Association of Poor Quality of Sleep with Vision-Threatening Diabetic Retinopathy: A Matched Case-Control Study.

INTRODUCTION: Vision-threatening diabetic retinopathy, a long-term microvascular complication of diabetes in the eye, is a major cause of blindness worldwide. Sleep is regulated by a special area of the brain, and poor quality of sleep has been implicated in long-term diabetic complications, including diabetic retinopathy. The study was aimed at exploring whether poor sleep quality is associated with the likelihood of developing vision-threatening diabetic retinopathy. METHODS: A matched case-control study was conducted from 6 May 2022 to 6 September 2022. The study was based on patients with diabetes (both type 1 and type 2), attending a retina clinic of the referral center. Patients with confirmed vision-threatening diabetic retinopathy were defined as cases and matched with control study subjects. Rating of sleep quality was done by Pittsburgh Sleep Quality Index assessment tool. Conditional logistic regression model was applied to assess the effect of overall poor sleep quality on vision-threatening diabetic retinopathy. RESULTS: The study recruited a total of 126 (63 duration-matched pairs) patients with diabetes. The overall quality of sleep was poor among 71.90% of patients in the case groups, significantly higher compared with those of the control groups (28.10%) (p < 0.00). The mean quality of sleep for cases [mean (M) = 7.10, standard deviation (SD) = 4.30] was higher than the control group (M = 3.60, SD = 2.70). The magnitude of the difference [M difference = 3.50, 95% confidence interval (CI): 2.25-4.75] was significant. Poor sleep quality predicted the chance of developing vision-threatening diabetic retinopathy in a diabetic cohort. CONCLUSIONS: This study revealed a significant association between the overall poor quality of sleep and vision-threatening diabetic retinopathy. Co-management of sleep disruption and vision-threatening diabetic retinopathy, and better sleep advisory are warranted.

Prevalence of Occupational Ocular Injury and Associated Factors Among Small-Scale Industry Workers in Gondar Town, Northwest Ethiopia, 2019.

PURPOSE: To assess the prevalence of occupational ocular injury and associated factors among small-scale industry workers in Gondar town, Northwest Ethiopia. METHODS AND MATERIALS: Institution-based cross-sectional study was conducted on 542 manufacturing and construction workers in Gondar town from April 23 to May 4, 2019. A pre-tested questionnaire was used to collect data using face-to-face interview. Binary logistic regression was used to identify factors associated with occupational ocular injury. RESULTS: A total of 542 small-scale industry workers participated with a 95.1% response rate. The prevalence of occupational ocular injury was 31.4% (95% CI, 27.2-35.5). Employment pattern (temporary workers) (AOR: 1.84, 95% CI: 1.14-2.95), health and safety training (AOR: 2.22, 95% CI: 1.06-4.66), non-use of eye safety device (AOR: 7.43, 95% CI: 4.44-12.43), and job category (woodwork (AOR: 0.56, 95% CI: 0.32-0.97)), and brickwork (AOR: 2.19, 95% CI: 1.08-7.21) had statistically significant with occupational ocular injury. CONCLUSION: This study showed the prevalence of occupational ocular injury among small-scale industry workers was 31.4%. Iron chips are the most common agent responsible for the injury. Type of employment, having health and safety training, use of eye safety devices, and job category had a significant association with occupational ocular injury.

Knowledge about diabetic retinopathy, eye check-up practice and associated factors among adult patients with diabetes mellitus attending at debark hospital, Northwest Ethiopia.

BACKGROUND: Routine eye examination plays a vital role in detecting diabetic retinopathy in its earliest stage before the onset of blindness. Patients' knowledge about the nature and the consequences of diabetic retinopathy and routine eye checkup helps for timely identification and early treatment. However, there is limited evidence on knowledge of patients with diabetes mellitus on diabetic retinopathy and their eye check-up practices in Ethiopia. The aim of this study was to assess knowledge about diabetic retinopathy, eye check-up practice and associated factors of diabetic retinopathy among adult diabetic patients at Debark hospital, Northwest Ethiopia. METHODS: Institution based cross-sectional study was conducted at Debark hospital, Northwest Ethiopia, from April 20/2018- May 20/2018. A pretested interviewer administered structured questionnaire was used to collect data among 230 diabetic patients aged 18 years and above. Data were entered in to Epi Info version 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable binary logistic regression analyses were done. Odds ratio with 95% confidence level was determined and variables with p-value of < 0.05 were considered as statistically significant. RESULT: Out of 238 sample 230 were participated, among this, 119 (51.7%) were males. The mean age of the respondents was 49 (SD ±17.6) years. One hundred nine (47.4%) participants had good knowledge and 91 (39.6%) had good eye check-up practice. Urban residence [AOR = 2.65;95% CI: 1.16-6.07)]), monthly income of 3501-8000 birr [AOR = 4.54;(1.31-15.7)], type II diabetes mellitus [AOR = 3.9;(1.6-9.6)], duration of diabetes (6-12 years [AOR = 4.4;(1.4-13.5)]), history of eye disease [AOR = 5.5;(2.3-13.0)] were associated with good knowledge. Similarly, longer duration of diabetes (13-25 years [AOR = 3.77; (1.05-13.5)]) and history of eye disease [AOR = 2.47; (1.09-5.62)] were associated with good eye check-up practice. CONCLUSION: The proportion of good knowledge about diabetic retinopathy among diabetic patients at Debark hospital was fair (47.4%) and good eye check-up practice (eye examination at least once in the past year) was low (39.6%). Longer duration of diabetes and history of eye disease were identified as positive factors for good knowledge and eye check-up practice. Knowledge and regular eye check-up practice needs to be enhanced through provision of appropriate health education.

Visual Impairment among Primary School Children in Gondar Town, Northwest Ethiopia.

BACKGROUND: An impairment of the visual system at or shortly after birth adversely affects educational performance of children which typically occurs through vision. Limited evidence on the magnitude and causes of visual impairment is one of the reasons for the low priority given to eye care in low-income countries. OBJECTIVES: To estimate the prevalence and determine the causes of visual impairment in primary school children in Gondar town, Northwest Ethiopia. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among 1289 children aged 5-15 years who were randomly selected in 9 primary schools (government and private) from May to June 2016. Visual acuity was measured at 6 m using Snellen's chart, and children with an acuity of less than 6/18 in the better eye underwent refraction and a detailed eye examination. A cause of their impairment was determined. Data were recorded using pretested tools. . Statistical Package for Social Sciences version 16 was used to enter and analyze the data using 95% confidence intervals. RESULTS: The prevalence of visual impairment was 1.8%. Refractive errors (nearly 70%) followed by strabismus and cataract, each contributing 4.3%, were the most frequent causes of visual impairment in the study population. Majority (87%) of the children had moderate degree of vision impairment, and 10-15-year age groups are the more affected ones. Children of age fifteen and above showed statistically significant association with visual impairment (p=0.005). CONCLUSION: The magnitude of visual impairment in primary school children in the study area is significant. School screening programme is recommended to minimize the burden of visual impairment in the study area.

Vision-Related Quality of Life among Adult Patients with Visual Impairment at University of Gondar, Northwest Ethiopia.

PURPOSE: The purpose of this study was to assess vision-related quality of life and associated factors among adult patients with visual impairment at the University of Gondar Tertiary Eye Care and Training Center, Northwest Ethiopia. METHODS: The institution-based cross-sectional study was conducted from April 24 to May 12, 2017, at the University of Gondar Tertiary Eye Care and Training Center among 484 patients with visual impairment. Pretested, structured National Eye Institute Visual Function Questionnaire-25 was used to collect data by interviewing. Data were entered using EPI-INFO version 3.5.1 and analyzed with SPSS version 20. Binary logistic regression was used to determine factors associated with vision-related quality of life. Variables with p value <0.05 in multivariable logistic regression were considered as statistically significant. RESULT: A total of 484 study subjects participated with a response rate of 98.9%. The median age of the participants was 60 years with the interquartile range of 25 years. The proportion of poor vision-related quality of life was 238 (49.2%) (95% CI: 44.2%-53.3%). Age >75 years (AOR = 1.87 (95% CI: 1.02-3.40)), rural residency (AOR = 1.71 (95% CI: 1.13-2.60)), severe visual impairment/blindness (AOR = 2.76 (95% CI: 1.80-4.23)), and history of visual impairment longer than 3 years (AOR = 2.85 (95% CI: 1.61-5.04)) had statistically significant association with poor vision-related quality of life. CONCLUSION: Almost half of the patients with visual impairment had poor vision-related quality of life. Severe visual impairment/blindness, long duration of visual impairment, older age, and rural residency had a statistically significant association with poor vision-related quality of life.

Awareness and knowledge of glaucoma and associated factors among adults: a cross sectional study in Gondar Town, Northwest Ethiopia.

BACKGROUND: Raising public awareness and knowledge about glaucoma is a key for early case identification and prevention of blindness. However, awareness and knowledge about glaucoma is unknown at community level, making provision of interventions difficult. This study was intended to assess the awareness and knowledge of adults about glaucoma and the factors affecting it in Gondar town, Northwest Ethiopia. METHODS: Community based cross - sectional study was conducted on 701 adults 35 and above years in Gondar from April 12-30, 2016. Multistage sampling technique was used to select study participants. Interviewer administered pretested structured questionnaire was used to collect data after verbal informed consent. Data were entered into EpiData version 3.1 and analyzed by Statistical Package for Social Sciences version 20. Bivariate and multivariate logistic regression models and Odds ratio with 95% interval were used to identify factors. P-value <0.05 was considered statistically significant. RESULTS: Seven hundred one adults age 35 and above years were participated with a response rate of 99.3%. The male to female ratio was 1:1.6 with median age of 48 years with interqurtile range of 20. The proportion of awareness was 35.1% (95% CI: 31.5%, 38.6%). Good knowledge was demonstrated in 49.6% (95%CI: 43.3%, 55%) of glaucoma aware participants. Education (primary [AOR: 3.21; 1.73, 5.95], secondary [AOR: 4.34; 2.30, 8.22]; college and above [AOR: 9.82; 4.27, 22.60]) and having eye examination [AOR: 2.78; 1.86, 4.15] were positively associated with awareness of glaucoma whereas older age (65 -74 years [AOR: 0.31(0.21, 0.76]) was inversely related. Level of Education (primary[AOR:2.83;1.04,7.71],secondary[AOR:3.45;1.33,9.41],college and above [AOR: 4.86;1.82,12,99] and having eye examination [AOR: 2.61;1.53,4.45] were significantly associated with knowledge. CONCLUSION: The study has indicated higher level of awareness and knowledge about glaucoma in urban communities than previous studies. It has also identified educational status, eye examination at least once in life are related with better awareness and knowledge. The present awareness and knowledge should be enhanced through public oriented glaucoma education via mass media and incorporating eye check up as a routine in older people.