Blindness and Visual Impairment among Adults in a Tertiary Eye Clinic, in Osogbo S W Nigeria.

BACKGROUND: To plan and implement appropriate management of patients with blindness and visual impairment (VI) requires the knowledge of the common presenting causes. AIM: The aim of the following study is to determine the common causes of VI in adults and develop a template for eye care delivery. MATERIALS AND METHODS: A retrospective descriptive analysis of subjects aged 17 years and above who attended LAUTECH Teaching Hospital eye clinic between October 2012 and March 2013. Information on demographic data, visual acuity, anterior and posterior segment examinations, and refraction were obtained from patients' records. Statistical Package for the Social Sciences version 16. 2, USA was used for descriptive analysis. Chi-square, P values and confidence intervals (CI) were derived for statistical significance. RESULTS: A total of 617 cases were reviewed including 306/617 (49.6%) males and 311/617 (50.4%) females. The frequently occurring age-groups were the 51-60 year 120/617 (19.4%) and the 61-70 year 115/617 (18.6%). The common causes of blindness and VI were cataract 225/617 (36.5%, CI: 32.7-40.3), glaucoma 124/617 (20.1%, CI: 16.93-23.25), refractive errors 119/617 (19.3%, CI: 16.17-22.4); trauma and cornea opacities 14/617 (6.1%) each. Refractive error 6/176 (3.4%) was a significant cause of blindness in this study. χ(2) = 33.68, P < 0.001. More females presented with refractive errors 79/311 (66.4%), while more males presented with trauma 32/306 (78.0%). χ(2) = 186.47, P < 0.001. CONCLUSIONS: The common causes of VI are avoidable. Planning for best practice methods, purchase of equipment/instruments, consumables, drugs, and manpower development is required. Establishment of low-cost cataract surgical and refractive services could reduce their incidence.

Asymptomatic bacteriuria among elderly and middle-aged rural community-dwellers in South-Western Nigeria.

Asymptomatic bacteriuria in elderly individuals has been well described in institutionalized settings, but to a lesser extent in the community. The purpose of this study was to determine the pathogens responsible for asymptomatic bacteriuria in elderly and middle-aged individuals in Alajue-Ede, South-Western Nigeria, and to identify any associated factors. Mid-stream urine samples were collected from apparently healthy elderly and middle-aged volunteers who were participating in community health screening. Samples were processed and bacterial isolates were identified following standard procedures. In total, 128 volunteers (48 men, 76 women) participated in the study. Twenty-eight (22.6%) urinary pathogens were isolated, comprising Klebsiella species in five (17.9%), Pseudomonas aeruginosa in one (3.6%), Escherichia coli in 19 (67.9%), and Proteus species in three (10.7%) cases. Women were identified as being at higher risk of asymptomatic bacteriuria, and the prevalence also increased with increasing age in men. The elderly in this community have a high prevalence of asymptomatic bacteriuria, and screening for comorbid medical conditions may be of benefit.

Prevalence of hypertension in the rural adult population of Osun State, southwestern Nigeria.

BACKGROUND: The purpose of this study was to determine the prevalence of hypertension in two rural communities of Osun State, Nigeria. METHODS: A consenting adult population of the Alajue and Obokun rural communities in southwestern Nigeria that presented for the screening exercise participated in this community-based cross-sectional descriptive study. Two hundred and fifty-nine respondents aged older than 18 years completed a standardized, pretested, structured questionnaire as part of activities celebrating World Kidney Day and World Glaucoma Day in 2011. Anthropometric data and blood pressure were recorded, and the data were analyzed using the Statistical Package for Social Sciences version 17. RESULTS: The mean age of the respondents was 49.7 ± 1.6 years, 100 (38.6%) were males, 84 (32.4%) were farmers, and 111 (42.9%) were traders. The prevalence of hypertension was 13.16% (present in 34 respondents). Seventeen (6.6%) had isolated systolic hypertension, while 11 (4.2%) had isolated diastolic hypertension. Two hundred and thirty-six (91.1%) undertook daily exercise lasting at least 30 minutes and 48 (18.5%) had ever taken antihypertensive drugs on a regular basis. Four respondents (1.6%) claimed a family history of hypertension. The average body mass index (BMI) among respondents was 23.4 ± 4.9 kg/m(2), 51 (19.6%) had a BMI of 25.0-29.9, and 30 (11.5%) had a BMI ≥ 30. A significant association existed between age older than 40 years and having hypertension (P < 0.05), while no relationship existed between age and BMI or between gender and hypertension (P > 0.05). Rates of older age and high BMI were significantly higher among hypertensives than among normotensives. Respondents with BMI ≥ 25 had at least a three times greater likelihood of developing hypertension than those with BMI < 25 (odds ratio 2.9, 95% confidence interval 0.007-0.056, P = 0.011). CONCLUSION: The prevalence of hypertension is high in this study population and we recommend scaling up primary prevention efforts to reduce this in Nigerian communities.

The anterior segment of the eye in diabetes.

PURPOSE: A prospective study to examine the anterior segment of the eye in patients with diabetes mellitus. MATERIALS AND METHODS: The anterior segments of the eyes of 181 patients with diabetes mellitus were examined. The commonest finding in the lids was warts, followed by poliosis and chalazia, and, in the conjunctiva, tortuous conjunctival vessels inferiorly (36.50%), pterygium (14.92%), and pingueculum (14.37%). Corneal sensitivity was reduced in 25 (13.80%) patients. Iris atrophy was the commonest finding in the iris. Dilatation of the pupil was delayed in 34 (18.79%) patients. Cataract was found in 119 (65.75%) patients. Forty-one (22.65%) patients had intraocular pressure greater than 21 mmHg. Seven (3.87%) patients, four (2.21%) patients, and one (0.55%) patient had seventh, third, and fourth palsy, respectively. No patient had sixth nerve palsy. CONCLUSION: Primary care physicians and other allied health care professionals who are first in contact with patients are enjoined to familiarize themselves with the anterior segment features of diabetes mellitus and take necessary action when they are detected.