Clinical characteristics and outcomes of endophthalmitis before and during the COVID-19 pandemic

Purpose: To evaluate the clinical characteristics and visual acuity outcomes of patients who presented with endophthalmitis prior to and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This multicenter retrospective case series with historical controls included consecutive patients presenting with any form of endophthalmitis from March 1, 2019 to September 1, 2019 (pre-COVID-19) and from March 1, 2020 to September 1, 2020 (COVID-19) at Mayo Clinic Rochester (MCR), Health System (MCHS), Arizona (MCA), and Florida (MCF) sites. Cases were divided into "pre-COVID-19" versus "COVID-19" groups depending on when they first presented with endophthalmitis. Results: Twenty-eight cases of endophthalmitis presented to all Mayo Clinic sites during the study period. Of these, 10 patients presented during the first six months of the COVID 19 pandemic. During the same six-month period the year prior, 18 patients presented with endophthalmitis. Endophthalmitis etiology (post-injection, post-cataract extraction, post glaucoma filtering surgery, post-pars plana vitrectomy, endogenous, and others) was similar between both groups (P = 0.34), as was post-injection endophthalmitis rate (P = 0.69), days to presentation (P = 0.07), initial management (P = 0.11), culture-positivity rate (P = 0.70), and need for subsequent pars plana vitrectomy (P = 1). Visual acuity outcomes were similar between both groups at six months, however, the mean LogMAR visual acuity at presentation was worse in the COVID-19 group compared to the pre-COVID-19 group (2.44 vs 1.82; P = 0.026). Conclusion: Clinical characteristics and the post-injection endophthalmitis rate were similar during both periods, however, patients presented with worse vision during the pandemic suggesting that the pandemic may have contributed to delayed presentation, regardless, outcomes are still poor

Prevalence and causes of visual impairment among older persons living in low-income old age homes in Durban, South Africa

Background: Visual impairment (VI) increases with age and has been reported to be more prevalent among older adults living in old age homes than in the general population. Aim: To determine the prevalence and causes of VI among older adults living in low-income old age homes in Durban, South Africa. Setting: This study was conducted at low-income old age homes in Durban. Methods: This cross-sectional study of 118 residents aged 60 years and older, collected socio-demographic data, presenting visual acuities (VAs) for each eye, and binocularly. Anterior segment eye examinations were conducted with a penlight torch and a portable slit-lamp, while posterior segment evaluation was conducted with direct and indirect ophthalmoscopy. Objective and subjective refractions were performed, and the best-corrected distance and near VAs were measured in each eye. VI was defined as presenting VA < 6/18 and included moderate VI (< 6/18−6/60), severe VI (< 6/60 ­3/60) and blindness (< 6/120). Results: The mean age of the participants was 73.3 years and included 80.5% females and 19.5% males. The prevalence of VI and blindness was 63.6%. Optical correction significantly reduced the prevalence of VI and blindness by 19.5% (p < 0.05). The main causes of non-refractive VI and blindness were cataract (54.5%), posterior segment disorders (25.5%) and corneal opacities (20%). Conclusion: The prevalence of VI and blindness is high among residents in low-income old age homes living in Durban. Refractive correction and surgical cataract intervention can significantly reduce the burden of VI and blindness among the elderly residents

Evaluation de la qualité de vie chez les patients atteints de glaucome primitif a angle ouvert en milieu urbain

Introduction : La qualité de vie se définit par le bien-être physique, émotionnel et social d'un individu. Le Glaucome Primitif à Angle Ouvert (GPAO) est une neuropathie optique cécitante, il peut modifier la qualité de vie de par son caractère chronique et irréversible. L'objectif de cette étude était d'évaluer la qualité de vie chez les patients atteints de GPAO en milieu urbain. Patients et méthodes: il s'agissait d'une étude quantitative transversale à visée descriptive sur 3 mois. Les patients suivis pour GPAO au CHU-IOTA avec un âge ≥ 18 ans ont été inclus et soumis au questionnaire GlauQOL-17 pour la collecte des données. Résultats : Nous avons colligé 100 patients glaucomateux, la moyenne d'âge des patients était de 52 ans avec un écart type de 14,02. Les extrêmes d'âges sont de 18 et 81 ans. Il y avait une prédominance masculine; (54%) avec un sex-ratio (M/F) de 1.7. Les acuités visuelles bonnes étaient majoritaires (supérieures ou égales à 3/10).Parmi nos patients 35% étaient au stade de glaucome débutant à OD et 30% au stade de glaucome modéré à OG. Nos patients avaient un mauvais score qualité de vie (score < à 50%) dans les dimensions Anxiété et conduite. Chez les patients de moins de 70 ans nous avons noté un mauvais score d'anxiété dans tous les stades évolutifs de la maladie. Les scores des dimensions image de soi, contraintes, et prise en charge étaient supérieurs à 60% chez les patients de plus de 70 ans. Conclusion: L'altération de certains domaines étudiés était proportionnelle à l'évolution du GPAO. Cette dégradation peut avoir des impacts physiques, psychologiques et sociaux sur ses patients

Cataract surgery in Ibadan, Nigeria: Visual outcome and post-operative refractive error

Background: Cataract is the leading cause of blindness worldwide and can be treated by various surgical techniques with good visual outcome.Objective: To describe the visual outcome and post-operative refractive status among patients who had cataract surgery in a tertiary centre.Methods: In a retrospective study, the demographic data, type of cataract, surgical procedure and complications, visual outcome and post-operative refractive status of the treated eye were retrieved from the hospital records of all adult patients who had cataract surgery.Results: Four hundred and sixty eyes of 456 patients (mean age 61.2 ± 17.3 years, Male: Female = 1.1: 1) had cataract surgery during the study period January 2012 and December 2014. The pre-operative visual acuity was < 3/60 in 415 (90.2%) eyes. All the surgeries were performed under local anaesthesia with 331 (72%) eyes undergoing extracapsular cataract extraction while 129 (28%) had small incision cataract surgery. Visual outcome in those who had a minimum of six weeks follow-up revealed unaided visual acuity of ≥ 6/18 in 185 (56.9%) eyes. Following refraction, 237 (72.9%) eyes had acuity of ≥ 6/18. Post-operative spherical refractive error ranged from ­6.75D to +4.50D (mean -1.61 ± 1.41D) while cylindrical error ranged from 0.00DC to 6.00DC (mean 2.33 ± 1.80DC). Pre-existing ocular problems contributing to poor post-operative visual outcome included glaucoma (50; 15.4%), and age-related macular degeneration (10; 3.1%). Conclusion: Extracapsular cataract extraction gave better visual outcome compared with small incision cataract surgery, but a higher incidence of post-operative cylindrical error was observed

Rétinopathie de Valsalva associée à un effort de défécation chez une adolescente drépanocytaire homozygote

La rétinopathie de Valsalva est une hémorragie rétinienne liée à une manœuvre de Valsalva qui consiste à une expiration forcée à glotte bloquée après une inspiration forcée. Pathologie rare survenant le plus souvent chez l'adulte entrainant une baisse brutale de l'acuité visuelle de l'œil atteint. Les auteurs rapportent un cas de rétinopathie de Valsalva, occasionnée par un effort de défécation chez une adolescente drépanocytaire de 17 ans, dans un conteste de constipation. L'absence de lésions vasculaires rétiniennes à l'angiographie oculaire a permis d'écarter la rétinopathie drépanocytaire. Les suites ont été simples

Prevalence; Distribution and Determinants of Myopia in Owerri; Nigeria

Background: Uncorrected myopia is a significant cause of visual impairment and avoidable blindness. Incidence of open-angle glaucoma has been shown to occur more often in myopia. This cross-sectional analytical study determined the prevalence; distribution and determinants of myopia in the adult population of Imo State; Nigeria with a view to establish a reference data for research purposes and future intervention in this locality. Materials and Method: A total of 3451 adults living in Owerri consisting of 2606 persons as test group and 845 persons as controls were randomly selected using standard optometric methods including subjective refraction. Results: Refractive error (ametropia) was found in 79.5 study and 76.8 control. Myopia was found in 23.4 study and 19.6 control. Highest prevalence of myopia was observed in females aged 40-49 years. Fifty percent of study and 68.1 of control group had myopia of -0.50DS to -3.00DS while 4.0 and 2.4 of study and control group respectively had myopic astigmatism. In all; 27.7 study and 16.2 control had myopia 5.00DS. The highest degree of myopia found in this study was - 24.00DS. Conclusion: This study provided information on the prevalence; distribution and determinants of myopia in Owerri; Nigeria and the data could be a basis for improved visual health care in the south-eastern sub-region of Nigeria

Presbyopia: Prevalence; Distribution and Determinants in Owerri; Nigeria

Background: Presbyopia causes blurring and impairment of vision at near. It is the most common physiologic change in the adult eye with advancing age. Good near vision is a necessity for domestic activities; office work and near vision tasks other than reading and writing; especially among adults in a resource-limited economy. The study determined the prevalence; distribution and determinants of presbyopia; presbyopic spectacle coverage; and provided data for ready-made near vision spectacles in Imo State; Nigeria. Materials and Methods: A total of three thousand; four hundred and fifty-one adults consisting of 2606 persons as study group and 845 persons as controls were randomly selected for the study. Structured questionnaire was administered to the subjects. Their visual acuity at far and near including tonometry; ophthalmoscopy; perimetry; retinoscopy and subjective refraction were done. Subjects who could not read N6 and emmetropes; who are 40 years and above were considered as presbyopic. Results: The prevalence of presbyopia was 70.9 and 75.0 of study and control groups respectively. Females aged 40-49 were in the majority (57.1 and 51.9 of females in the study and control groups respectively). Subjects requiring additions at near of ?+1.50DS to 2.00DS were in the majority (39.0 and 46.4 of study and control groups respectively). Amongst the presbyopes 61.3 and 78.7 of study and control groups respectively did not have presbyopic correction. The subjects were also ignorant of corneal inlay technology in treatment of presbyopia. A higher prevalence exists among rural dwellers and the contributory factors were environmental influences; poor nutrition and irrational use of chloroquine for treatment of malaria. Conclusion: Over seventy-percent of presbyopia was found in this study. The determinants were age; gender; nutrition and drug use. Majority of the presbyopes were domicile in the rural area and did not have corrective spectacles. We recommend visual health education; regular vision screening and intervention to achieve the targets of vision 2020 in low-and-medium-income countries

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

Pattern of diabetic retinopathy in Kano, Nigeria

BACKGROUND:The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, Nigeria. MATERIALS AND METHODS: Consecutive patients who were attending the diabetic clinic and who consented were examined over a three-month period. Information obtained includes patient's bio data, type and duration of disease, and findings on eye examination. The fundus was examined with direct and indirect ophthalmoscopes, +90 D with slit lamp and fundal photography. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRDSS). RESULTS: A total of 214 patients were examined during the study period. There were 88 males and 126 females (M: F = 1: 1.43). The mean age of the study population was 52.14 ± 13.23 years. The mean age of patients without diabetic retinopathy (DR) was 49.14 ± 13.17 years and the mean age of patients with DR was 58.51 ± 10.94 years. Forty nine patients (23%) had insulin-dependent diabetes mellitus (IDDM) while 165 patients (77%) had non insulin dependent diabetes mellitus (NIDDM). There was statistically significant difference in presence of retinopathy in patients with IDDM compared to those with NIDDM [X(2) =29.77 {95% CI}, P=0.000]. DR was significantly more common in patients with disease duration of 15 years or more compared with those with disease duration of 14 years or less [X(2) = 65.85, {95% CI} P= 0.000]. Based on ICDRDSS scale, 136 patients (64%) had no retinopathy and 78 patients (36%) had retinopathy. Some patients were visually impaired and the cause of blindness was DR in 6 patients (2.8%). Cataract and glaucoma were the cause in 6 patients (2.8%).CONCLUSION:Diabetic retinopathy is common in our environment and is more frequent in IDDM and those with long disease duration. DR is a cause of visual disability although diabetic patients are not exempted from blindness from other eye diseases such as cataract and glaucoma. A screening program needs to be developed to facilitate early detection and prompt treatment

Ocular disorders in children in Zaria children's school

BACKGROUND:The main causes of blindness in children change over time. The prevalence and pattern of eye diseases in children were studied in northern Nigeria 6 years ago. This study like the previous one was a school eye health screening conducted in Zaria children school located at the centre of Zaria, a city in northern Nigeria.AIMS AND OBJECTIVES:to determine the current prevalence and pattern of eye diseases affecting school children in Zaria. This is to serve as a current template for planning eye care for children in Zaria and environs.MATERIALS AND METHODS:a cross sectional study of 327 children who completed a pre-designed school eye screening format was conducted. Consent was obtained from the school authority and the parents before the screening exercise. It involved assessment of visual acuity, anterior and posterior segment examination and colour vision testing. Intraocular pressure measurement and refraction were done for those with indications.RESULT :A total of 327 children were examined, out of which 45.6% (n=149) were males and 54.4% (n=178) were females. M: F=1:1.2. Age range 5-17 yrs with mean of 9.6 ± 3.1(SD). The commonest causes of eye disorders were refractive errors 8.0% (n=26), allergic conjunctivitis 7.3 % (n=24), glaucoma suspects 3.7% (n=12) and colour deficiency 1.5%(n=5).CONCLUSION :The major causes of childhood eye disorders were uncorrected refractive errors and allergic conjunctivitis. The predominance of uncorrected refractive error is similar to what is obtainable in other parts of the world especially in the urban areas

Relation entre pression pulsee; troubles visuels et severite de la retinopathie diabetique en Afrique sub-saharienne

Objectif: Determiner la relation entre la pression pulsee; les facteurs de risque traditionnels; les troubles visuels et la prevalence des differentes formes cliniques de la retinopathie diabetique. Materiel et methodes : Une etude transversale a ete menee entre le 1er decembre 2004 et le 16 juillet 2005 dans les centres de sante a Kinshasa. RDC. La population mere (n=3010 diabetiques) a servi a estimer la prevalence de la retinopathie diabetique tandis qu_fun echantillon representatif (n=301) a ete soumis a une approche analytique : age.20 ans; anthropometrique; composantes de la pression arterielle; glycemie a jeun; optometrie; fond d_foeil; severite de la retinopathie diabetique. Resultats : La baisse subjective etait associee a la retinopathie diabetique dans l_fechantillon (Or=2;7 IC951;1-5;4 ; p0;05) et en cas de diabete de type 2 (OR1;1-3;4 ;p0;05). La baisse subjective de l'acuite visuelle etait associee a la retinopathie diabetique dans l'echantillon (OR1;1-12;6 ;p0;05). Le risque de deficience visuelle etait plus que triple par la retinopathie diabetique chez les femmes (OR1;1-12;6 ;p0;05). Porter une grossesse apres le diagnostic de diabete multipliait par 3 le risque de retinopathie diabetique chez les femmes (OR1;1-13;2 ;p0;05). Apres regression logistique; le risque multivarie de retinopathie diabetique etait predit de facon independante par les antecedetnss familiaux de diabete sucre (OR1;2-8;8 ; p0;05); la duree du diabete . 4 annees (OR1;4-8;5 ;p0;01); la pression pulsee .60 mmHg (OR2- 12;8 ;p0;001). Conclusion : Un programme de prevention et de controle de la retinopathie diabetique et de ses facteurs de risque est souhaite pour l le benefice de l'urgence

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

Prevalence of Pterygium in a Rural Community of District; Southern Ethiopia

Background: Pterygium is principally prevalent in tropical Africa. Though Ethiopia is located in the tropics; the prevalence of pterygium has not been well studied previously. Aim: To determine the prevalence of pterygium among people older than 20 years and its association with age; sex; smoking and exposure to ultraviolet light (UVL) in Meskan District of Gurage zone; Southern Ethiopia. Methods: This cross-sectional study was conducted from March 15 to May 15; 2006. Two peasant associations (PA) were randomly selected from the total of 42 in the district. Based on the sampling fraction; every third household in the selected peasant associations was included in the study. All individuals above 20 years of age in the selected households were interviewed and examined for the presence of pterygium. Measurements of pterygium were made with ruler. Visual acuity was taken for those individuals with pterygium and checked with pinhole if found to be less than 6/18. Results: A total of 922 individuals; 400 (43.4) males and 522 (56.6) females; were involved in the study. The mean age was 38.2 ranging from 21-95 years. Pterygium was found in 81 (8.8; 95CI: 7.0;10.6) of the study subjects. For those individuals whose age was above 40 years; the prevalence was found to be 17.4indicating an increased risk with age (p0.001). It also occurred among 50 (12.5) males and 31 (5.9) females and the difference was statistically significant (p0.001). Males have about twice the risk of developing pterygium compared to females. Conclusion: The prevalence of pterygium obtained (8.8) from this study was relatively low compared to many other reports from tropical areas. However; in agreement with other reports; advancing age and males have been identified as risk factors for the development of pterygium. Pterygium was associated with visual impairment in 13.1of cases

Modifications endotheliales au decours de la keratoplastie transfixiante

Les auteurs ont analyse les resultats post operatoires de la keratoplastie transfixiante apres ablation des sutures dans le service d'Ophtalmologie du Centre Hospitalier Universitaire de Tours. L'age des patients variait de 20 a 90 ans avec une moyenne de 56;83 ans. 41;7des patients avaient une keratopathie bulleuse de l'aphake ou du pseudophake. L'hypertonie oculaire etait la complication post operatoire la plus frequente. L'ablation definitive des sutures a ameliore la clarte du greffon et donc l'acuite visuelle malgre l'importance de la perte cellulaire endotheliale (65;65a un an) et de l'oedeme corneen residuel

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

Visual Damage Following Direct Sighting of Solar Eclipse in Ghana

A study was carried out at the department of Ophthalmology and Otorhinolaryngology at the Komfo Anokye Teaching Hospital/School of Medical Sciences; at Kumasi Ghana from March 29th to May 29th 2006 to study visual acuity changes in patients suspected of solar eclipse retinopathy after they viewed an eclipse of the sun on 29th March 2006. In all; seven patients with eye complaints were seen. Examination included assessment of Visual Acuity (VA); Slit Lamp examination; Fundoscopy; Amsle Test; Intra-ocular pressure evaluation and Goldman's Tonometre Test. Six patients had normal visual acuity while only one had VA of 6/24 in both eyes; which was corrected. All patients had normal colour vision and normal Amlser grid. None of them had any evidence of Maculopathy. 3 patients had superficial punctuate Keratitis. The absence of solar burns of the macular observed in the region is indicative of the effectiveness of mass public education concerning the damaging effects of the solar eclipse. Advanced techniques; such as scanning laser Ophthalmoscopy and the multifocal electroretinography (ERG) offer the possibility of detailed examination of small retina lesions in Ghana after an eclipse of the sun

The Timing of Surgery and Salvable Vision in Pituitary Adenoma

Two cases of pituitary macroadenomas are the basis for this study. The first; a 70 year old female who had a nonfunctioning pituitary macroadenoma presented with headache and visual impairment. Surgery was indicated but she declined until two years later when visual acuity got worse. The second was a 25 year old male who presented with a prolactinoma and diabetes. Visual abnormalities were related only to the left eye. When it was suggested that surgery might be indicated; he never kept the next appointment. Delay in effecting appropriate surgery timely is known to upset desired results. What is particular in this case is the attendant loss of vision; a very serious disability which could have been prevented. Those prone to fear of surgery should be assisted to understand their situations better and efforts made to encourage them to take the correct decision

Onchocerciasis prevalence in previously known foci in western Uganda: results from a preliminary survey in Kabarole district

A prevalence survey of onchoceriasis was done in Kabarole district; Uganda; in 1990. The objective was to determine the prevalence of onchocerciasis among communities living in previously known foci. A total number of 1186 persons was included in the study. The infection rate among the communities studied ranged from 0pc to 67pc. The most frequent clinical signs and symptoms of onchocerciasis were: pruritus (80pc); rough skin (46pc); skin rash (30pc); leopard skin (6pc) and sclerosing keratitis (7pc). 3.6pc of all cases with onchocercasis were found to have no perception of light. The total number of cases in the district was estimated to be 32;000. The study showed that the foci; where Simulium neavei is the vector; are still active. In contrast; very few infections with Onchocerca volvulus were found in the Rwenzori focus; where S. damnosum s. 1. was the vector. The results indicate that onchocerciasis is of public health importance in Kabarole district and needs to be controlled