Comparison of microscopic and xpert MTB diagnoses of presumptive mycobacteria tuberculosis infection: retrospective analysis of routine diagnosis at Cape Coast Teaching Hospital.

INTRODUCTION: Tuberculosis is a global health problem that causes 1. 4 million deaths every year. It has been estimated that sputum smear-negative diagnosis but culture-positive pulmonary TB diagnosis contribute to 12.6% of pulmonary TB transmission. TB diagnosis by smear microscopy smear has a minimum detection limit (LOD) of 5,000 to 10,000 bacilli per milliliter (CFU/ml) of sputum result in missed cases and false positives. However, GeneXpert technology, with a LOD of 131-250 CFU/ml in sputum samples and its implementation is believe to facilitate early detection TB and drug-resistant TB case. Since 2013, Ghana health Service (GHS) introduce GeneXpert MTB/RIF diagnostic in all regional hospitals in Ghana, however no assessment of performance between microscopy and GeneXpert TB diagnosis cross the health facilities has been reported. The study compared the results of routine diagnoses of TB by microscopy and Xpert MTB from 2016 to 2020 at the Cape Coast Teaching Hospital (CCTH). METHODS: The study compared routine microscopic and GeneXpert TB diagnosis results at the Cape Coast Teaching Hospital (CCTH) from 2016 to 2020 retrospectively. Briefly, sputum specimens were collected into 20 mL sterile screw-capped containers for each case of suspected TB infection and processed within 24 h. The samples were decontaminated using the NALC-NaOH method with the final NaOH concentration of 1%. The supernatants were discarded after the centrifuge and the remaining pellets dissolved in 1-1.5 ml of phosphate buffer saline (PBS) and used for diagnosis. A fixed smears were Ziehl-Neelsen acid-fast stain and observed under microscope and the remainings were used for GeneXpert MTB/RIF diagnosis. The data were analyze using GraphPad Prism. RESULTS: 50.11% (48.48-51.38%) were females with an odd ratio (95% CI) of 1.004 (0.944-1.069) more likely to report to the TB clinic for suspected TB diagnosis. The smear-positive cases for the first sputum were 6.6% (5.98-7.25%), and the second sputum was 6.07% (5.45-6.73%). The Xpert MTB-RIF diagnosis detected 2.93% (10/341) (1.42-5.33%) in the first and 5.44% (16/294) (3.14-8.69%) in the second smear-negative TB samples. The prevalence of Xpert MTB-RIF across smear positive showed that males had 56.87% (178/313) and 56.15% (137/244) and females had 43.13% (135/313) and 43.85% (107/244) for the first and second sputum. Also, false negative smears were 0.18% (10/5607) for smear 1 and 0.31% (16/5126) for smear 2. CONCLUSION: In conclusion, the study highlights the higher sensitivity of the GeneXpert assay compared to traditional smear microscopy for detecting MTB. The GeneXpert assay identified 10 and 16 positive MTB from smear 1 and smear 2 samples which were microscopic negative.

Comparison of anterior segment parameters in myopia with and without primary open-angle glaucoma.

PURPOSE: To compare anterior segment parameters between myopes with and without primary open-angle glaucoma using Pentacam scheimpflug tomography. METHODS: This was a single-center retrospective cross-sectional study. Records of patients examined with a Pentacam scheimpflug tomographer (Wavelight-Allegro Oculyzer, GmbH, Erlangen, Germany) were reviewed. Variables studied were recorded from the topographic map and included anterior chamber angle, anterior chamber volume, anterior chamber depth, keratometric readings, and corneal thickness. A general linear model for age-and spherical equivalent refraction-adjusted intergroup comparisons of the anterior segment parameters was conducted. RESULTS: The study included myopes previously diagnosed with primary open-angle glaucoma (POAG) [Mild defect, n = 81; Moderate-severe defect, n = 50] and non-glaucomatous myopes (n = 247). The results revealed a smaller anterior chamber angle, shallower anterior chamber depth, and flatter cornea curvature in the mildly glaucomatous group compared to the non-glaucomatous group (p < 0.05). Smaller anterior chamber angle, shallower anterior chamber depth, and thinner cornea thickness were also observed in the moderate-severely glaucomatous group compared to the non-glaucomatous group (p < 0.05). CONCLUSION: Glaucomatous damage in myopic patients with POAG was associated with comparatively small anterior chamber angle, shallow anterior chamber depth, flat cornea curvature, and thin cornea.

Age- and sex-related differences in the measures of anterior segment parameters in a myopic clinical sample using Pentacam Scheimpflug tomography.

PURPOSE: To assess age-and sex-related differences of anterior segment parameters in a myopic clinical sample. METHODS: This clinic-based retrospective study involved eligible subjects grouped into myopia (i.e., low-to-moderate) and high myopia. Demographics and anterior segment parameters measures were recorded and analyzed. RESULTS: Some 153 eligible eyes were analyzed-98 myopia and 55 high myopia-comprising 87 males and 66 females. The mean ages and ranges were 28.47 years (SD = 9.59 years), 8-50 years, and 27.82 years (SD = 9.69 years), 10-51 years, for the myopia and the high myopia groups, respectively. The means of the spherical equivalents were - 3.02 D (SD = 1.46 D, range: - 0.50 to - 5.85 D), for the myopia group and - 10.42 D (SD = 5.50 D, range: - 6.00 to - 21.86 D) for the high myopia group. No significant difference was found between degree of myopia and anterior segment measures. Males had larger anterior chamber volume (mean 175.71 ± 26.27, range: 124-225 mm3); (P = 0.007) and deeper anterior chamber depth (3.73 ± 0.27, range: 3.06-4.41 mm) (P = 0.017) than females in the myopia group. Females also had significantly steeper anterior corneal curvature, Km (ant.) but flatter posterior corneal curvature, Km (post.), (- 6.31 ± 0.25, range - 7.00 to - 5.90 D) in both the myopia group [Km (ant.): 44.06 D ± 1.33 D, range: 41.30-47.10; Km (post.): - 6.31 D ± 0.25 D, range: - 7.00 to - 5.90; P = 0.008, P = 0.002, respectively] and the high myopia group [Km (ant.): 43.79 D ± 0.33 D, range: 41.00-47.10; Km (post.): - 6.22 D ± 0.30 D, range: - 6.80 to - 5.60; P = 0.034, P = 0.049, respectively]. Age was not correlated with the anterior segment parameters in both degrees of myopia. CONCLUSION: Sex has significant influence on the corneal curvature, anterior chamber volume and anterior chamber depth regardless of the degree of myopia.

Meibomian Gland Dysfunction and Lipid Profile: A Study Among Pregnant Women.

PURPOSE: This study aimed to estimate the frequency of meibomian gland dysfunction (MGD) and its associated factors among pregnant women. METHODS: This was a hospital-based cross-sectional study of consecutive pregnant women visiting the University of Cape Coast hospital's antenatal clinic. Meibomian gland assessment and tear function test were performed along with the administration of a symptom questionnaire. Correlation, analysis of variance, and logistic regression analyses were used to examine predictors of MGD. RESULTS: All 201 pregnant women who met the inclusion criteria and gave informed consent were included in the study. The mean age of the entire sample was 29.96 (±4.74) years. The frequency of MGD among the cohort of pregnant women was 22.9% (95% confidence interval, 17.4%-28.9%). Univariate logistic regression revealed that the following factors were significantly associated with MGD: high-density lipoprotein (HDL) (odds ratio [OR] 1.017; 95% confidence interval [CI], 1.001-1.034; P=0.042), total cholesterol (TC) (OR 1.009; 95% CI, 1.003-1.016; P=0.006), and low-density lipoprotein (LDL) (OR 1.008; 95% CI, 1.00-1.016; P=0.049). In multivariate analysis, the model confirmed that MGD was not significantly associated with TC, LDL, and HDL. CONCLUSIONS: In summary, this study showed a high frequency of MGD in pregnant women but comparable with that reported in the normal population. Clinicians examining pregnant women for dry eye disease may need to pay attention to other causative instigators aside MGD to enable the clinicians to make an appropriate etiology-based diagnosis.

Optical coherence tomography indices in the diagnosis and discrimination of stages of primary open-angle glaucoma in an African population.

PURPOSE: The objective of this study was to determine the structure-function association of the optical coherence tomography (OCT) indices (retinal nerve fibre layer (RNFL), ganglion cell complex (GCC) and optic nerve head (ONH) parameters) with the visual field sensitivity and their diagnostic ability at different stages of primary open-angle glaucoma (POAG) among a population West-African descent. METHODS: The study was a clinic-based prospective study which employed purposive sampling in the recruitment of clinically diagnosed POAG and non-glaucoma patients. OCT and visual field test (VFT) results were collated. Classification of the POAG cases was done using the Hodapp-Parrish-Anderson criteria. ROC was used for assessing the diagnostic ability of OCT indices. Pearson's correlation was used to assess the structure-function association. P value < 0.05 was considered statistically significant. CONCLUSIONS: Of the 497 subjects (497 eyes), 301 (60.6%) were males and 196 (39.4%) were females. The average, superior and inferior RNFL and GCC showed a strong positive correlation with the visual field sensitivity, but the average RNFL had the highest correlation (r = 0.673, p < 0.001). The parameters of the ONH showed a moderate-to-weak correlation with the visual field sensitivity. However, there was no significant correlation between structure and function in early POAG (p > 0.05). Superior GCC showed the highest diagnostic ability for POAG (AUC = 0.655; p < 0.001) comparable to the RNFL. Macula (GCC) and (RNFL) have a comparable ability to diagnose POAG at all the stages of POAG and can be used complimentarily for glaucoma assessment and diagnosis.

Laser-induced autofluorescence assisted by multivariate techniques discriminates a cataractous lens from healthy lens tissues of Sprague-Dawley rats.

Laser-induced autofluorescence (LIAF), combined with multivariate techniques, has been used to discriminate a cataractous lens from healthy lens tissues. In this study, 405 nm and 445 nm were used as excitation sources to induce the autofluorescence. Results show higher autofluorescence intensity in cataractous lens tissues than in healthy ones. Cataractous lens tissues show a red shift of 0.9 nm and 1.2 nm at 405 nm and 445 nm excitations, respectively. Using principal component analysis (PCA), three principal components (PCs) gave more than 99% variability for both 405 nm and 445 nm excitation sources. Based on the three PCs, Fisher's linear discriminant model was developed. An accuracy of 100% was obtained in classifying the lens tissues using Fisher's linear discriminant analysis (FLDA). The LIAF technique assisted by PCA and FLDA may be used for objective discrimination of cataractous lens from healthy lens tissues of Sprague-Dawley rats.

Meibomian Gland Dysfunction in a Youthful Clinical Sample in Ghana.

SIGNIFICANCE: This study showed a high frequency of nonobvious obstructive meibomian gland dysfunction, which can be detected only via the expression of the meibomian glands. The study advocates that meibomian gland expressibility should be a routine part of the clinical examination of patients especially those with dry eyes to avoid missing meibomian gland dysfunction among a youthful population. PURPOSE: The aim of this study was to estimate the frequency of meibomian gland dysfunction including asymptomatic and symptomatic meibomian gland dysfunction and obvious and nonobvious obstructive meibomian gland dysfunction among a youthful population in Ghana. METHODS: This was a clinic-based prospective cross-sectional study of consecutive patients visiting the University of Cape Coast Optometric clinic for comprehensive eye examination. RESULTS: Two hundred fifteen clinical subjects consented to participate in the study. Mean age of the entire sample was 21.9 (±3.8) years with an age range of 17 to 40 years. One hundred five males and 107 females participated. Frequency of meibomian gland dysfunction among the sample was 25.5% (95% confidence interval [CI], 19.8 to 31.6%). Frequencies of asymptomatic and symptomatic meibomian gland dysfunction were 10.1% and 15.4%, respectively. Frequencies of obvious and nonobvious obstructive meibomian gland dysfunction were 0.9% and 24.6%, respectively. In univariate logistic regression analysis, age (odds ratio, 1.246; 95% CI, 1.037 to 1.496; P = .019) was significantly associated, but sex (odds ratio, 1.315; 95% CI, 0.707 to 2.446; P = .387) was not significantly associated, with meibomian gland dysfunction. There was a statistically significant difference in the mean corneal staining scores between meibomian gland dysfunction subjects and non-meibomian gland dysfunction subjects (t = 3.51, P = .01). There was also a statistically significant difference in the mean tear breakup time between meibomian gland dysfunction subjects and non-meibomian gland dysfunction subjects (t = 4.44, P < .001). CONCLUSIONS: Because of the high frequency of nonobvious obstructive meibomian gland dysfunction, reliance on overt posterior lid margin abnormalities for the diagnosis of meibomian gland dysfunction may lead to underdiagnosis of meibomian gland dysfunction among clinicians in a youthful population.

Impact of Dry Eye on Psychosomatic Symptoms and Quality of Life in a Healthy Youthful Clinical Sample.

OBJECTIVE: To determine the impact of dry eye on quality of life, depression, anxiety, and stress in a healthy youthful clinical sample. METHODS: This was a clinic-based cross-sectional study. Subjects were patients visiting the University of Cape Coast Eye Clinic for comprehensive eye examination. The age range for recruitment into the study was 16 to 35 years. Eligible participants completed three questionnaires namely the Ocular Surface Disease Index (OSDI), short version of the depression, anxiety, and stress scale (DASS-21), dry eye quality of life score (DEQS) questionnaire. All eligible participants underwent clinical assessment including meibomian gland expressibility, corneal staining, tear breakup time, and Schirmer 1 test. The Spearman correlation coefficient was used to determine the relationship between variables. Univariate and multivariate analyses of variance were used to determine the impact of the OSDI score on DASS-21 subscales scores and the dry eye quality of life scores. RESULTS: All 211 subjects who met the inclusion criteria were included in the analysis. The mean age for the entire sample was 21.6±3.0 years with a range of (17-31) years. Spearman correlation coefficient showed a statistically significant association between OSDI scores and DEQSs (P<0.001), anxiety scores (P<0.001), depression scores (P<0.001), and stress scores (P<0.001). Spearman correlation coefficient showed no statistically significant association between clinical test results and quality of life scores (P>0.05), DASS-21 subscales scores (P>0.05), except anxiety subscale and meibomian gland expressibility score (P=0.026). There were no statistically significant association between clinical test results and OSDI scores (P>0.05) except for the tear breakup time (P=0.018). Using Pillai's trace in the multivariate analysis of variance (MANOVA), there was a significant effect of OSDI severity classification on depression, anxiety, and stress subscales scores of the DASS-21, V=0.37, F(3, 207)=9.67, P<0.001. Furthermore, separate univariate analyses of variances on the outcome variables revealed a significant effect of OSDI severity classification on depression F(3, 207)=35.24, P<0.001, anxiety F(3, 207)=25.27, P<0.001, and stress F(3, 207)=13.08, P<0.001. The MANOVA was followed up with a discriminant analysis, which revealed three discriminant functions. When subjects were classified according to the OSDI grading of severity, there were a statistically significant difference between all levels of severity dry eye symptoms for the DEQSs (F(3, 207) = 63.9.3 P<0.001, η=0.48). CONCLUSION: The study showed that the severity of dry eye symptoms impacted on psychosomatic symptoms and quality of life. The study also revealed that the severity of dry eye symptoms impacted more on the depressive symptoms compared with other psychosomatic symptoms in this youthful clinical sample.

Factors influencing the decision of GHANAIAN optometry students to practice in rural areas after graduation.

BACKGROUND: Human resources for eye health are inequitably distributed in most developing countries including Ghana. In spite of this, most eye care workers are concentrated in urban areas to the disadvantage of rural dwellers who need the services of these workers the most. The aim of the study was to investigate factors that will influence Ghanaian Optometry students' decision to work in rural areas after completion of their training. METHOD: A cross-sectional survey was conducted among Ghanaian optometry undergraduate students. All undergraduate optometry students (first to sixth year) who agreed to take part in the research completed a 37 item questionnaire that explored; demographic characteristics, views about practice choice and possible attractions and incentives to practice in the rural area. RESULTS: A total of 333 (87.4%) participants out of 381 Ghanaian optometry students who were registered for the 2015/2016 academic year completed the questionnaire. Rural origin students had the greatest desire to practice in the rural setting when employed by the Government (78.9%) or by NGO (80.3%). Financial incentives (76.6%), scholarship for further studies (76.0%), better living conditions (71.2%) and career ladder jump for rural health workers (71.2%) were the main incentives that influenced the intention of graduate optometrists to practice in the rural areas. CONCLUSION: Rural origin students are more inclined to work in rural areas than urban origin students, a finding which is informative for optometry training schools when managing their admission policies. Financial incentives among other factors will encourage more students to engage in rural optometric practice irrespective of their place of origin.

Efficacy and safety of extemporaneously prepared miconazole eye drops in Candida albicans-induced keratomycosis.

PURPOSE: Extemporaneously prepared miconazole eye drops (EPMD) are used by some eye care practitioners to manage keratomycosis in Ghana. This study therefore aimed to determine the efficacy and safety of EPMD using in vitro and in vivo experimental models. METHODS: The minimum inhibitory concentration (MIC) of EPMD was determined by the agar-well diffusion method. In vivo, the activity of EPMD on corneal ulcer, neovascularization, clouding, edema, carring and on keratomycotic conjunctivitis and corneal scarring (clinical features) associated with Candida albicans-induced keratomycosis in rabbits was determined by treating them with 0.034-1.08% (weight-in-volume) EPMD for a period of 30 days. The safety of EPMD on the healthy eye was determined by instilling various concentrations into the intact eye of the rabbits. RESULTS: The MIC of EPMD on Candida albicans was 1.08% (zone of inhibition of 13 mm ± 0.578), which resulted in significantly better improvements (p ≤ 0.001) in clinical findings than eyes treated with sterile water (p > 0.05), and showed no significant difference (p > 0.05) compared to eyes treated with 0.3% fluconazole. There were no visible signs of ocular toxicity on instilling it into healthy eyes of rabbits. CONCLUSION: The extemporaneously prepared miconazole eye drops are effective and safe to use in keratomycosis.

Symptomatic Dry Eye and Its Associated Factors: A Study of University Undergraduate Students in Ghana.

BACKGROUND: To estimate the prevalence and risk factors of symptomatic dry eye disease (DED) among undergraduate students in a Ghanaian university. METHODS: This cross-sectional study included 700 undergraduate students of the University of Cape Coast, aged 18 to 34 years. Participants completed questionnaires delivered directly to randomly and systematically selected subjects to detect symptomatic dry eye and its predictive factors. Symptomatic dry eye was defined as any reported symptom on the Standard Patient Evaluation Eye Dryness (SPEED) questionnaire reported as often or constant or if any symptom on the Ocular Surface Disease Index (OSDI) was reported as most of the time or all of the time. Furthermore, OSDI ≥13 and SPEED ≥6 were used to defined symptomatic dry eye and prevalence were also estimated with these criteria as secondary measures. Current symptoms of dry eye and possible risk factors such as age, gender, current alcohol drinking, use of oral contraceptives, use of computer more than an hour daily, environmental conditions, allergies, and self-medication with over-the-counter eye drops were the main outcome measures. We used logistic regression analysis to examine the associations between dry eye and its predictive factors. RESULTS: Of the 700 participants, 650 completed the questionnaire. The prevalence of symptomatic dry eye was 44.3% (95% confidence interval [CI], 40.6%-48.2%). There was a significant association between symptomatic dry eye and discomfort with eyes in windy conditions (χ=110.1; df=4; P<0.001), areas with low humidity (χ=91.6; df=4; P<0.001), and air-conditioned rooms (χ=89.0; df=4; P<0.001). Self-medication with over-the-counter eye drops (OR 4.20; 95% CI, 2.61-6.74; P<0.001), any allergies (OR 2.46; 95% CI, 1.42-4.29; P=0.001), and use of oral contraceptives (OR 4.04; 95% CI, 1.02-16.01; P=0.047) were predictive factors of symptomatic dry eye. Sex was predictive in univariate analysis but was not significantly associated in multivariate analysis. CONCLUSIONS: The prevalence of symptomatic dry eye among undergraduate students in Ghana is high and it is associated with self-medication with over-the-counter eye drops, allergies, use of oral contraceptive, windy conditions, very low humid areas, air-conditioned rooms, and sex. Relevant input directed against modifiable risks factors may have a positive impact on the well-being of undergraduate students in Ghana.

Knowledge and awareness of ocular allergy among undergraduate students of public universities in Ghana.

BACKGROUND: Ocular allergy is a growing public health problem that greatly impacts the day-to-day life of sufferers and their families. Other aspects of their activities of daily living such as schooling, professional, and social life are affected hence an increased awareness and knowledge of ocular allergies, their detection and treatment is paramount. This study was to assess the level of knowledge and awareness of ocular allergy among undergraduate students of public universities in Ghana. METHODS: A descriptive cross sectional survey was conducted among 1000 students from three selected public universities in Ghana. Each respondent completed a questionnaire that had questions concerning awareness and knowledge of ocular allergy. RESULTS: Out of the 1000 students, 347 (34.7 %) were aware of ocular allergy. Of these 347 students, the level of knowledge of ocular allergy was generally low. Majority of the students had their source of information about ocular allergy from the media and the internet. There was statistical significant association among awareness of ocular allergy, sources of information and programme of study (p < 0.001). CONCLUSION: Level of awareness among university students is generally low. Students' programmes of study influenced their knowledge of ocular allergy. Public health measures are recommended to help educate students on the prevention and control of ocular allergy as well as the complications associated with this condition.

Cost of the medical management and prescription pattern for primary open angle glaucoma (POAG) in Ghana-a retrospective cross-sectional study from three referral facilities.

BACKGROUND: Glaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana. METHODS: A retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) cases seen in the year 2012 at three referral facilities. Demographics, ocular history, resource consumption, medication, test, surgery and other related cost were extracted from 84 patients who had fully complied with their treatment to calculate total cost (TC) based on 2012 estimates. Glaucoma drugs prescribed to patients who had adhered to all their review visits within the period evident from case folders were recorded and analysed for the prescription pattern. RESULTS: Out of 891 POAG cases seen in 2012, 351(39.4 %) attended all the required review visits, but only 84 (9.4) had fully and continually adhered to all their treatment regimes. They comprised 41(48.8 %) males and 43(51.2 %) females with a mean age of 65 ± 14.8. Majority of the respondents were elderly above 60 year of age (65.5 %). The total estimated cost for the 84 cases in the year was GH¢ 81,237 ($40,619), comprising GH¢ 72,193 ($36,097) direct medication cost and GH¢9,045 ($4,523) direct non-medication cost (surgery and test cost), and an average of GH¢ 967 ($484) for a mean visit of 5.6 ± 1.1 in the year. A total of 673 glaucoma medications had been prescribed for 351 patients for the year, with timolol being the most prescribed (64.19 %) and monotherapy as the most adopted form of therapy (61.06 %). Age and income showed concurrent increase with cost (P ≤ 0.05). CONCLUSIONS: Cost of managing glaucoma constitutes a substantial financial burden and influenced the pattern of medication prescription.

Anti-asthmatic property and possible mode of activity of an ethanol leaf extract of Polyscias fruticosa.

CONTEXT: Polyscias fruticosa (L.) Harms (Araliaceae) is used as a traditional remedy for asthma in Ghana. OBJECTIVE: The objective of this study is to establish the anti-asthmatic property and a possible mode of activity of an ethanol leaf extract of P. fruticosa (PFE). MATERIALS AND METHODS: The time (min) for pre-convulsive dyspnea, and time for recovery, after sensitization with 150 µg OVA and induction of bronchospasm with 1% acetylcholine or histamine in normal, and 100, 250, and 500 mg/kg PFE-treated Dunkin Hartley guinea pigs, were recorded. Atropine (0.1 mg), mepyramine (0.1 mg), and PFE (1 mg) effect on a contractile response of 2.0 × 10(-2) µg/ml acetylcholine and 5.8 × 10(-2) µg/ml histamine on the isolated guinea pig ileum was investigated. Cytological and histological studies were conducted using guinea pig peritoneal mast cells and mesenteric cells, respectively, to establish PFE effect on compound 48/80-induced mast cell degranulation. RESULTS: PFE (100-500 mg/kg) prolonged the onset of pre-convulsive dyspnea by 76.1-180.2% (p ≤ 0.01-0.001), and decreased recovery time by 71.9-78.5% (p ≤ 0.01-0.001). It also enhanced percentage protection against histamine-induced bronchospasm by 15.8-80.1-fold (p ≤ 0.05-0.01), and decreased percentage recovery time 2.5-3.3-fold (p ≤ 0.05-0.01). PFE significantly inhibited (60.4 ± 8.3%) contractile responses of histamine and produced significant inhibition (56-79%: p ≤ 0.001) of mast cell degranulation. CONCLUSION: PFE has anti-asthmatic, antihistaminic, and mast cell stabilization effect making it useful in traditional asthma management.

Demographic characteristics of Ghanaian optometry students and factors influencing their career choice and institution of learning.

Optometry is only provided at tertiary level in two institutions in Ghana, with an average of 50 students graduating each year for a population of approximately 24.6 million. No information on the demography of optometry students and factors that influence their choice of optometry as a career and institution of learning is available. This information is important as it will assist optometry institutions to formulate effective student recruitment strategies. To assess the demographic characteristics of Ghanaian optometry students, the factors that influence their selection of optometry as a career and institution of learning. We conducted a cross sectional study among Ghanaian optometry students using a structured questionnaire to collect data on the demographic characteristics and factors that might influence their choice of optometry as a career as well as choice of institution of learning. Two hundred and eighty students from the two optometry training institutions in Ghana; University of Cape Coast (48.2%) and Kwame Nkrumah University of Science and Technology (51.8%) responded to the questionnaire. Their ages ranged from 17 to 28 years with most being males (72.5%), and the majority (79%) being from urban areas. The main factors that influenced their career choice were job availability after graduation (90%) and desire to help other people (89.2%). Factors that influenced their institution choice were preference for an institution (36.8%) and proximity to home (24.4%). In the absence of adequate optometry jobs in the public health sector, women will remain marginalised specifically those in rural areas. This marginalisation is however, a reflection of a broader societal disadvantage for women. Greater effort needs to be made to recruit high school students from rural areas to study optometry and more institutions need to provide optometry instruction throughout the country.

The effect of caffeine on tear secretion.

PURPOSE: Caffeine, probably the most widely consumed psychoactive substance, is claimed to have conflicting effects on some tear film dynamics. This study sought to investigate the effect of orally ingested caffeine on tear secretion. METHODS: In an examiner-masked, placebo-controlled, crossover experimental model, the effect of caffeine intake on tear secretion was studied in 41 healthy volunteers aged 20 to 26 years (mean, 23.0 ± 2.1 years). Participants were randomly assigned into two groups, A and B, to receive two different treatments in two sessions. Subjects in group A were exposed to 5.0 mg/kg body weight of caffeine dissolved in 200 mL of water on their first visit, whereas those in group B were exposed to 200 mL of water. On the second visit, however, the order of treatment was reversed. Schirmer 1 scores were measured repeatedly at 45, 90, 135, and 180 minutes after treatment. The baseline Schirmer 1 scores were compared with posttreatment scores. RESULTS: Schirmer 1 scores increased after caffeine intake. The increase was statistically significant at 45 and 90 minutes (p < 0.05) after caffeine intake. Age, body mass, and blood pressure had no correlation with Schirmer 1 scores (Spearman correlation test, p > 0.05). There was no influence of gender in caffeine's effect on tear secretion (F = 0.994, p = 0.399). CONCLUSIONS: From our study, orally ingested caffeine appears to stimulate tear secretion in healthy non-dry eye subjects.

Care practices of contact lens solutions and microbial contamination among wearers in Ghana.

PURPOSE: This study sought to assess contact lens solutions care practices, and their microbial contamination among contact lens wearers in Ghana and to profile their antibiotic susceptibility pattern. METHODS: The study employed a biphasic approach which involved a cross-sectional design that investigated participants' habits related to care for the solutions with a two-part questionnaire and a microbiological analysis of samples of contact lens care solutions of the participants for microbial contamination. A snowball sampling method provided access to 32 different contact lens wearers in four care facilities in Ghana. In most cases, the participants had no pre-existing familial relationship with each other or with the care facilities. RESULTS: Out of 32 samples of contact lens solutions, 30 were tested for microbial contamination. A total of 23 (76.67 %) samples of contact lens solution were found to be contaminated with Enterobacter sp. (34.80 %), Pseudomonas sp. (21.70 %), Bacilli sp. (21.70 %), Klebsiella sp. (17.20 %), and Escherichia coli (4.60 %). The duration of solution storage in the open bottle and nonadherence to manufacturer instructions for solution storage showed a statistically significant association with microbial contamination (p ≤ 0.05). CONCLUSION: Contact lens care solutions have been found to harbour multiple antibiotic-resistant bacteria that are potentially pathogenic to the corneal surface. The contamination is associated with some unhealthy solution-care practices among wearers.

Compliance with spectacle wear among learners with hearing impairment in Ghana.

Background: Hearing-impaired learners with refractive problems require correction because poor vision hinders their development and educational pursuits. Objectives: To determine the level of compliance with spectacle wear in learners with hearing impairment in Ghana. Method: A descriptive cross-sectional study design was used to investigate the level of compliance with spectacle wear in hearing-impaired learners with uncorrected refractive errors (URE). The participants were from six schools for the hearing impaired, comprising three schools from each sector (Northern and Southern) of Ghana. Results: Of the 1914 learners screened, 69 (3.61% CI: 2.82-4.54%) had URE. Sixty-two (89.9%) learners with URE had myopia (-0.50 Dioptre Sphere (DS) to -2.00DS), and 7 (10.1%) had hyperopia (+2.00DS to +10.00DS). There were more females (53.6%) with URE than males, and their ages ranged from 8 to 35 years, with a mean of 17.35 ± 5.19 years. Many (56.5%) learners complied with spectacle wear after 3 months of reassessment, with females being more compliant than males, but the difference was not significant (p = 0.544). Learners who complied well with the spectacle wear were those with moderate visual impairment (VI), followed by mild VI, while those with no VI were the least compliant. A significant difference was observed between spectacle compliance and presenting VI (p = 0.023). Conclusion: The spectacle wear compliance level was high compared to a previous study (33.7%) in Ghana. Contribution: This study highlights the importance of addressing URE among learners with hearing impairment in Ghana and Africa.

Prevalence and risk factors of Vernal Keratoconjunctivitis among a Ghanaian clinical cohort: A case-control study.

Background: Vernal Keratoconjunctivitis (VKC) has been determined to be highly prevalent in countries within the tropical climate region. However, little evidence from studies conducted within this region has been put forward to support this claim. Aim: To determine the prevalence and risk factors of VKC among a Ghanaian clinical cohort. Methods: A 3-year case-control study was conducted in a tertiary eye care institution, and medical records of patients who had been diagnosed of VKC between 2018 and 2021 were reviewed. Results: Medical records of 3800 patients were reviewed. Some 359 cases of VKC were identified, with a population prevalence rate of 9.45%. Males comprised 57.1% of the population with VKC, with a male-to-female ratio of 1.33:1. The disease was more prevalent (40.8%) in children (≤17 years), and the overall odds of incidence decreased by 10% for a unit increase in age. Age and sex-adjusted models revealed significant positive associations between Keratoconus [aOR = 40.760, 95% CI -5.948 to 339.937], Rhinitis [cOR = 5.183, 95% CI -2.074 to 12.022] and VKC. However, the incidence of VKC was relatively less expressive among pterygium cases [cOR = 0.315, 95% CI -0.077 to 0.846]. Conclusion: VKC is highly prevalent among children and is often associated with comorbidities of atopic origin that exacerbate the impact of the disease among this vulnerable population. It is imperative that clinicians provide holistic care for children with VKC.

Schistosomiasis-Microbiota Interactions: A Systematic Review and Meta-Analysis.

INTRODUCTION: Schistosomiasis, a tropical disease affecting humans and animals, affected 251.4 million people in 2021. Schistosoma mansoni, S. haematobium, S. intercalatum, and S. japonicum are primary human schistosomes, causing tissue damage, granulomas, ulceration, hemorrhage, and opportunistic pathogen entry. The gut and urinary tract microbiota significantly impact a host's susceptibility to schistosomiasis, disrupting microbial balance; however, this relationship is not well understood. This systematic review and meta-analysis explores the intricate relationship between schistosomiasis and the host's microbiota, providing crucial insights into disease pathogenesis and management. METHODS: This systematic review used PRISMA guidelines to identify peer-reviewed articles on schistosomiasis and its interactions with the host microbiome, using multiple databases and Google Scholar, providing a robust dataset for analysis. The study utilized Meta-Mar v3.5.1; descriptive tests, random-effects models, and subgroups were analyzed for the interaction between Schistosomiasis and the microbiome. Forest plots, Cochran's Q test, and Higgins' inconsistency statistic (I2) were used to assess heterogeneity. RESULTS: The human Schistosoma species were observed to be associated with various bacterial species isolated from blood, stool, urine, sputum, skin, and vaginal or cervical samples. A meta-analysis of the interaction between schistosomiasis and the host microbiome, based on 31 studies, showed 29,784 observations and 5871 events. The pooled estimates indicated a significant association between schistosomiasis and changes in the microbiome of infected individuals. There was considerable heterogeneity with variance effect sizes (p < 0.0001). Subgroup analysis of Schistosoma species demonstrated that S. haematobium was the most significant contributor to the overall heterogeneity, accounting for 62.1% (p < 0.01). S. mansoni contributed 13.0% (p = 0.02), and the coinfection of S. haematobium and S. mansoni accounted for 16.8% of the heterogeneity (p < 0.01), contributing to the variability seen in the pooled analysis. Similarly, praziquantel treatment (RR = 1.68, 95% CI: 1.07-2.64) showed high heterogeneity (Chi2 = 71.42, df = 11, p < 0.01) and also indicated that Schistosoma infections in males (RR = 1.46, 95% CI: 0.00 to 551.30) and females (RR = 2.09, 95% CI: 0.24 to 18.31) have a higher risk of altering the host microbiome. CONCLUSIONS: Schistosomiasis significantly disrupts the host microbiota across various bodily sites, leading to increased susceptibility to different bacterial taxa such as E. coli, Klebsiella, Proteus, Pseudomonas, Salmonella, Staphylococcus, Streptococcus, and Mycobacterium species (M. tuberculosis and M. leprae). This disruption enables these bacteria to produce toxic metabolites, which in turn cause inflammation and facilitate the progression of disease. The impact of schistosomiasis on the vaginal microbiome underscores the necessity for gender-specific approaches to treatment and prevention. Effective management of female genital schistosomiasis (FGS) requires addressing both the parasitic infection and the resulting microbiome imbalances. Additionally, praziquantel-treated individuals have different microbiome compositions compared to individuals with no praziquantel treatment. This suggests that combining praziquantel treatment with probiotics could potentially decrease the disease severity caused by an altered microbiome.