Storm time IRI-Plas model forecast for an African equatorial station.

The limitation of ionospheric models in describing short-term ionospheric events has led to the development of data assimilative models e.g. the International Reference Ionosphere extended to Plasmasphere (IRI-Plas) model. This paper compares the IRI-Plas derived total electron content (TEC), the peak height (hmF2) and critical frequency (foF2) of the F2-layer with those obtained from Global Positioning System (GPS) receiver's and Digisonde Precision Sounder (DPS-4) measurements over Ilorin (Geog. Lat. 8.50oN; Long. 4.50oE, dip: - 7.9o) during geomagnetic storm days. The model estimation was done by assimilation of Ionosonde foF2 and TEC derived from GPS (GPS-TEC) and Global Ionospheric Map (GIM-TEC) into the model code. In order to study the effect of data assimilation on the model's representation, the "no input" option of the model was used as reference. The result shows that with the exception of the foF2 assimilation mode, all the options generally reproduced TEC quite well for all the storm days considered. Overall, the model adjusted with GPS-TEC gives the best prediction of TEC as it reduced the prediction error of TEC by a multiple of up to three compared to using the GIM-TEC. Also, all the options failed to reproduce the storm induced prominent features in the storm-time features of foF2 and hmF2. In other word, assimilation with the TEC does not generally improve the storm-time predictions of foF2 and hmF2 at the station. Consequently, for storm-time estimation of the F2-layer peak parameters, the 'no input' representation of the model is more valid at this station.

CHALLENGES IN THE MANAGEMENT OF GLAUCOMA IN A DEVELOPING COUNTRY; A QUALITATIVE STUDY OF PROVIDERS' PERSPECTIVES.

BACKGROUND: Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. METHODS: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services. The discussions were recorded with the aid of a micro-cassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified. Quotes that reflect the themes and sub-themes were then identified in the data. RESULTS: In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burden constituting about 35% of outpatient visits. Identified patient related challenges include; late presentation, lack of glaucoma awareness, delay in referral from optometrists, and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting of drugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant. Some respondents considered the current number of glaucoma surgeries as adequate, while some think otherwise. Reasons put forward for reluctance to offer glaucoma surgery include; late presentation, lack of patient satisfaction, complications of surgery, and negative publicity. CONCLUSION: Even though the challenges in the management of glaucoma in developing countries are many, they are not insurmountable. There is need for concerted and integrated efforts involving all cadres of eye care practitioners, patients, institutions and governments to address this important eye disease. Improved awareness, provision of adequate equipment, availability and affordability of medications, need for training and retraining of eye care providers are all important measures that can lead to better management of the glaucoma patient.

Managing glaucoma in Lagos State, Nigeria - availability of Human resources and equipment.

AIMS AND OBJECTIVES: There is a paucity of data onthe human resourcesand ophthalmic equipmentavailable for the diagnosis and management of glaucoma in Nigeria. This study is aimed at describing the ophthalmic human resources, as well as available and functioning equipment used in diagnosing and managing glaucoma in Lagos State, Nigeria. MATERIALS AND METHODS: This was a prospective multicentre cross sectional study.Data on human resources and equipmentavailable were collected from all government tertiaryand secondary health institutions in the state. One large-practice private eye hospital in the state was included for comparative purposes. RESULTS: The average number of ophthalmologists per hospital was 1.3 and 4.5 in the secondary and tertiary centres respectively, with overall ophthalmologists to population ratio of 1:400,000, and ophthalmic nurses to population ratio of 1:150,000. There were only 2 full time low vision therapists and 3 equipment technicians. Only the private hospital had a dedicated patient counsellor and an eye unit manager. 64% of ophthalmic equipment in the government sector were functioning compared with 100% in the private centre. Overall, equipment to population ratios were; slit lamp=1:517,000, 78/90D lens=1:1,487,000, tonometer=1:660,000, visual field analyser=1:2,380,000, and pachymeter=1:5,950,000. CONCLUSIONS: Current population ratios for ophthalmologists and ophthalmic nurses in the state meets vision 2020 recommendations, but there are shortages of other key human resources such as equipment technicians, low vision therapists and patient counsellors. In addition, equipment required for the management of glaucoma wereinadequate, not available or not functioning. Findings from this study suggest that there is an urgent need for increased government funding to glaucoma services in Lagos State.

Poor cataract surgical output: eye care workers perspective in north central Nigeria.

BACKGROUND: Cataract remains a disease of priority being the leading cause of blindness globally. Although surgically curable, cataract surgical output has remained low in Nigeria, Kwara state inclusive. A study was carried out to investigate the perception of eye care workers (ECW) on low surgical output and their adjudged reasons; this has hitherto not being evaluated. MATERIALS AND METHODS: A cross-sectional quantitative survey with the aid of pretested structured questionnaire of all ECW and qualitative survey using in-depth interview on selected workers in Kwara State, Nigeria was done. RESULTS: A total of 142 out of the 157 ECWs (90.5%) working in the 14 surgical eye centers in the state were interviewed with a mean age of 40.37 years, SD ± 8.67. There were 94 (66.2%) females, with a female to male ratio of 2:1. 91 (64.1%) participants were of the opinion that the numbers of cataract surgeries in the state were inadequate. Hospital-based and human resource efficiency-related issues such as long clinic waiting time, multiple paying and procedural sites, poor staff mix, and gaps in available human resource were the major reasons given for low cataract output. Others reasons were high cost and fear of surgery, distance of eye clinics from patients. CONCLUSIONS: Regular operational researches, proper deployment, and efficient use of human and material resources in addition to subsidized cost and appropriate health education to allay fear of surgery are steps that could enhance cataract surgical output.

Minimising corneal scarring from the use of harmful traditional eye remedies in developing countries.

Corneal scarring is the fourth largest cause of blindness globally, and a much more prominent factor in developing countries. Blindness from corneal scarring is largely a preventable phenomenon, and is capable of causing significant morbidity that can last for a lifetime. A significant proportion of these cases are caused by the use of harmful traditional eye medicines/remedies, and are used and prescribed by friends, relatives and traditional healers, with widespread use especially in developing countries. Use of traditional remedies can also cause harm indirectly by causing delays before seeking medical treatment. Reducing corneal scarring from the use of harmful traditional medicine is through a combination of approaches with the key strategies being community diagnosis, education, participation, and intervention, with provision of basic eye care integrated into the primary health care of the community. Collaboration with traditional healers in the community is also another approach that has been found to be useful.

Minimising cornea scarring from the use of harmful traditional eye remedies in developing countries.

Corneal scarring is the fourth largest cause of blindness globally, and a much more prominent factor in developing countries. Blindness from corneal scarring is largely a preventable phenomenon, and is capable of causing significant morbidity that can last for a lifetime. A significant proportion of these cases are caused by the use of harmful traditional eye medicines/remedies, and are used and prescribed by friends, relatives and traditional healers, with widespread use especially in developing countries. Use of traditional remedies can also cause harm indirectly by causing delays before seeking medical treatment. Reducing corneal scarring from the use of harmful traditional medicine is through a combination of approaches with the key strategies being community diagnosis, education, participation, and intervention, with provision of basic eye care integrated into the primary health care of the community. Collaboration with traditional healers in the community is also another approach that has been found to be useful.

Willingness of Nigerians to donate a kidney.

BACKGROUND: Kidney transplantation is a popular modality of RRT in the developed world. OBJECTIVE: To assess the willingness of the general population of Nigerians across the country to donate a kidney METHODS: This is a multiregional, cross sectional, questionnaire based study. One thousand Three hundred respondents participated in the study. This study was carried out in four major Towns and cities across Nigeria between January 2009 and December 2010. The locations are Birnin Kebbi in the north, Ilorin in the middle belt, Iddo Ekiti in the south and Lagos, the economic capital of Nigeria. The respondents were randomly selected within the four localities. Those below the age of 16 or above the age of 65 years were excluded from the study RESULTS: There were 727 (55.9%) males. The mean age (S.D) of respondents was 39.5 (10.7) years. The largest population of participants, 494 (38.3%) were non health workers and 692 (53.2%) of them were Muslims. Eight hundred and fifty eight (66%) of the participants were willing to donate a kidney. Twenty five percent (25% were not willing and 115 (8.9%) were not sure. Majority of those who were unwilling to donate a kidney, 325 (99.4%) will not change their minds even if they were to be given incentives CONCLUSION: Nigerians are willing to donate a kidney irrespective of geographical location, religion or gender and many are willing to do so altruistically.

Visual function survey of commercial intercity vehicle drivers in Ilorin, Nigeria.

OBJECTIVE: To determine the prevalence of visual impairment among commercial intercity vehicle drivers (CIVDs) in Ilorin, Nigeria. DESIGN: A cross-sectional descriptive study. PARTICIPANTS: Among the estimated 450 drivers operating in 5 motor parks for CIVDs in Ilorin, 399 drivers participated in the study. METHODS: A structured questionnaire was administered at the motor parks to consecutive and consenting drivers, and basic ocular examinations were done. RESULTS: Using the Federal Road Safety Commission's requirement for commercial drivers in Nigeria, the prevalence of drivers with inadequate visual acuity (VA) was determined to be 11.5%, and 3.3% had monocular blindness. The prevalence of abnormal colour vision and visual field loss was 4.3% and 5.5%, respectively. There was no statistically significant relationship between visual impairment (VA and visual fields) and involvement in road traffic accidents (p > 0.05). Uncorrected refractive error, cataract, and glaucoma were the commonest causes of visual defects. Three hundred thirty-seven drivers (84.5%) did not have their eyes tested at first licensing and 370 drivers (92.7%) did not have testing at least once during renewals. CONCLUSIONS: A significant number of CIVDs in Ilorin are operating with VA that is far below the expected for their class of licence, and another unacceptably high percentage did not undergo any form of ocular examination prior to obtaining their driving licence. There is a need for renewed efforts to enforce a compulsory basic ocular examination for all prospective commercial drivers, and to ensure that the visual requirement for driving is met.

HIV seropositivity and related eye diseases in Uith, Ilorin.

INTRODUCTION: HIV is assuming an alarming pandemic worldwide and presently in Nigeria it is a source of concern to all and sundry. AIM: To review the demography of cases positive for HIV in the eye clinic over a 5-year period and to identify ocular diseases that have high predictive value for HIV. METHODS: A retrospective study of all the patients that were screened for HIV in the eye clinic over a 5-year period was done. Screening was by ELISA method with confirmation by Western blot test. RESULTS: A total of 60 patients were screened and 26 (43.3%) of them were HIV positive. The male to female ratio of HIV positive patients was 1:1. All the seropositive patients were between the ages of 20-49 years and about a third were students from the higher institutions. Half of the patients were single. Diagnoses with high predictive values were Herpes Zoster Ophthalmicus (62%), Steven Johnson syndrome (50%), HIV retinopathy (75%), Bilateral Unresolving Toxoplasmosis (42%). The common presentations however are Herpes Zoster Ophthalmicus (HZO) and unresolving bilateral Uveitis. CONCLUSION: HIV and ocular involvement is increasing in Ilorin. The high-risk groups among patients presenting to the hospital are students of higher institutions and Soldiers. Diseases of high predictive indices are Herpes zoster Ophthalmicus, Steven Johnson's syndrome, HIV retinopathy.