Active trachoma two years after three rounds of azithromycin mass treatment in Cheha District Gurage Zone, Southern Ethiopia.

BACKGROUND: Azithromycin mass distribution was given to residents of Gurage zone Cheha district in 2004, 2005 and 2006 for three consecutive years with more than 90% coverage. The effect of treatment in the study community was not yet determined. The present study was therefore designed to assess the effect of azithromycin on the prevalence of active trachoma two years after three rounds of mass treatment of the community at Cheha district, Gurage zone. METHODS: A multistage stratified cluster random survey was employed to determine the prevalence of active trachoma among children aged 1 to 9. Selected children were examined for trachoma using the simplified WHO grading system and their households were assessed for trachoma risk factors. RESULTS: This survey demonstrated that the prevalence of active trachoma in the study community was 22.8% (95% CI 18.24% - 27.36%) that was lower than that of Southern Nations, Nationalities, and People's Regional prevalence (33.2%) in 2006. Only 27.6% (95% CI 25.7% - 30.1%) of the study population had a safe and clean water supply, whereas 42.7% (95% CI 39.8% - 46.2%) of the visited households had simple pit latrines. CONCLUSION: This survey demonstrated that despite repeated mass oral azithromycin distributions, the prevalence of active trachoma was still high. Therefore, the other components of the SAFE strategy such as fly control program, improving the water sources, measures to improve face washing and construction of utilizable latrines that are being implemented through the health extension package have to be integrated with mass azithromycin treatment to eliminate active trachoma in the district.

Liposarcoma presenting as a recurrent eyelid tumor.

Liposarcoma of the head and neck is rarely reported Orbital and eye lid involvement has been found to be extremely rare. A 25 year old male patient from Harar presented with left eyelid mass of two years duration and diagnosed to have liposarcoma by incisional biopsy. Despite the difficulty in obtaining wide surgical margins, the small tumor size at presentation and the apparent predominance of well-differentiated type means that the prognosis for orbital liposarcoma was generally good. The epidemiological, clinical feature and histological findings are discussed. It is recommended to consider liposarcoma as a differential diagnosis of orbital mass lesions.

Altitude-a risk factor for active trachoma in southern Ethiopia.

BACKGROUND: Trachoma is the leading cause of preventable blindness world wide. It is common in areas of the world that are socio-economically deprived of basic needs in housing, health, water and sanitation. METHODS: A cross sectional study on the prevalence and risk factors for trachoma infection in children 1-10 years of age in three different altitude zones of Kembata zone, southern Ethiopia was done from May - July 2001. Using stratified cluster sampling, households and children 1-10 years of age were selected. RESULTS: A total of 1169 children were examined. The male to female ratio was 1 : 1.2. Trachoma follicles (TF) were found in 17.3%, 33.5%, and 42.3% in high, medium and low altitude zones respectively. Like wise Trachoma intense inflammation (TI) was found in 4.2%, 23.5% and 36.5%. Females, living at lower altitude and farther distance from a water source were risk factors for trachoma infection. CONCLUSIONS: Trachoma is a public health problem in the medium and low altitude regions of the area. Multiple logistic regression analysis revealed low altitude as a consistent and highly significant risk factor for trachoma infection. Thus, SAFE strategy should be implemented. Altitude should be used as a priority-setting tool in selecting endemic areas for trachoma intervention programs.

Pattern of retinal diseases at a teaching eye department, Addis Ababa, Ethiopia.

The purpose of this study was to evaluate the pattern of retinal diseases as seen at a teaching and tertiary eye care center in Addis Ababa. In a descriptive, cross-sectional study, all consecutive patients seen at the retina clinic of Menelik II Hospital during a 19 months period (January 2000 to August 2001) were included in this series. Pertinent demographic and clinical data were recorded for all patients. A total of 1390 new patients with retinal diseases were seen at the retina clinic during the study period, accounting for 12.5% of the total outpatient population of the eye department. The male to female ratio was 1.8 : 1. The mean age was 45.2 years +/- 17.3 years (range 2 months to 92 years) and median of 44.5 years. Two hundred and twenty-four (16.1%) patients were bilaterally blind, 465 (33.5%) patients were unilaterally blind, 280 (20.1%) patients had bilateral visual impairment and 195 (14.0%) patients had unilateral visual impairment, while 213 (15.3%) patients had normal vision. Retinal detachment was the commonest cause of both bilateral (54.9%) and unilateral blindness (41.2%), while diabetic retinopathy and myopia were the leading causes of bilateral visual impairment accounting for 36.8% and 28.2% respectively. Retinal vascular diseases accounted for the largest group of patients (38.1%) of which diabetic retinopathy accounted for 75.1%. Retinal detachment was the second largest group of diseases, accounting for 24.5% of the total. The proportion of patients with age-related macular degeneration was only 2.7%. Most of the patients presented with advanced disease, which required vitreo-retinal surgery. There is a need to improve on the early diagnosis and early referral of retinal diseases at primary and secondary care levels. Selected tertiary care centers should develop capacity to provide laser and vitreo-retinal surgery. The introduction of posterior vitrectomy in Ethiopia is long overdue.