Profile of Cataract Surgical Patients at the National Eye Centre, Kaduna, Nigeria.

Background: Cataract surgery has evolved over the years. This study aims to highlight the profile of the patients that underwent cataract surgery at a tertiary hospital with emphasis on patient demographics, surgical techniques performed, intraocular lens powers implanted, and the complications managed. Methodology: A retrospective cross-sectional descriptive study of all patients who had undergone cataract surgery within two years at the National Eye Centre, Kaduna, Nigeria. Data extracted from the electronic version of the manual cataract surgical records included the patient's age, sex, comorbidities, technique of cataract surgery performed, the intraocular lens powers implanted, and complications encountered. Intraoperative and postoperative complications up to the twelfth week were considered. All patients had biometry-guided intraocular lens implantation. Results: One thousand four hundred and seventy- two (1,472) patient records of all ages met the inclusion criteria with a male-female ratio of 1.4:1. The mean age was 51.4 ± 22.6 years. The difference in the mean age of the sexes was statistically significant (p=0.01) and 95% CI was 7.37- 10.40 years. Glaucoma was the commonest ocular comorbidity 142(9.65%) and only 5% (74) had systemic comorbidities. The mean intraocular lens (IOL) power was 19.25 ± 1.8Diopters (Range 10.5D to 26D). The commonest surgery performed was small incision cataract extraction with posterior chamber intraocular lens implant (SICS + PCIOL) 91.2% followed by Trabeculectomy with SICS + PCIOL (3.87%). Phacoemulsification accounted for 2.72% of surgeries. Intra-operative complications were posterior capsular rent in 7.1% (104) and vitreous loss in 4% (58). The commonest post-operative complications were corneal edema6.9% (103) and striae keratopathy 4.6% (68). Conclusion: Most cataract patients were male, above 50years of age and likely to be older than the females at surgery. The most performed surgical technique was small incision cataract surgery with posterior chamber intraocular lens implantation (SICS + PCIOL) while the mean intra-ocular lens power was 19.25 ± 1.8Dioptres. Globally accepted cataract surgical techniques utilizing recent technological advancements were employed with biometry-guided intraocular lens power calculation and implantation. Complications fell within the accepted global rates.

Household coverage of ivermectin distribution in birnin kudu local government area of Jigawa State, Nigeria.

Purpose: To assess community-directed treatment coverage with Ivermectin (CDTI) in Onchocerciasis-endemic communities in Birnin Kudu local government area (LGA) Jigawa state. Subjects and Methods: This was a community-based multistaged cross-sectional survey based on probability proportional to size. The study involved the administration of a questionnaire on 2021 respondents from 207 households. Also, 30 Community Leaders and Community Directed Distributors (CDDs) were purposively selected for interview from the communities visited. Results: Overall, 2021 respondents from the 2031 sampled population took part in the study giving a response rate of 99.6%. Slightly above half, 1130 (55.9%) were males. The geographic and therapeutic coverage of mass drug administration of Ivermectin achieved in the LGA was 100% and 79.9%, respectively. The key factors affecting coverage includes the unavailability of drugs (48.8%), absenteeism of some of the household members (31%), and inadequate incentives to the CDDs by the government and poor record keeping by the CDDs. Conclusion: This study found that the minimum geographic and therapeutic coverage of Ivermectin distribution was achieved by CDD as recommended by the World Health Organization for the control of onchocerciasis. For this to be sustained and to achieve elimination, there must be an adequate supply of ivermectin, training of CDDs, retraining of CDDs, adequate supervision in record keeping, and health education to the community.

Résumé Objectif: Évaluer la couverture du traitement sous direction communautaire à l'ivermectine (TIDC) dans les communautés endémiques de l'onchocercose de la zone d'administration locale de Birnin Kudu (LGA) dans l'État de Jigawa. Sujets et méthodes: Il s'agissait d'une enquête transversale communautaire à plusieurs degrés basée sur une probabilité proportionnelle à la taille. L'étude a impliqué l'administration d'un questionnaire sur 2021 répondants de 207 ménages. De plus, 30 leaders communautaires et distributeurs dirigés par la communauté (CDD) ont été délibérément sélectionnés pour un entretien dans les communautés visitées. Résultats: Globalement, 2021 répondants sur la population échantillonnée de 2031 ont participé à l'étude, soit un taux de réponse de 99,6 %. Un peu plus de la moitié, 1130 (55,9 %) étaient des hommes. La couverture géographique et thérapeutique de l'administration massive d'ivermectine obtenue dans la LGA était de 100 % et de 79,9 %, respectivement. Les principaux facteurs affectant la couverture comprennent l'indisponibilité des médicaments (48,8%), l'absentéisme de certains membres du ménage (31%), et les incitations inadéquates aux DC par le gouvernement et la mauvaise tenue des dossiers par les DC. Conclusion: Cette étude a révélé que la couverture géographique et thérapeutique minimale de la distribution d'ivermectine était atteinte par le CDD tel que recommandé par l'Organisation mondiale de la santé pour le contrôle de l'onchocercose. Pour que cela soit durable et pour parvenir à l'élimination, il doit y avoir un approvisionnement adéquat en ivermectine, une formation des DC, un recyclage des DC, une supervision adéquate de la tenue des dossiers et une éducation sanitaire de la communauté. Mots-clés: Distributeurs communautaires, TIDC, ivermectine, onchocercose.

Impact of Eighteen-Year Varied Compliance to Onchocerciasis Treatment with Ivermectin in Sentinel Savannah Agrarian Communities in Kaduna State of Nigeria.

Baseline and impact assessment data were generated in 1994 (n = 532) and 2011 (n = 593) from 6 sentinel villages with generalized onchocerciasis. Only volunteers and a cohort (n = 445, 75%) were screened at both visits. Each village had received 11 (64.7%) annual treatments and 92.6%, range 88.7-100%, treatment compliance. Overall mean number of treatment was 2.9 ± 1.6 with a range 2.0 ± 1.2-3.3 ± 0.6. Significant decreases in skin microfilaria prevalence from 201 (38%) to 0 (0%), palpable nodule from 77 (15%) to 4 (0.7%), dermal changes from 51 (9.6%) to 2 (0.04%), optic nerve disease from 24 (4.5%) to 4 (2.0%), and onchocercal inducible ocular lesions from 31 (5.8%) to 12 (2.0%) were recorded, P < 0.05, (t-test of unpaired data). Cases of glaucoma, 8 (1.4%), and blindness, 6 (1.05%), remained unchanged. Visual acuity ≥6/24 in one or both eyes, 198 (33.45%); cataract, 169 (28.5%); pterygium 157 (26.5%); and acute senilis, 165 (27.9%), were significantly increased and positively correlated with increase in age (R (2) = 0.898 - 0.949). Dissected parous Simulium damnosum caught (n = 222) were without infective third stage larva. Active onchocerciasis transmission seems halted despite varied compliance to long-term ivermectin treatment. We recommend continued surveillance and targeted treatment of controlled and hypoendemic areas.