Profiling and factors associated with glaucoma diagnostic practice in sub-Saharan Africa-a cross sectional study of Nigerian and Ghanaian optometrists.

BACKGROUND: Ghana and Nigeria are the two countries in Africa that currently run the Doctor of Optometry (OD) program in sub-Saharan Africa (SSA). Optometrists in these countries are licensed to provide glaucoma care. Despite the clinically relevant practice guidelines for glaucoma, there is no data on the practice patterns for glaucoma eye care in SSA, a region with the highest prevalence of glaucoma. This study aimed to profile glaucoma diagnosis adherence to practice guidelines among optometrists in two neighbouring anglophone countries (Nigeria and Ghana). METHODS: A web-based cross-sectional survey of practising optometrists was conducted in both countries. Each country data was weighted to reflect the total number of licensed and practising optometrists at the time of this survey. Descriptive analyses were performed against demography and practice factors using survey commands to adjust for sampling weights when estimating confidence intervals (CI) around prevalence estimates. Simple and multiple logistic regression analyses were performed to identify factors associated with glaucoma diagnosis. RESULTS: A total of 493 optometrists (238, 48.3% and 255, 51.7%) from Ghana and Nigeria respectively, responded to the survey-the first to document and compare the glaucoma diagnostic criteria between optometrists in Ghana and Nigeria. More Ghanaian than Nigerian optometrists diagnosed glaucoma and over 90% in both countries reported that they frequently performed either tonometry, visual field testing, or fundus examination during glaucoma diagnosis. Ghanaian optometrists were significantly more likely to diagnose glaucoma than Nigerian optometrists (adjusted odd ratio, AOR = 6.15, 95%CI:1.63-23.15, P = .007). Optometrists who have practiced for more than 10 years (AOR = 7.04; 95%CI:1.74-28.47, P = .006) and private practice optometrists (AOR = 3.33; 95%CI:1.13-9.83, P = .03) were more likely to diagnose glaucoma. CONCLUSIONS: The study provides information for evaluating glaucoma assessment for optometrists in both countries. Optometrists in both countries are reasonably well-equipped to diagnose glaucoma and are practicing at an adequate level, but with room for improvement.

The impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa.

BACKGROUND: Vaccination remains the most powerful weapon against the emergence of new variants of coronavirus (COVID-19). However, false information about COVID-19 vaccines through various platforms including social media remains a major threat to global public health. This study examined the impact of information sources on COVID-19 vaccine hesitancy and resistance in sub-Saharan Africa (SSA). METHODS: A validated web-based cross-sectional study was conducted from 14 March to 16 May 2021, and was administered in both French and English to 2572 participants aged 18 years and over. Data on sociodemographic characteristics, medical and vaccination history, and the information sources (mainstream media and social media) used by the participants during the pandemic were obtained. There were three main outcomes: The vaccinated group were those who responded in the affirmation (Yes) to the question of whether they have been vaccinated against COVID-19. Those who responded 'not sure' or 'no' to the question were then asked if they were willing to be vaccinated when the vaccine became available in their home countries. The responses to this follow-up question were used to derive the second and third outcome variables of 'vaccine hesitancy' and 'vaccine resistance', respectively. A series of logistic regression analyses were used to examine the impact of information sources on the three main outcomes. RESULTS: The prevalence of COVID-19 vaccine hesitancy among the participants was lowest among newspaper readers (42%) and highest among TV (72%) and social media users (73%). The prevalence of COVID-19 vaccine-resistance was also lowest among newspaper readers (37%) but highest among social media users (87%). Multivariate analyses revealed that compared to those who did not use these information sources, SSA participants who relied on the radio (aOR 0.83, 95%CI = 0.70, 0.99), TV (aOR 0.80, 95%CI = 0.65, 0.97) and social media (aOR 0.79, 95%CI = 0.65, 0.97) for information during the pandemic were less likely to be hesitant towards taking the vaccines. However, social media users (aOR 2.13, 95%CI = 1.62, 2.80), those who watched TV (aOR 1.40, 95%CI =1.08, 1.80), relied on healthcare workers (HCWs: aOR 1.32, 95%CI = 1.07, 1.63) and families/friends (aOR 1.31, 95%CI = 1.06, 1.61) for COVID-19 related information during the pandemic were more likely to resist taking the COVID vaccines in this study. Participants who relied on the newspaper for information during the pandemic were less likely to resist the vaccines (aOR 0.77, 95%CI = 0.62, 0.95) compared to non-readers of a newspaper. CONCLUSION: We found that all six information sources except radio were strong predictors of the resistance towards COVID-19 vaccination. Further research on how these channels can be used to improve the availability of reliable healthcare information is needed. Investments in these resources will protect people and empower them to make appropriate choices about their health.

Factors associated with protective eyewear use among cocoa farmers in Ghana.

To determine the factors that are associated with the use of protective eyewear (PEW) among cocoa farmers in Ghana, a multistage random sample of 556 cocoa farmers were recruited from four districts in the country. A questionnaire was used to elicit information on the use of PEW and barriers to its use among these farmers. Only 34 (6.1%) participants reported using PEW. Being female, old age and perception of good distance vision was associated with lower odds of PEW use. However, higher educational attainment, application of fertiliser and pesticides were associated with higher odds of PEW use. Participants cited non-availability, unaffordability and ignorance/lack of training as the main barriers to the use of PEW. The low use of PEW could be addressed through ocular health education and occupational health and safety policy initiatives.

Optometric education in Africa: historical perspectives and challenges.

The African continent, with a population of more than one billion and 55 recognized developing countries, is still grappling in some countries with socioeconomic and other challenges inherent in developing countries. The continent is working toward a single political entity known as the African Union, and development is taking place faster than ever in most countries. The continent is known to have high levels of health problems, including visual impairment and blindness. Most nations in the continent are making efforts to reduce the scourge of health problems including visual impairment and blindness. Visual impairment in the continent is mostly caused by refractive errors. Consequently, optometry can help reduce the prevalence of visual impairment on the continent. The educational programs currently offered by the different institutions include Diploma in Optometry (DipOptom), Bachelor of Optometry (BOptom), and Doctor of Optometry (OD). There are 17 established institutions offering optometry degree programs on the continent, of which 14 are fully accredited. Considering the optometric manpower needed in the continent, more optometry institutions need to be established. Staffing and infrastructural and training facilities are major challenges facing the majority of the existing institutions. There is also a need to place greater emphasis on postgraduate education to meet the institutional, national, and international professional training standards and to ensure sustainability of optometry education. This article addresses the historical development, educational issues, challenges, and needs, as well as recommendations, for improving the standard and sustainability of optometric education.

The association between road traffic accidents and visual functions: A systematic review and meta-analysis.

BACKGROUND:  Poor visual functions have been reported to be related to the occurrence of road traffic accidents. AIM:  To review the association between visual function and road traffic accidents (RTAs) from published relevant empirical studies. SETTING:  Worldwide. METHODS:  A random effects (RE) model meta-analysis was conducted using STATA 18. Statistical tests conducted include meta-summary statistics, RE meta-analysis (forest plot), meta-regression (relationship between mean age and effect sizes), funnel plots, Egger's and Begg's tests for publication bias and small study effects. RESULTS:  A total of 17 relevant studies, which were either cross-sectional or observational by design, were included in the meta-analysis. Reported effect sizes were within computed confidence intervals (CI) at 95%. The computed Q test of homogeneity was 61.94. The overall mean effect size of 1.43 (95% CI of 0.985-1.883) was statistically significant at a 5% level (Z = 6.26; p  0.001). The I-squared = 62.17% (p = 0.00) confirmed moderate heterogeneity and the Q-value of 61.94 (p = 0.00) rejected the null hypothesis that the effect size was the same in all the studies. The funnel plot showed that the remaining majority of 13 studies were within the funnel plot on the right-hand side of the line of no effect. CONCLUSION:  These results provide evidence of associations between visual functions and RTAs, and highlight the need for targeted interventions and further research to address the challenges associated with impaired visual functions and road safety.Contributions: The study contributes to the understanding of the implications of visual functions for road safety.

Inflammatory mechanisms contributing to retinal alterations in HIV infection and long-term ART.

People living with HIV (PLWH) may face an increased risk of eye complications associated with ageing, chronic inflammation, and the toxicity arising from long-term antiretroviral therapy (ART). This review aims to understand how inflammatory pathways contribute to retinal alterations observed in PLWH on long-term ART. This review was conducted using four electronic database searches, namely Scopus, Hinari, Google Scholar, and PubMed; from 1996 (when ART became available) until January 2022, without language restriction. Sources from clinical trials, meta-analyses, randomised controlled trials, and systematic reviews were used. Dysregulated para-inflammation (chronic inflammation) damages the blood-retina barrier, resulting in the altered retinal immune privilege and leading to the development of retinal and blood vessel changes. There is an interplay between the effects of the disease versus ART. ART causes mitochondrial toxicity, which affects the retinal ganglion cells and retinal pigment epithelium (RPE) due to oxidative stress. Infection by HIV also affects retinal microglia, which contributes to RPE damage. Both of these mechanisms affect the blood vessels. Assessing the integrity of the inner and outer blood-retina barrier is a pivotal point in pinpointing the pathogenesis of inner retinal alterations. Optical coherence tomography is a valuable tool to assess these changes. There is a paucity of research to understand how these structural changes may affect visual function, such as contrast sensitivity and colour vision.

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.

Ocular parameters and anthropometry in Indo-Trinidadians.

To assess ocular parameters and their association with anthropometric measurements in Indo-Trinidadians adults. This was a clinical, descriptive, cross-sectional study of ocular parameters and anthropometry in adults Trinidadians of South Asian descent (Indo-Trinidadian). Ocular parameters were measured using optical coherence tomography, intraocular lens master biometer, and an autorefractor. Weight, height, and body mass index (BMI) were measured by anthropometry. Univariable and multivariable linear regressions were used to determine the association between demographic variables, anthropometric and ocular parameters. A total of 149 participants (298 eyes) comprising of 90 females (60.6%) and 59 males (39.4%). Aged 18 to 67 participated in the study. Males were taller, heavier, and had longer axial lengths than females which were statistically significant (P < .05). Age was negatively correlated with central corneal thickness (CCT) (r = -0.353, P = .044) and retinal nerve fiber layer thickness (r = -0.348, P = .047) but positively correlated with lens thickness (R = 0.881, P < .001). Education level was positively associated with CCT (R = 0.408, P = .018) but negatively associated with lens thickness (r = -0.521, P = .002). Weight was negatively correlated with corneal topography (r = -0.427, P = .013). Height was negatively correlated with cup-to-disc ratio (r = -0.410, P = .018), CCT (r = -0.382, P = .028), and corneal topography (r = -0.453, P = .008). There was no correlation between BMI, ocular parameters and CCT. There was a significant difference in the ocular parameters between males and females of South Asian descent in Trinidad and Tobago. Weight was negatively associated with the corneal topography. Height was negatively associated with the cup-to-disc ratio, central corneal thickness, and corneal topography. BMI had no statistically significant association with the ocular parameters investigated.

Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria.

Aim: Globally, one of the leading causes of preventable blindness is primary open-angle glaucoma (POAG). The study assessed the clinical presentations of POAG patients attending an eye center in Abuja, Nigeria. Materials and methods: Records of 188 eyes, collected from 94 patients diagnosed with POAG for a period of 1 year at the eye center, were reviewed. Clinical records, including age, gender, visual acuity (VA), central cornea thickness (CCT), intraocular pressure (IOP), cup-to-disk ratios, and retinal nerve fiber layer (RNFL) thickness of the participants, were extracted and analyzed. Results: The majority of the participants were males (56.4%) and adults (57.4%), most of whom had normal VA (>70% in each eye). Our analysis revealed normal average estimates of RNFL thickness, IOP, and CCT among the participants. Females had thicker RNFL compared to males (p = 0.02). Although CCT decreased with age (r = -0.28, p = 0.005), there was no such link between IOP and CCT (r = 0.09, p = 0.38). Conclusion: Central cornea thickness (CCT), RNFL thickness, and IOP in isolation should not be used as early indicators for POAG; rather, a combination of these and other indices is recommended. Early detection through active screening and treatment in the community for at-risk groups is highly advised. How to cite this article: Ezinne NE, Kwarteng MA, Ekemiri KK, et al. Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria. J Curr Glaucoma Pract 2023;17(3):113-117.

Acceptance and Risk Perception of COVID-19 Vaccination among Pregnant and Non Pregnant Women in Sub-Saharan Africa: A Cross-Sectional Matched-Sample Study.

This study aims to evaluate the acceptance and risk perception of pregnant and non pregnant women towards COVID-19 vaccines using a cross-sectional matched-sample study approach. A web-based questionnaire with closed- and open-ended questions was administered to adults older than 18 years in the sub-Saharan African (SSA) region. Respondents (n = 131) were grouped based on their pregnancy status (54 pregnant and 77 non pregnant women) and matched for comparison by age. The matched groups were compared using the chi-square test and the t-test where appropriate. Compared to non pregnant women, pregnant women reported significantly lower risk perception scores of COVID-19 infection (3.74 vs. 5.78, p < 0.001) and were less likely to take the COVID-19 vaccine (odds ratio = 0.12, 95% confidence interval (CI) 0.06-0.27, p < 0.001). A similar proportion of pregnant and non pregnant women believed in false information about the COVID-19 vaccine, and 40% of unvaccinated pregnant women (n = 40) were concerned about the safety of the vaccine. After adjustment, women's education, marital status, belief in misconceptions and risk perception were associated with non-vaccination among pregnant women. The content analysis revealed that pregnant women refused the vaccine due to mistrust of their countries' health systems, concerns about the country where the vaccines were manufactured and a lack of confidence in the production process of the vaccines. This study shows the poor acceptance of COVID-19 vaccines among pregnant women in SSA, who perceived a lower risk of COVID-19 infection. Understanding the reasons for non-acceptance and the motivation to accept the COVID-19 vaccine could guide the development of health education and promotion programmes, and aid governments and policymakers in implementing targeted policy changes.

Self-reported knowledge and skills related to diagnosis and management of keratoconus among public sector optometrists in the Limpopo province, South Africa.

BACKGROUND: Keratoconus (KC) has been regarded as a rare condition, although recent studies, including those in South Africa, suggest it is common and is increasing in prevalence. Furthermore, South African-based studies have shown that KC is normally detected at advanced or severe stages. Knowledge and skills for examination, diagnosis and management of KC by optometrists are important for the early detection and management of the disease. AIM: This study aimed to evaluate self-reported knowledge and skills for examination, diagnosis and management of KC patients among public sector optometrists. SETTING: Seven public hospitals of the Capricorn district of the Limpopo province, South Africa. METHODS: A quantitative cross-sectional descriptive study design was used. A self-administered online questionnaire was used to collect data on demographic characteristics of participants and their knowledge, skills and practice for the diagnosis and management of KC. RESULTS: Twenty-four optometrists (n = 24) with a mean age of 39 ± 5.67 years, 18 (75%) of whom were female, participated in the study. Nineteen (79%) reported that their hospitals did not have the appropriate equipment to examine, diagnose and manage KC patients. Lack of equipment, poor knowledge, skills and competencies, hospital's level of services, policy and lack of interest were cited as barriers to contact lens fittings in KC patients. Using a dichotomised summation of self-reported knowledge and skills of KC, 13 (54.2%) of the optometrists were knowledgeable and skilled on risk factors of KC and examining, diagnosing and managing KC patients. CONCLUSION: A significant proportion of optometrists did not have the appropriate knowledge and skills to examine, diagnose and manage KC patients. Lack of equipment and poor knowledge and skills were the main barriers to contact lens fittings in managing KC.Contribution: This article highlights the need for the district to upskill the optometrists through a structured programme with a theory and practical component and also provide the necessary equipment to enhance patient care.

Demographic profiles of contact lens wearers and their association with lens wear characteristics in Trinidad and Tobago: A retrospective study.

PURPOSE: Contact lenses (CL) remain a popular mode of refractive error correction globally and in the Caribbean, mostly among young people. However, no data on the characteristics of the CL population wearers in the Caribbean is available. This study reported on the characteristics of CL wearers and the associated factors in Trinidad and Tobago (T&T). METHODS: This retrospective study reviewed the clinical records of 243 CL wearers who attended the University of the West Indies (UWI) optometry clinic between 2017 and 2018. Data on their demographic profiles, CL wearing characteristics including lens type, material, purpose of wear, replacement schedule and lens care systems were extracted and analyzed. The associations between the demographic characteristics and CL wearing characteristics were also determined. RESULTS: About half of the CL wearers used them for fashion (more among those aged 18 to 30 years, 61.0%), therapeutic (more among those <18 years, 43.8%, P = 0.001) and refractive error correction purposes (more in those >40 years, P = 0.001). Females were more likely to use CLs for fashion compared with males (67.0% versus 40.7%). Age (P<0.0005) and gender (P = 0.030) were associated with the lens materials. Those aged 18-30 years were more likely use hydrogels compared with the younger ones (64.1% versus 25.0%). Rigid gas permeable (RGP) CL use was more common in males than females (21.8% versus 10.9%, P = 0.031). Daily disposables were predominantly used by younger respondents (18-30 years old, 31.3%, P < 0.001) and more in females than males (66.7% vs 49.4%, P = 0.040). CONCLUSION: The study found that the CL appears to be more commonly worn for fashion in younger females and for refractive error correction in older males. Age, gender, and employment status were the main determinants of lens wear among respondents attending the university clinic in T&T.

Public awareness and perception towards COVID-19 in Sub-Saharan African countries during the lockdown.

Background: The coronavirus disease (COVID-19) outbreak has caused a universal health crisis resulting in significant morbidities and mortalities particularly among high-risk groups. This study sought to determine regional factors associated with knowledge and attitude towards COVID-19 mitigation practices and risk perception of contracting the disease in Sub-Saharan African (SSA) countries. Methods: A cross-sectional anonymous online study was conducted among 1970 participants between April and May 2020, during the lockdown in many SSA countries. Recruitment of participants was via WhatsApp, Facebook and emails using authors' networks. The outcome variables were KAP (knowledge, attitudes and practice) of COVID-19 and analysis of variance (ANOVA) with post hoc test was run to assess the level of KAP by four regions in SSA. Simple and multiple linear regression (MLR) analyses were performed to examine factors associated with the outcome measures in the four SSA regions. Results: Mean knowledge (P=0.707) and risk perception (P=0.904) scores by four regions in SSA did not differ significantly. However, the mean attitude score was higher among West Africans compared with Southern (P=0.019) and Central Africans (P=0.003). MLR analysis revealed that among those living in West (adjusted coefficient ß=-0.83 95% CI: -1.19, -0.48) and Southern Africa (ß=-0.91 95% CI: -1.42, -0.40), having a primary or secondary education was associated with a decrease in knowledge scores while not being worried about COVID-19 decreased risk perception scores across the four SSA regions(West [ß=-6.57, 95% CI: -7.53, -5.62], East [ß=-6.24: 95% CI: -8.34,-4.15], Central [ß=-6.51, 95% CI: -8.70, -4.31], and Southern Africa [ß=-6.06: 95% CI: -7.51, -4.60]). Except among Southern Africans, participants who practiced self-isolation had positive attitude towards COVID-19. Conclusion: Future research on health education regarding COVID-19 or a future related pandemic in SSA should target people with lower education, those who do not self-isolate, those living in Southern and Western Africa and not worried about contracting COVID-19.

Availability of low vision services and barriers to their provision and uptake in Ghana: practitioners' perspectives.

BACKGROUND: Provision and uptake of low vision services are essential. OBJECTIVE: To assess the availability of low vision services and barriers to their provision and uptake in the Ashanti and Brong Ahafo regions of Ghana from the perspective of eye care practitioners. METHODS: A descriptive, quantitative, cross-sectional study design using semi-structured questionnaires was used to collect information from eye care practitioners selected from 58 eye care facilities in the Ashanti and Brong Ahafo regions of Ghana. RESULTS: Forty-four eye care practitioners from Ashanti region and 10 from Brong Ahafo region responded to the questionnaire. Seventeen (34%) of the 50 eye care facilities who reported having patients seeking low vision services in their facilities provided such services. Lack of low vision devices (94.4%) and equipment (87%) were reported to be the main barriers to the provision of low vision services. Major barriers to low vision services uptake were lack of awareness (88.7%), high cost (70.4%) and social unacceptability of low vision assistive devices (59.3%). CONCLUSION: Lack of adequate low vision services and barriers to their provision and uptake impact negatively on efforts to prevent visual impairment and blindness in Ghana.

Opinion and uptake of chloroquine for treatment of COVID-19 during the mandatory lockdown in the sub-Saharan African region.

BACKGROUND: As the search for effective treatment of coronavirus disease 2019 (COVID-19) infection continues, the public opinion around the potential use of chloroquine (CQ) in treating COVID-19 remains mixed. AIM: To examine opinion and uptake of CQ for treating COVID-19 in the sub-Saharan African (SSA) region. SETTING: This study was conducted through an online survey software titled SurveyMonkey. METHODS: Anonymous online survey of 1829 SSA countries was conducted during the lockdown period using Facebook, WhatsApp and authors' networks. Opinion and uptake of CQ for COVID-19 treatment were assessed using multivariate analyses. RESULTS: About 14% of respondents believed that CQ could treat COVID-19 and of which, 3.2% took CQ for COVID-19 treatment. Multivariate analyses revealed that respondents from Central (adjusted odds ratios [aOR]: 2.54, 95% confidence interval [CI] 1.43, 4.43) and West Africa (aOR: 1.79, 95% CI 1.15, 2.88) had higher odds of believing that CQ could treat COVID-19. Respondents from East Africa reported higher odds for uptake of CQ for COVID-19 than Central, Western and Southern Africans. Knowledge of the disease and compliance with the public health advice were associated with both belief and uptake of CQ for COVID-19 treatment. CONCLUSION: Central and West African respondents were more likely to believe in CQ as a treatment for COVID-19 whilst the uptake of the medication during the pandemic was higher amongst East Africans. Future intervention discouraging the unsupervised use of CQ should target respondents from Central, West and East African regions.

Factors affecting willingness to comply with public health measures during the pandemic among sub-Sahara Africans.

Background: The unprecedented outbreak of coronavirus disease (COVID-19) drastically spread worldwide, resulting in extraordinary measures put in place in various countries including Sub Saharan Africa (SSA) countries. Objective: To assess the factors associated with compliance with the public health measures imposed by various SSA countries. Method: Cross sectional study using self-administered surveys distributed on social media platforms between April 18th and May 16th, 2020, corresponding with the mandatory lockdown period in most SSA countries. Multivariate analysis examined the associated factors. Results: The prevalence of hand hygiene, quarantine, self isolation practices, wearing of face mask and attending large gatherings during COVID-19 were 94%, 39%, 31%, 64% and 14%, respectively. In multivariate models, older age 49+ years: adjusted OR 2.13, 95%CI 1.22,3.71), females (OR 1.41,95%CI 1.03,1.93), Central African countries (OR 3.73,95%CI 2.02,6.87) were associated with wearing face mask. Living alone (aOR 1.52,95%CI 1.04,2.24) during the lockdown was associated with avoiding large gatherings including religious events. Female respondents (aOR 1.61, 95%CI 1.30, 2.00), married (aOR 1.71,95%CI 1.33,2.21) and unemployed (aOR 1.62,95%CI 1.25,2.09) SSAs were more likely to practice self-quarantine measures. Conclusion: The low prevalence of mitigation practices suggest the need for targeted education campaign programs to sensitise the population.

Differences in Perceived Risk of Contracting SARS-CoV-2 during and after the Lockdown in Sub-Saharan African Countries.

This study investigated risk perception of contracting and dying of SARS-CoV-2 in sub-Sahara Africa during and after the lockdown periods. Two online surveys were conducted one year apart, with participants 18 years and above living in sub-Sahara Africa or the diaspora. Each survey took four weeks. The first survey was taken from 18 April to 16 May 2020, i.e., during the lockdown. The second survey was taken from 14 April to 14 May 2021, i.e., after the lockdown. A cross-sectional study using adopted and modified questionnaires for both surveys were distributed through online platforms. Question about risks perception of contracting and dying of SARS-CoV-2 were asked. The Helsinki declaration was applied, and ethical approvals were obtained. Total responses for both surveys, i.e., both during and after the lockdown, was 4605. The mean age was similar in both surveys (18-28 years). The mean risk perception scores were higher after lockdown by 3.59%. Factors associated with risk perception of COVID-19 were survey period, age group, region of residence, and occupation. Non-health care workers had a lower risk perception of COVID-19. This first comparative study on the level of risk perception of Africans during and after the lockdown shows that one in every three and every four persons in sub-Sahara Africa felt at high risk of contracting COVID-19 and thought they could die from contracting the same, respectively.

Prevalence and Factors Associated with Mental and Emotional Health Outcomes among Africans during the COVID-19 Lockdown Period-A Web-based Cross-Sectional Study.

Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments' response and recovery strategies of any future pandemic.

Effects of spectacles and telescopes on visual function in students with oculocutaneous albinism.

PURPOSE: To investigate the effects of spectacle and telescope corrections on visual acuity (VA), contrast sensitivity (CS) and reading rates (RR) in students with oculocutaneous albinism (OCA). METHODS: An observational study design was conducted on 81 students with OCA. Distance and near VA, CS and RR were measured without correction, with spectacle correction and with a combination of spectacle correction and telescopes. RESULTS: The mean distance and near VA values with a combination of spectacle correction and telescopes were significantly better than those without correction and with spectacle correction alone (p = 0.01). Mean CS values achieved with spectacles alone were significantly better than those obtained with a combination of spectacles and telescopes (p = 0.01). There was no significant difference between logCS values obtained without correction compared to those obtained with a combination of spectacle correction and telescopes. There were no significant differences between RR values obtained with a combination of spectacles and telescopes and those without and with spectacle correction alone (all p > 0.05). CONCLUSION: This article provides valuable information to eye care practitioners on the effects of spectacles and telescopes on visual acuity, contrast sensitivity and reading rate in students with OCA.

Prevalence and causes of visual impairment among older persons living in low-income old age homes in Durban, South Africa.

BACKGROUND: Visual impairment (VI) increases with age and has been reported to be more prevalent among older adults living in old age homes than in the general population. AIM: To determine the prevalence and causes of VI among older adults living in low-income old age homes in Durban, South Africa. SETTING: This study was conducted at low-income old age homes in Durban. METHODS: This cross-sectional study of 118 residents aged 60 years and older, collected socio-demographic data, presenting visual acuities (VAs) for each eye, and binocularly. Anterior segment eye examinations were conducted with a penlight torch and a portable slit-lamp, while posterior segment evaluation was conducted with direct and indirect ophthalmoscopy. Objective and subjective refractions were performed, and the best-corrected distance and near VAs were measured in each eye. VI was defined as presenting VA 6/18 and included moderate VI ( 6/18-6/60), severe VI ( 6/60 -3/60) and blindness ( 6/120). RESULTS: The mean age of the participants was 73.3 years and included 80.5% females and 19.5% males. The prevalence of VI and blindness was 63.6%. Optical correction significantly reduced the prevalence of VI and blindness by 19.5% (p 0.05). The main causes of non-refractive VI and blindness were cataract (54.5%), posterior segment disorders (25.5%) and corneal opacities (20%). CONCLUSION: The prevalence of VI and blindness is high among residents in low-income old age homes living in Durban. Refractive correction and surgical cataract intervention can significantly reduce the burden of VI and blindness among the elderly residents.