Profil épidémiologique des patients consultants et des cas positifs Covid-19 de l'unité de triage EHU Oran (mars 2020 - août 2020) / Epidemiological profile of consulting patients and Covid-19 positive cases in the triage unit - EHU Oran (March 2020 - August 2020)

Introduction. En décembre 2019, la population de Wuhan, une grande ville chinoise de 11 millions d'habitants, est atteinte par une pneumonie virale extrêmement contagieuse due au coronavirus SARSCoV-2. En Algérie, le premier cas a été identifié le 25 février 2020, un plan de riposte national élaboré par le ministère de la santé a été mis en place pour affronter l'épidémie. Dès le début de la pandémie, l'établissement hospitalier et universitaire d'Oran (EHUO), centre de soins de première ligne, d'une capacité 780 lits desservant environ 2 millions d'habitants s'est complètement réorganisé, en aménageant principalement des circuits pour le tri des patients « suspects Covid 19 ¼. L'objectif de notre travail consiste à décrire le profil épidémiologique des patients consultants et des cas incidents Covid-19 au niveau de l'unité de triage EHUO depuis le début de l'épidémie au 07 Aout 2020. Méthodes. Les données sont collectées à partir des enquêtes épidémiologiques auprès des patients consultant au niveau de l'unité de triage Covid-19 de l'EHUO. Résultats. À la date du 7 aout 2020, un total de 7110 cas suspects de Covid-19 ont été enregistrés. Du total des cas suspects, 3036 (42,7 %) étaient positifs par RT-PCR. Il s'agissait de 1421 de sexe masculin (46,8 %) et de 1615 de sexe féminin (53,2 %), soit une sex-ratio de 0,88. La répartition globale des cas Covid19 par tranches d'âge était la suivante : 21,9 % des patients avaient un âge entre 30 et 39 ans, 17,3 % entre 40 et 49 ans. Le tableau clinique était dominé par la toux (26,5%), suivi de céphalées (19 %), de fièvre (16,2 %) et d'anosmie (15,9 %). 234 patients (7,7 %) avaient une SpO2 < 95 %. Conclusion. L'épidémiologie de l'infection Covid 19 reste encore peu connue à l'heure actuelle dans notre wilaya. Un dépistage de masse permettrait d'avoir une vision plus claire sur le nombre réel de patients atteints. La Covid 19 est une infection avec un large panel de symptômes autres que respiratoires, souvent non spécifiques, faisant d'elle une pathologie difficile à diagnostiquer cliniquement, d'où la nécessité de la confirmation biologique (PCR).

Hearing and vision screening for preschool children using mobile technology, South Africa

Objective:To implement and evaluate a community-based hearing and vision screening programme for preschool children in the Western Cape, South Africa, supported by mobile health technology (mHealth) and delivered by community health workers (CHWs).Methods:We trained four CHWs to provide dual sensory screening in preschool centres of Khayelitsha and Mitchells Plain during September 2017­December 2018. CHWs screened children aged 4­7 years using mHealth software applications on smartphones. We used logistic regression analysis to evaluate the association between screening results and age, sex and test duration, and, for hearing, excessive background noise levels.Results:CHWs screened 94.4% (8023/10 362) of eligible children at 271 centres at a cost of 5.63 United States dollars per child. The number of children who failed an initial hearing and visual test was 435 (5.4%) and 170 (2.1%), respectively. Hearing test failure was associated with longer test times (odds ratio, OR: 1.022; 95% confidence interval, CI: 1.021­1.024) and excessive background noise levels at 1 kilohertz (kHz) (e.g. OR for left ear: 1.688; 95% CI: 1.198­2.377). Visual screening failure was associated with longer test duration (OR: 1.003; 95% CI: 1.002­1.005) and younger age (OR: 0.629; 95% CI: 0.520­0.761). Of the total screened, 111 (1.4%) children were diagnosed with a hearing and/or visual impairment.Conclusion:Health-supported CHW-delivered hearing and vision screening in preschool centres provided a low-cost, acceptable and accessible service, contributing to lower referral numbers to resource-constrained public health institutions

Vision Screening to Detect Efractive Errors in Three Selected Secondary Schools in Birnin Kebbi; North West; Nigeria

Objective: The objective of this study was to determine the prevalence of uncorrected refractive error among students in three selected secondary schools in Birnin Kebbi metropolis as many children with poor vision due to refractive error remain undiagnosed and perform poorly in schools. Materials and Methods: This was a cross-sectional study that was conducted over a period of 2 months (May-June 2014). A total of 614 students were included from three randomly chosen secondary schools in Birnin Kebbi; Nigeria. Subjects were selected using random sampling technique from the list of students available through the help of their class teachers. Visual acuity (VA) was measured with a Snellen chart; while students with subnormal vision (VA = 6/9) were examined using pinhole; and subsequently referred for detailed eye examination and retinoscopy evaluation. Results: The age range was from 11 to 20 years comprising 50.8 (n = 312) males and 48.2 (n = 302) females. Refractive error in either eye was present in 30 (4.8) children. Of these; myopia was diagnosed in 18 (60) children; and then hyperopia in 7 (23.3); and astigmatism in 5 (16.7) subjects. Spectacle coverage was low as only three pupils were found to be using glasses with lack of awareness and lack of access to eye care services as major barriers. Conclusions: Uncorrected refractive error is found among secondary schools students in Birnin Kebbi; and there is a need for the establishment of regular and effective school vision screening program to detect and refer patients for treatment

Making a Difference with Vision 2020: The Right to Sight? Lessons from two States of North Western Nigeria

Settings and Aim: The World Health Organization launched in 1999 an initiative to eliminate the global avoidable blindness and prevent the projected doubling of avoidable visual impairment between 1990 and 2020 (Vision 2020: The Right to Sight). The World Health Assembly (WHA) adopted resolutions WHA 59.25; WHA 56.26 urging member states to adopt the Vision 2020 principles. More than 90 nongovernmental development organizations; agencies; and institutions; together with a number of major corporations; are now working together in this global partnership. Two neighboring states in North Western Nigeria provide eye care services using different approaches; one state uses the principles of Vision 2020; the other uses a different strategy. The aim of the study was to assess awareness and utilization of eye care services in two Nigerian states. Design: A population-based cross-sectional interview of households was conducted in two neighboring states using a structured questionnaire. Data analysis was performed using SPSS version 21 and a P 0.05 was considered as significant. Findings: Participation rate was 97 in the two states. The population in the Vision 2020-compliant state were significantly more aware about general eye care services (80 vs. 44; P 0.0005); had less proportion of households unaware of any eye care service (55 vs. 69; P 0.0005); and have a significantly higher felt the need to utilize eye care services (47 vs. 5.9; P 0.0005). The service utilization rate was however low in the two states. Conclusion: The principles of Vision 2020: The Right to Sight is adaptable to different cultures/societies and has demonstrated a potential to increase awareness and a felt need for eye care in poor resource settings

Corneal Ulcers in a Tertiary Hospital in Northern Nigeria

Background/Objective: To highlight the pattern of corneal ulcers at the Guinness Ophthalmic Unit; Ahmadu Bello University Teaching Hospital; Kaduna; Nigeria.Materials and Methods: A retrospective review of case notes of patients who presented with corneal ulcer at the Guinness Ophthalmic Unit; Ahmadu Bello University Teaching Hospital between January 1995 and December 2005. Information obtained include demographic data; presenting complaints; predisposing factors; microbiological diagnosis; use of orthodox or traditional medications before presentation; duration before presentation and; presenting and final visual acuity.Results: A total of 228 cases presented within the 10 years study period. There were 129 (56.6) males and 99 (43.4) females. The age range was 15 months to 66 years. The commonest presenting complaints was poor vision 109 (47.8) followed by lacrimation 97 (42.5) and ocular pains 96 (42.1). The common predisposing factors were trauma 117 (51.3); use of traditional eye medications 39 (17.1); self medication with topical steroids 13 (5.7) and measles 9 (4.0). The presenting visual acuity was 6/60 in 49.8 of the patients; 6/18-6/60 in 23.4; and 6/6-6/18 in 25.5 of the patients. At discharge; 45.6 had a visual acuity of 6/6-6/18; 27.2 had borderline vision (6/18-6/60); 18.0 had severe visual impairment (6/60); while 6.6 had no light perception. The commonest organisms isolated were Staphylococcus aureus in 19.7; fungal hyphae in 15.8and Streptococcus pneumoniae in 4.8.Conclusion: In this study most patients with corneal ulcer presented with poor vision and excessive lacrimation. Trauma was the commonest predisposing factor with bacterial organisms as the commonest isolate

Experience with Extra-capsular Cataract Exraction and Intra-ocular Lens Implant in Children

BACKGROUND: In developing countries congenital cataract has become an important cause of treatable blindness in childhood. However; difficulty in correcting aphakia is one of the reasons for poor visual outcome. OBJECTIVE: To determine the visual outcome after extra capsular cataract extraction and intra ocular lens implant and factors militating against good visual outcome in children. METHODS: A prospective interventional study of cataract extraction in children with intra ocular lens implant. Extra capsular cataract extraction with intra ocular lens implant was performed using the superior limbal approach. Polymethyl Methacrylate lenses were inserted. Posterior capsulotomy was done with a 25G needle bent at the tip in 26 eyes. RESULTS: Thirty two eyes of twenty five children aged between 4 months and 16 years were operated. Extra capsular cataract extraction with posterior chamber intraocular lens implant was done in 27 (83.4) eyes; plain extra capsular cataract extraction in 3 (9.4) eyes; extra capsular cataract extraction with anterior chamber intraocular lens implant in 1 (3.1) eye and vectis extraction in 1 (3.1) eye. Twenty six eyes had primary posterior capsulotomy. Thirty-two (100) eyes and 15 (60) children were blind before surgery. Result of post operative visual acuity in 18 children after refraction was 6/18 or better in 4 (22.2) children 6/24-6/60 in 11 (61.1) and 3/60 in 3 (16.7) children. CONCLUSION: Visual rehabilitation following extra capsular cataract extraction with Intra Ocular Lens Implant is encouraging in children

Causes of Low Vision and Visual Outcome after Using Low Vision Devices in Sudanese Children

Aims: To determine the main causes of low vision in Sudanese children; evaluate low vision services provided to them and to assess their visual outcome after using low vision devices (LVD) for distance and near tasks. Material and Methods: This study was conducted in Makkah Eye Complex; Khartoum and Walidain Charity Eye Hospital; Omdurman; Sudan from September 2006 to March 2006. Patients included in this study were seen first by an ophthalmologist and then refracted and assessed for LVDs by an optometrist. All children in the age group 1 - 16 years attending low vision clinics during the above mentioned period were included in the study. Results: The study included 239 children with low vision. Majority were 12 years of age and above. Few children presented before the age 6. Males were more than females (55.2and 44.8respectively). There were 20 diseases causing low vision in children; of which; retinitis pigmentosa was the commonest (16.7) followed by congenital cataract (14.2). Conclusion: Children seeking low vision consultation present at school age (12 years and above); hence; School children need to be examined regularly to diagnose low vision and its causes as early as possible; as many causes are either preventable or curable at early stages. Ophthalmologists and optometrists must be aware about the benefit and value of using LVDs for children

Presenting Visual Acuities in a Referral Eye Center in an Oil-Producing Area of Nigeria

Objectives: To determine the pattern of presenting visual acuities at an eye center in the Niger Delta region of Nigeria. Study Design: Retrospective chart review Methods: A retrospective review of patient records attending a private referral eye center providing services for company patients and the general public in the region. Information was obtained from computerized medical records of 6533 patients who attended the center for various eye concerns in a 5-year period (January 1998 to December 2002). Results: A total of 6533 patients were seen in this 5-year period of which 2472 (37.8) were company patients and 4061 (62.2). were private patients. There were 3879 males (59.4) and 2654 females (40.6). A visual acuity of 6/6 or better was seen in 50.8of the patients. In 76.6of patients; a visual acuity of 6/18 or better was recorded. There were 21.4of patients in the low vision group. Bilateral blindness occurred in 2.1of patients. Monocular blindness occurred in 3.7of patients. Low vision occurred in 16.9of company patients and 24.1of private patients. Bilateral blindness occurred in 0.9of company patients and 2.7of private patients; while monocular blindness occurred in 1.2of company patients and 5.2of private patients. The main ocular problems were refractive error; glaucoma; conjunctivitis; headaches; ocular trauma; retina and related pathologies; cataract; uveitis; pterygium and corneal problems. Conclusion: The incidence of low vision and blindness is high in the oil-producing area of the Niger Delta region of Nigeria. Low vision and blindness were more common in private patients than in company patients

Simple Vision Screening in Lower Primary School Children in Port Harcourt City

Background: Vision disorders are significant causes of morbidity worldwide and in children; can lead to life long visual impairment or blindness. Thus; the impact on a child's education and life if not detected and ameliorated on time; can constitute a huge socio-economic burden to the child; family and community. Aim: To determine the prevalence of reduced vision in lower primary school children in Port Harcourt city. Methods: A multi-staged sampling technique was used to select 1;234 lower primary school pupils from 12 schools in Port Harcourt for visual screening. Visual acuity (VA) measurements using Snelling's charts; and a basic eye examination using a pen torch was carried out in all the pupils. Vision was regarded as reduced if VA is 6/18; in which case a pinhole was presented to the affected eye and VA repeated; to check for presence of refractive error. Results: A total of 1;234 school children were screened; 73 pupils had reduced vision in one or both eyes giving a prevalence of 5.9. Refractive errors accounted for 72.6of cases of reduced vision. Gross external eye abnormalities accounted for 9.6of cases of reduced vision; with corneal opacity and nystagmus being the most commonly seen. Conclusion: Reduced vision is an important cause of visual disability in primary school pupils in Port Harcourt city; mostly due to correctable refractive errors. There is therefore a need for routine vision screening of all pupils; especially on commencement of school for early detection and treatment; to prevent life long visual disability

A review of the changes in the ophthalmic and visual system in pregnancy

Pregnancy is often associated with ocular changes which may be more commonly transient but occasionally, permanent. It may be associated with the development of new ocular conditions, or can exacerbate pre-existing conditions. The ocular effects of pregnancy may be physiological or pathological or may be modifications of pre-existing conditions. Adnexial changes include chloasma, spider angiomas and ptosis. Anterior segment changes include a decrease in conjunctival capillaries and an increase in the granularity of conjunctival venules and in corneal curvature, changes in corneal thickness, refractive index, accommodation and refractive errors, and a decrease in intraocular pressure. Posterior segment changes include worsening of diabetic retinopathy, central serous chorioretinopathy, increased risk of peripheral vitreochorioretinal dystrophies and retinal detachment, and a beneficial effect on non-infectious uveitis. Systemic disorders of importance include preeclampsia, Graves disease and multiple sclerosis. Intracranial disorders with ocular effects in pregnancy include Pseudotumor cerebri, prolactinomas and Sheehan's syndrome (Afr J Reprod Health 2008; 12[3]:185-196)

Presenting Visual Acuities in a New Eye Centre in Port Harcourt : Initial Report

Background: Visual acuity is a fundamental of an eye examination. It establishes in a quantitative way how well an eye can see. Apart from being a starting point in dealing with an eye; it is also a prognostic reference point and a medico-legal tool. Very few studies directly related to visual acuities are available as many authors concentrate on blindness and visual impairment. Aim: To document the presenting visual acuity of patients seen in a new Eye Centre in Port Harcourt over a 12 -month period. Methods: The visual acuities of the first 202 patients seen at a new private eye centre were obtained from case file records. The visual acuities were then analysed from 6/6 and better to No Light Perception. The visual acuities were further analysed into satisfactory vision; low vision; bilateral and uniocular blindness. Also analysed were age and sex distribution and a panoramic overview of the ocular problems of the patients. Results: Visual acuities 6/6 and better was seen in 32.2of the patients. In functional vision groupings 78.7had satisfactory vision; while 20.9had low vision. Bilateral blindness was found in 0.5and uniocular blindness in 0.9. Males were 54.0of the patients while 46.0were female. The age range 20-50 years accounted for 63.8of the patients. Conclusion: This study has documented the prevalence of satisfactory vision; low vision; bilateral and uniocular blindness in Port Harcourt and it will serve as a reference point in future visual acuity studies in the region

La retinite pigmentaire: a propos de 22 cas observes a Brazzaville

Les auteurs ont rapporte leur experience de la retinite pigmentaire a partir de 22 cas colliges en 42 mois. La frequence hospitaliere a ete de 1;6 pour 1000 consultants. Les principaux signes d'appel ont ete l'hemeralopie (22 cas); la baisse de l'acuite visuelle (18 cas); et la dyschromatopie (12 cas). La retinite pigmentaire etait isolee dans 16 cas; peripherique et bilaterale dans 14 cas. La baisse de l'acuite a ete d'autant plus frequente que le malade etait plus age. Les auteurs ont insiste sur l'interet d'un caryotype et d'un electroretinogramme pour le depistage precoce et l'orientation des enfants dans les centres specialises pour malvoyants