Astenopia em docentes universitários durante a pandemia da COVID-19 / Asthenopia in college lecturers during the COVID-19 pandemic

RESUMO Objetivo: Avaliar sintomas astenópicos e fatores sociodemográficos, hábitos comportamentais e clínicos nos docentes universitários durante a pandemia da COVID-19. Métodos: Trata-se de estudo transversal que avaliou a ocorrência de astenopia em 104 docentes. Questionários de sintomatologia visual validados foram adaptados para a coleta de dados. Houve comparação dos docentes quanto à ocorrência ou não de sintomas astenópicos, bem como foi aplicada regressão logística binária, para aferir a associação com variáveis independentes (p<0,05). Resultados: Houve maior aparecimento de sintomas astenópicos durante o período pandêmico, em que o tempo de exposição a telas parece ter sido o fator mais determinante. Além disso, os indivíduos com tempo de tela superior a 5 horas diárias, que faziam uso de telas para o lazer e usavam colírio/lubrificantes apresentaram significativamente maior chance de estar no grupo com sintomas astenópicos. Conclusão: Foi identificada associação significativa entre a ocorrência de sintomas astenópicos e o uso de telas durante o período pandêmico, principalmente nos grupos com maior duração do tempo de tela. O estudo chama atenção para a saúde ocular de docentes universitários em ensino remoto, além de suscitar novos estudos para investigação desse quadro em distintos ambientes escolares.

ABSTRACT Objective: To assess asthenopic symptoms and sociodemographic factors, behavioral and clinical aspects in college lecturers during the COVID-19 pandemic. Methods: This is a cross-sectional study evaluating asthenopia in 104 lecturers. Some validated visual symptom questionnaires were adapted for data collection. Lecturers were compared regarding the occurrence or not of asthenopic symptoms, and binary logistic regression was applied to measure the association with independent variables (p<0.05). Results: Asthenopic symptoms occurred more often during the pandemic, when exposure to screens was a determinant factor. The individuals with screen time longer than five hours a day, who used screens for leisure, and who used eye drops/lubricants were significantly more likely to be in the group with asthenopic symptoms. Conclusion: A significant association was identified in occurrence of asthenopic symptoms and screen use during the pandemic period, especially in groups with longer screen time. The study draws attention to the eye health of college lecturers in distance learning, and the need for further research on this situation in different school environments.

Impact of mass supplementation of vitamin A.

OBJECTIVE: To study the impact of mass supplementation of Vitamin A solution on morbidity due to diarrhea, Acute respiratory infection (ARI) and xerophthalmia. METHODS: The two rounds of age specific mass distribution of Vitamin A solution were undertaken during January 2000 and December 2000 respectively covering 27,642 (98.7%) and 31,762 (88.0%) children respectively out of total beneficiaries in two round of PPI in Chandigarh. A random sample of 276 children from intervention area and 252 children from control area in the age group of 1-5 yr were followed up on monthly basis for morbidity pattern for a period of nine mth. The morbidity pattern for intervention and control area children was compared to see the impact of mass supplementation of Vitamin A solution. RESULTS: The average annual episodes of diarrhea in intervention children were lower (3.9 per yr) as compared to control children (5.2 per yr) although difference was not statistically significant (P>0.05) except in initial month. The average annual episodes of ARI in intervention children were lower (5.1 per yr) as compared to Control children (6.0 per yr) although difference was not significant (P>0.05) except in initial first mth. There was significant decline in vitamin A deficiency (VAD) as no case of Bitot's spot was found in intervention children as compared to control children where the prevalence of Bitot's spot ranged from 4.3-5.08% during different visits. The mortality rate was found to be higher in control children with a death rate of 8 per 1000 children during the study period as compared to intervention children where no death was recorded. CONCLUSION: It is concluded that mass supplementation of vitamin A led to significant reduction in xerophthalmia and decline in mortality in the intervention area as compared to control area.

Xerophthalmia: a study among malnourished children of West Mednipur District.

To study the correlation of stages of xerophthalmia in different grades of malnutrition, having 200 children clinically diagnosed having malnutrition as per criteria laid down by the Indian Academy of Pediatrics (IAP) were examined to detect the dinical stages of xerophthalmia as proposed by World Health Organisation (WHO). Out of 200 cases with different grades of malnutrition 81 (40.5%), 78 (39.0%), 22 (11.0%) and 19 (9.5%) were found malnourished in grades I, II, III, and IV respectively. Night blindness was earliest feature and seen in 97 cases (48.5%). All the 97 cases of night blindness fell in group of X(N) in which one case had corneal scar and falls in the group of X(S) in clinical staging of xerophthalmia. Thirty-nine (40.2%), 35 (36.1%), 19 (19.6%), 3 (3.1%) and (1.1%) were in clinical stages of xerophthalmia of X(1A), X(1B), X2, X(3A), X(3B)respectively. Severity of xerophthalmia was found directly proportional to severity of malnutrition.

Classification of 154 clinical cases of vitamin A deficiency in children [0-15 years] in a tertiary hospital in North West Frontier province Pakistan

To share our experience of 154 cases of clinical vitamin A deficiency in Pakistani children. Methods and The data on age, sex, date of presentation and clinical stage of vitamin A deficiency was recorded. A total of 154 children aged 0-15 years suffering from clinical vitamin A deficiency [xerophthalmia] were recorded. One hundred and twenty three [79.9%] children were 0-6 years with 99 [64.3%] male children. Blinding xerophthalmia [corneal xerosis, corneal ulcers ad keratomalacia] was present in 94 [61%] children. Thirty nine% children presented in summer, 28% in autumn, 20% in winter and 13% in spring respectively. This report indicates that clinical cases of vitamin A deficiency in children do occur in Pakistan. Children under 6 years of age are the most vulnerable age group and there is a seasonal variation in presentation. Both life and sight of these children are at risk. Community based studies may be helpful to identify the magnitude of the problem and possible risk factors at national, provincial and district levels

Mass supplementation of vitamin A linked to National Immunization Day.

OBJECTIVE: Main objectives were to assess the feasibility of linking vitamin A delivery with National Immunization Days (NIDs) and to see the impact on xerophthalmia. METHODS: An Intervention study of mass distribution of vitamin A solution was undertaken to control widespread xerophthalmia prevalent in children living in about 26 slums of Chandigarh in the year 2000. Two rounds of mass distribution of Vitamin A solution covering 27642 and 31762 children in 1-5 years of age in first and second rounds, respectively, were undertaken. The findings of second round and post evaluation after intervention are presented here. An additional team of two persons per pulse polio immunization (PPI) centre delivered age specific doses of vitamin A solution through 98 centres and operational problems were recorded. PPI staff provided the supervision and PPI tally sheets were used. RESULTS: The programme achieved a vitamin A coverage rate of 99% in first round and 88% in second round. Only two parents refused vitamin A solution. No side effect or cases of toxicity due to vitamin A were reported by health institutions in the area or in a stratified random sample of 101 children. There was a significant decline (13.4%) in xerophthalmia after two rounds of mass distribution (P < .001). The strategy to deliver vitamin A was successfully integrated into NID's and appeared to achieve a significant decline in xerophthalmia. CONCLUSION: Linking of vitamin A distribution with PPI could be a basis for launching similar initiatives in other areas of India and other countries where xerophthalmia is a public health problem.

National Vitamin A Prophylaxis Programme: need for change in current age strategy.

Child survival and Safe Motherhood Programme emphasises on giving vitamin A prophylaxis upto three years of age only, contrary to earlier practice of its administration upto six years of age, based on the assumption of reduction of serious manifestations of vitamin A deficiency three years of age onwards. A cross-sectional study enrolling 1094 children was done to investigate vitamin A deficiency in under six children in urban slums of Nagpur city in Central India in post CSSM scenario. Clinical as well as subclinical (detected by abnormal conjunctival impression cytology) assessment of vitamin A status was performed according to standard procedures, as per WHO recommendations. The overall prevalence of xerophthalmia was 8.7%. Only milder manifestations of xerophthalmia were observed. Significantly higher prevalence of xerophthalmia was observed in more than three years of age. Although nonsignificant, higher prevalence of subclinical vitamin A deficiency was observed in above three years of age group. In view of current age strategy for vitamin A supplementation (< or = 3 years) and observed higher prevalence of clinical and subclinical vitamin A deficiency above three years of age in this study (also endorsed by earlier studies) a call for review of current age strategy for vitamin A supplementation is warranted.

Control of vitamin A deficiency in Africa

This paper presents a brief summary of vitamin A deficiency and xerophthalmia in Africa; and an overview of strategies for prevention and control. Indeed the epidemiological picture is complex in all dimensions. 18-20 countries in Sub-Saharan or Sahelian zones are estimated to have vitamin A deficiency problem of public health dimensions; and in a few more it is sporadically or occasionally present. Distribution of vitamin A supplements would be organized quite widely in Africa; especially in times of drought and emergencies

Xerophthalmia in school children.

The prevalence of xerophthalmia was studied in 5135 school children of Jodhpur ranging between 6 and 16 years of age. The total prevalence of xerophthalmia was found to be 9.89%. Night blindness (XN) and milder conjunctival form (XIA, XIB) of the disease were predominantly prevalent in the studied population. Corneal disease (X2, X3A, X3B) was found in 8 cases and xerophthalmia scar (XS) in only one case. Recognition of early xerophthalmia and urgent vitamin A therapy is of paramount importance to preclude the onset of the corneal stage and irreversible blindness. It is suggested that xerophthalmia screening be made an essential component of routine medical check-up in schools with XN (night blindness with or without conjunctival xerosis) and XIB (Bitot's spots) used as criterion for screening to effectuate early detection and treatment of xerophthalmia.