. Data analysis used measures of central tendency and t testing.Results: Most HCWs reported the use of HBB daily. The commonest NR method used was suctioning (89.5 %), followed by drying and positioning (86%), however there was 0% reported use of bagmask- ventilation. Most HCWs (98%) reported sharing K&amp;S with colleagues. Following training,100% HBB trainers remained at original employment but 53% HBB providers moved to new employment and did not utilize their HBB K&amp;S at their new employment site.Conclusion: Frequent, brief, refresher practice sessions and implementation of a system for training new hires may improve HCW readiness for NR and their peer mentoring capabilities. Ensuring adequate equipment availability is critical for HCW to utilize acquired K&amp;S. Significant HCW turnover occurred within a year of training. Trained HCW who left to new employment subsequently had limited impact at their new place of employment

Kuluttajabarometri maakunnittain 2000, 2. neljännes

Suomen virallinen tilasto (SVT

Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery

This was an investigator-initiated study funded by Nestle Health Sciences through an unrestricted research grant and by a National Institute for Health Research (UK) Professorship held by R.P. The study was sponsored by Queen Mary University of London