Synchronous myopia development induced by bilateral form deprivation in chicks.

Form deprivation (FD) is a widely employed experimental paradigm, typically used to induce unilateral myopia in animal models. This model is weakened by potential influence upon the FD eye from vision in the freely-viewing contralateral eye, which could be eliminated by imposing FD in both eyes; but while a few previous studies have explored the feasibility of inducing bilateral FD in chicks, substantial discrepancies in treatment outcomes were noted. Consequently, this study aimed to establish a bilateral FD myopia model in chicks, with validation by investigating the associated ocular growth patterns, feeding, and social behavior. Six-day-old chicks were treated with bilateral (n = 21) or unilateral (n = 10) FD for 12 days; the fellow untreated eyes in the unilateral FD group served as controls. Refractive error, corneal power, and ocular axial dimensions were measured at 4-day intervals after the onset of form deprivation, with a Hartinger refractometer, a custom-made videokeratography system, and a high-resolution A-scan ultrasonographer, respectively. Body weight was monitored to assess the chick's physical development. Our results showed that birds treated with bilateral FD grew as robustly as the unilaterally form-deprived chicks, with similar or slightly heavier body weights and mortalities. Unilateral FD induced significantly higher myopia in the treated eye, with stronger corneal power, deeper anterior and vitreous chambers, and longer axial length. Moreover, either bilaterally or unilaterally FD eyes developed similar refractive error (bilateral FD, left: -28.03 ± 9.06 D, right: -28.44 ± 9.45 D; unilateral FD: -29.48 ± 8.26 D) and ocular biometric changes; but choroidal thickness was thicker in bilaterally FD eyes, rather than thinner as in unilaterally FD eyes. In addition to the highly synchronized (symmetrical, parallel) development reported previously in bilateral FD, we found in this study that the correlations between bilaterally form-deprived eyes were highest for ocular biometric parameters directly contributing to myopia development, including corneal power (r = 0.74 to 0.93), anterior chamber depth (r = 0.60 to 0.85), vitreous chamber depth (r = 0.92 to 0.94), and axial length (r = 0.90 to 0.96). The remarkably synchronized growth pattern confirmed the feasibility of the bilateral FD paradigm for future research on myopia.

Risk of major myopia-associated non-communicable ocular health disorders in Ghana.

OBJECTIVE: To assess the differential association of myopia with major non-communicable ocular diseases in an African clinical cohort. METHODS: A five-year hospital-based retrospective study of myopia cases. Patients' folders, Optical Coherence Tomography scans, and fundus photographs were reviewed for the abstraction of relevant data. Only records that employed recognized standards and classification systems for diagnosing and staging the various ocular conditions were included. Demographic characteristics, non-cycloplegic objective refractive findings, and non-communicable eye diseases were retrieved from the records. Myopia-associated risk factors were then determined using logistic regression and correlation. RESULTS: Some 16018 patients (32027 eyes) met the inclusion criteria for at least one eye comprising 50.8% males (n = 8137) and 49.2% females (n = 7881). The mean age of the patients was 43.14 ± 17.88 years (range: 2-98 years). The mean spherical equivalent± Standard deviation for myopia was -2.30±3.23 DS (range: -0.50 to -25DS). Binary logistic regression analysis showed that myopic eyes had a higher odd of AC (OR, 0.53; 95% CI, 0.50-0.57), POAG (OR, 6.0; 95% CI, 5.26-6.82), DR (OR, 10.70; 95% CI, 3.91-29.27) and cataracts (OR, 20; 95% CI, 15.32-26.20) but not dry eye (OR, 0.74, 95% CI, 0.68-0.81), macular degeneration and pterygium (OR, 0.36; 95% CI, 0.32-0.40). CONCLUSION: Africans with myopia are more at risk of developing allergic conjunctivitis, cataracts, POAG, and DR but not for dry eye, macular degeneration, and pterygium.

Maternal and child factors associated with late neonatal bathing practices in Nigeria: evidence from a national survey.

BACKGROUND: Twohundred and seventy out of every thousand live births died in Nigeria in 2019. These deaths were attributable to infections, complications of preterm birth, and intrapartum-related conditions. The World Health Organization recommends withholding bathing of neonates until 24 h after birth or until their vital signs become stable to prevent hypothermia. Despite the link between neonatal bathing and thermal control, the subject is understudied in Nigeria. This study aimed at investigating the factors associated with late neonatal bathing practices in Nigeria. METHODS: The study adopted a cross-sectional design and extracted data from the women's file of the 2018 Nigerian Demographic and Health Survey. The unit of analysis was limited to 12,972 women who had complete data for the study. We applied chi-square test of independence to ascertain the association between the outcome variable and explanatory variables. At 95% confidence interval, two logistic regression models were built with Model I consisting of only maternal factors whilst Model II contained both maternal and child factors, and results were presented in adjusted odds ratio. RESULTS: Descriptively, 12% (CI = 0.122-0.134) of the women bathed their neonates after 24 h of delivery. Inferentially, women with secondary/higher education [AOR = 1.30, CI = 1.05-1.61], the rich [AOR = 1.24, CI = 1.03-1.50], those with access to mass media [AOR = 131, CI = 1.15-1.50], women that professed other religions [AOR = 9.28, CI = 4.24-17.56], those who delivered in a health facility [AOR = 1.93, CI = 1.66-2.25], whose child was small in size at birth [AOR = 1.46, CI = 1.21-1.77] and delivered by caesarean section [AOR = 2.50, CI = 1.97-3.18] had higher odds of bathing their neonates 24 h after birth. CONCLUSIONS: The proportion of women who practised late neonatal bathing was generally low. To improve the practice of late neonatal bathing, much-concerted effort should be directed to women's education and approaches to increasing receptivity of late neonatal bathing among pregnant women through the media. The Nigerian Ministry of Health should incorporate routine counselling on the risks of bathing newborns prematurely into antenatal and postnatal care services.

Association between mass media exposure and endorsement of HIV-infected female teachers' teaching: insight from 2014 Ghana Demographic and Health Survey.

INTRODUCTION: Ghana recorded 19,931 new annual HIV infections in 2018 translating to 14,181 AIDS-related deaths. Mass media is capable of ensuring the sustainability of initiatives aimed at curbing HIV/AIDS epidemic by reducing HIV/AIDS stigma and discrimination. The study aimed at exploring if mass media plays a role in whether HIV-infected female teachers should be allowed to teach in Ghana. MATERIALS AND METHODS: The study used women's file of the 2014 Ghana Demographic and Health Survey (GDHS). The current study was restricted to 6025 women who had complete information on the variables analysed. Binary Logistic regression was conducted between mass media and the dependent variable whilst controlling for the effect of the significant covariates. The results were presented in odds ratio (OR) and adjusted odds ratio (AOR) at 95% confidence interval (CI). All analyses were carried out using STATA version 14.0. RESULTS: Generally, 51% of the women mentioned that HIV-infected female teachers should be allowed to teach in Ghana. Women who accessed mass media had higher odds of endorsing that HIV-infected female teachersshould be allowed to teach compared to those without access to mass media [AOR = 1.37, CI 1.200-1.555], just as among those  with secondary or higher education compared to those with no formal education [AOR = 1.30, CI 1.102-1.529]. Rural inhabitants had decreased odds of proclaiming that HIV-infected female teachers should be allowed to continue teaching compared with urban residents [AOR = 0.83, CI 0.717-0.957]. CONCLUSIONS: Endorsement of HIV-positive female teachers' continued teaching was associated with access to mass media. This is suggestive that various mass media platforms could help to reach the public with HIV/AIDS-related information, particularly those that touch on stigma and discrimination, which will potentially increase women's knowledge and shape their perceptions about persons living with HIV.

Association between Hunger and Truancy among Students in Liberia: Analysis of 2017 Global School-Based Student Health Survey.

BACKGROUND: About 83% and 49% of Liberians live beneath the poverty line of US$1.25/day and experience hunger, respectively. Studies have established that hunger has long-term adverse consequence on truancy among students. However, no national level study has investigated contribution of hunger on truancy among in-school students in Liberia. This paper therefore seeks to examine the association between hunger and truancy among students in Liberia. The study hypothesises that there exists a positive association between hunger and truancy. METHODS: This study used the 2017 Liberia Global School-Based Student Health Survey (LGSSHS) and sampled 2,744 students. However, the present study was restricted to 1,613 respondents who had complete information about variable of interest analysed in the study. Hunger and truancy are the main explanatory and outcome variables for this study. At 95% confidence interval, two binary logistic regression models were built with Model I examining relationship between hunger and truancy and Model II controlled for the influence of covariates on truancy. Our findings were reported in odds ratio (OR) and adjusted odds ratio (AOR). All the analysis was done using STATA version 14.0. RESULTS: Descriptively, 46% were truant, and 65% of students ever experienced hunger. Inferentially, students that ever-encountered hunger had higher odds to truancy (AOR = 1.32, CI = 1.06-1.65). The odds to be truant also increased among those at 15 years and above (AOR = 2.00, CI = 1.46-2.72), who witnessed bullying (AOR = 1.36, CI = 1.10-1.68), that felt lonely (AOR = 1.35, CI = 1.06-1.71), that currently smoke cigarette (AOR = 2.58, CI = 1.64-4.06), and wards whose parents go through their things (AOR = 1.26, CI = 1.03-1.55). CONCLUSIONS: The study concluded that hunger was associated with truancy among students in Liberia. Additionally, students' age, bullying, feeling lonely, cigarette use, and parental concern also determined truancy. Governments, policy makers, and other partners in education should therefore roll out some school-based interventions, such as the school feeding program, which will help minimise the incidence of hunger among students. Such programs should consider the variations in students' background characteristics in its design.

Circumcising daughters in Nigeria: To what extent does education influence mothers' FGM/C continuation attitudes?

Education has been adjudged as an important behavioural change intervention and a key player in combating Female Genital Mutilation/Cutting (FGM/C). An assumed pathway is that it influences FGM/C attitudes. However, empirical evidence that explores this assumption is scarce. Hence, our study examines whether the associative effect of FGM/C continuation attitudes on circumcision of daughters is influenced by the level of a mother's education in Nigeria. We extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study focused on youngest daughters that were born in the last five years preceding the survey. A sample of 5,039 children with complete data on variables of interest to the study were analysed. The main outcome variable for this study is "circumcision among youngest daughters". The key explanatory variables were maternal "FGM/C continuation attitudes" and "education". At 95% confidence interval, we conducted a two-level logistic regression modelling and introduced interaction between the key independent variables. In the study's sample, the prevalence of FGM/C was 34%. It was lower for daughters whose mothers had higher education (12%) and believe FGM/C should discontinue (11.1%). Results from the multivariate analysis show statistically significant odds of circumcision for a daughter whose mother has had higher education and believes FGM/C should discontinue (OR-0.28, 95%CI: 0.08-0.98). For women who believe FGM/C should discontinue, the probability of daughter's circumcision reduced by 40% if the mother has attained higher education. Among those who believe FGM/C should continue, the probability of daughter's circumcision worsened if the mother had attained higher education (64%), however, this result was influenced by mothers' experience of circumcision. Education influences FGM/C attitudes, nonetheless, women's cutting experience can be a conduit for which the practice persists. Promoting female education should be accompanied by strong political commitment towards enforcing laws on FGM/C practice.

Understanding the determinants of postnatal care uptake for babies: A mixed effects multilevel modelling of 2016-18 Papua New Guinea Demographic and Health Survey.

BACKGROUND: Papua New Guinea (PNG) recorded 22 neonatal deaths out of every 1,000 livebirths in 2019. Some of these deaths are related to complications that arise shortly after childbirth; hence, postnatal care (PNC) utilisation could serve as a surviving strategy for neonates as recommended by the World Health Organisation. National level study on determinants of PNC uptake in PNG is limited. Utilising the Bronfenbrenner's Ecological Model of Human Development, the study aimed at assessing determinants of PNC utilisation for babies by their mothers aged 15-49 in PNG. METHODS: The study used data from the women's file of the 2016-18 PNG Demographic and Health Survey (2016-18 PNGDHS) and a sample of 4,908 women aged 15-49 who had complete information on the variables of interest to the study. Nineteen (19) explanatory variables were selected for the study whereas PNC for babies within first two months after being discharged after birth was the main outcome variable. At 95% confidence interval (95% CI), six multilevel logistic models were built. The Akaike Information Criterion (AIC) was used to assess models' fit. All analyses were carried out using STATA version 14.0. RESULTS: Generally, 31% of the women utilised PNC for their babies. Women with primary education [aOR = 1.42, CI = 1.13-1.78], those belonging to the middle wealth quintile [aOR = 1.42, CI = 1.08-1.87], working class [aOR = 1.28, CI = 1.10-1.49], women who had the four or more ANC visits [aOR = 1.23, CI = 1.05-1.43], those with twins [aOR = 1.83, CI = 1.01-3.29], women who belonged to community of medium literate class [aOR = 1.75, CI = 1.34-2.27] and those of moderate socioeconomic status [aOR = 1.60, CI = 1.16-2.21] had higher odds of seeking PNC for their babies. The odds to seek PNC services for babies reduced among the cohabiting women [aOR = 0.79, CI = 0.64-0.96], those at parity four or more [aOR = 0.77, CI = 0.63-0.93], women who gave birth to small babies [aOR = 0.80, CI = 0.67-0.98] and residents in the Highlands region [aOR = 0.47, CI = 0.36-0.62]. CONCLUSIONS: Maternal education, wealth quintile, occupation, partner's education, ANC visits, marital status, parity, child size at birth, twin status, community literacy and socioeconomic status as well as region of residence were associated with PNC uptake for babies in PNG. Variation in PNC uptake for babies existed from one community/cluster to the other. There is the need to strengthen public health education to increase awareness about the benefits of seeking PNC services for babies among women in PNG. Such programs should consider maternal and community/cluster characteristics in their design.

Individual and community-level factors associated with home birth: a mixed effects regression analysis of 2017-2018 Benin demographic and health survey.

BACKGROUND: Home birth is a common contributor to maternal and neonatal deaths particularly in low and middle-income countries (LMICs). We generally refer to home births as all births that occurred at the home setting. In Benin, home birth is phenomenal among some category of women. We therefore analysed individual and community-level factors influencing home birth in Benin. METHODS: Data was extracted from the 2017-2018 Benin Demographic and Health Survey females' file. The survey used stratified sampling technique to recruit 15,928 women aged 15-49. This study was restricted to 7758 women in their reproductive age who had complete data. The outcome variable was home birth among women. A mixed effect regression analysis was performed using 18 individual and community level explanatory variables. Alpha threshold was fixed at 0.05 confidence interval (CI). All analyses were done using STATA (v14.0). The results were presented in adjusted odds ratios (AORs). RESULTS: We found that 14% (n = 1099) of the respondents delivered at home. The odds of home births was high among cohabiting women compared with the married [AOR = 1.57, CI = 1.21-2.04] and women at parity 5 or more compared with those at parity 1-2 [AOR = 1.29, CI = 1.01-1.66]. The odds declined among the richest [AOR = 0.07, CI = 0.02-0.24], and those with formal education compared with those without formal education [AOR = 0.71, CI = 0.54-0.93]. Similarly, it was less probable for women whose partners had formal education relative to those whose partners had no formal education [AOR = 0.62, CI = 0.49-0.79]. The tendency of home birth was low for women who did not have problem in getting permission to seek medical care [AOR = 0.62, CI = 0.50-0.77], had access to mass media [AOR = 0.78, CI = 0.60-0.99], attained the recommended ANC visits [AOR = 0.33, CI = 0.18-0.63], belonged to a community of high literacy level [AOR = 0.24, CI = 0.14-0.41], and those from communities of high socio-economic status (SES) [AOR = 0.25, CI = 0.14-0.46]. CONCLUSION: The significant predictors of home birth are wealth status, education, marital status, parity, partner's education, access to mass media, getting permission to go for medical care, ANC visit, community literacy level and community SES. To achieve maternal and child health related goals including SDG 3 and 10, the government of Benin and all stakeholders must prioritise these factors in their quest to promote facility-based delivery.

Factors influencing early postnatal care utilisation among women: Evidence from the 2014 Ghana Demographic and Health Survey.

INTRODUCTION: Early postnatal care (EPNC) utilisation is crucial for averting maternal deaths as recommended by the World Health Organisation. About 30% of women do not obtain EPNC in Ghana and no national level study have investigated the determinants of EPNC. Therefore, this study aimed at assessing factors associated with EPNC uptake among women aged 15-49 in Ghana. MATERIALS AND METHODS: The study utilised data from the women's file of the 2014 Ghana Demographic and Health Survey (GDHS) and sampled 1,678 women aged 15-49 who had complete data on EPNC. Descriptive computation of EPNC was done. Since EPNC (which is the main outcome variable for the study) was dichotomous, the binary logistic regression was used to determine factors influencing utilisation of EPNC at 95% two-tailed confidence interval. The results were presented as adjusted odds ratio (AOR). Stata version 14.0 was used for all the analyses. RESULTS: Descriptively, the results indicated that 31% of women aged 15-49 sought EPNC. At the inferential level, women aged 40-44 were more likely to seek EPNC compared to those aged 15-19 [AOR = 3.66, CI = 1.25-10.67]. Islam women had higher odds of EPNC as compared with Christians [AOR = 1.70, CI = 1.23-2.35]. Comparatively, women of Mande ethnic group had higher propensity to seek EPNC than the Akan [AOR = 3.22, CI = 1.20-8.69]. Residents of the Greater Accra region were over 11 times probable to utilise EPNC compared with the residents of Western region. CONCLUSION: The key determinants of EPNC were age, religion, ethnicity, marital status and region. Therefore, the Health Promotion and Education Unit and Reproductive and Child Health Department of the Ghana Health Service need to scale up EPNC sensitisation programmes and should target women aged 15-19, Christians and other category of women with less likelihood of EPNC in order to offset the disparities.

Postnatal care utilisation among women in rural Ghana: analysis of 2014 Ghana demographic and health survey.

BACKGROUND: Maternal mortality is high in Ghana, averaging 310 maternal deaths per 100,000 live births in 2017. This is partly due to inadequate postnatal care especially among rural communities. Ghana can avert the high maternal deaths if women meet the World Health Organisation's recommended early postnatal care check-up. Despite the association between geographical location and postnatal care utilisation, no study has been done on determinants of postnatal care among rural residents in Ghana. Therefore, this study determined the prevalence and correlates of postnatal care utilization among women in rural Ghana. METHODS: The study utilised women's file of the 2014 Ghana Demographic and Health Survey (GDHS). Following descriptive computation of the prevalence, binary logistic regression was fitted to assess correlates of postnatal care at 95% confidence interval. The results were presented in adjusted odds ratio (AOR). Any AOR less than 1 was interpreted as reduced likelihood of PNC attendance whilst AOR above 1 depicted otherwise. All analyses were done using Stata version 14.0. RESULTS: The study revealed that 74% of the rural women had postnatal care. At the inferential level, women residing in Savanna zone had higher odds of postnatal care compared to those in the Coastal zone [AOR = 1.80, CI = 1.023-3.159], just as among the Guan women as compared to the Akan [AOR = 7.15, CI = 1.602-31.935]. Women who were working were more probable to utilise postnatal care compared to those not working [AOR = 1.45, CI = 1.015-2.060]. Those who considered distance as unproblematic were more likely to utilise postnatal care compared to those who considered distance as problematic [AOR = 1.63, CI = 1.239-2.145]. CONCLUSIONS: The study showed that ethnicity, ecological zone, occupation and distance to health facility predict postnatal care utilisation among rural residents of Ghana. The study points to the need for government to increase maternal healthcare facilities in rural settings in order to reduce the distance covered by women in seeking postnatal care.

Controlled blood sugar improves the eye's accommodative ability in type-1 diabetes.

PURPOSE: To evaluate the impact of blood sugar level on ocular measures, including refractive error (RE), amplitude of accommodation (AoA), and lag of accommodation (LoA), in pre-presbyopes with type-1 diabetes. METHOD: The fasting blood sugar (FBS) and ocular measures of type-1 diabetes patients (age: 14-39 years; n = 30) on insulin treatment was recorded while they fasted on two separate visits, at baseline and 3 months later. The AoA and LoA was measured with the appropriate spectacle correction worn. The Welch's t-test was used for comparison of the baseline measures between the normal FBS ≤ 7 (n = 10) and higher FBS > 7 (n = 20) patients, and the paired t-test used to investigate for differences between the baseline and follow-up data in patients with changes in FBS. RESULTS: On average, the spectacle correction for the normal FBS group was marginally more myopic (RE: -0.30 ± 0.67 D vs. +0.18 ± 1.00 D, p = 0.032), and they showed greater AoA (5.38 ± 1.08 D vs. 3.68 ± 1.43 D, p < 0.001) and lower LoA (1.00 ± 0.30 D vs. 1.30 ± 0.38 D, p = 0.004) compared with the higher FBS group at baseline. On the follow-up visit attended by 25 patients, the FBS of 15 patients was reduced by an average of 7.0 mmol/L, 8 patients had an average increase of 5.2 mmol/L, while 2 patients recorded no changes relative to the baseline. The patients whose FBS was reduced showed improvement in the mean AoA from 3.78 ± 1.58 D to 4.88 ± 1.61 D (p < 0.001) and a reduction in the mean LoA from 1.37 ± 0.40D to 0.87 ± 0.19D (p < 0.001), whereas those with deteriorated control of the FBS showed an opposite trend. CONCLUSIONS: Controlling hyperglycemia improves ocular accommodation in type-1 diabetes.

Association between dry eye symptoms and signs.

PURPOSE: To evaluate the association between subjective dry eye symptoms and the results of the clinical examinations. METHODS: The study was a clinical-based survey involving 215 first-year students selected consecutively during a regular ocular health examination at the University of Cape Coast Optometry Clinic. The data collection process spanned for a period of four months. Out of the 215 students, 212 returned their completed questionnaires and were subsequently included in the study. Dry eye tests including meibomian gland assessment, tear break up time, fluorescein staining, Schirmer test, and blink rate assessment, were performed on each subject after completion of the Ocular Surface Disease Index (OSDI) questionnaire. Shapiro-Wilk test was used to determine the normality of the clinical tests, and Spearman's correlations co-efficient was used to determine the correlations between the clinical test results and dry eye symptoms. RESULTS: Statistically significant associations were found between OSDI scores and blink rate (rs = 0.140; P < 0.042), and associations between OSDI scores and contrast sensitivity scores (rs = 0.263; P < 0001). However, the results of corneal staining (rs = -0.006; P < 0.926), Schirmer test (rs = -0.033; P = 0.628), tear break up time (rs = -0.121; P < 0.078), meibomian gland expressibility (rs = 0.093; P < 0.180), and meibomian gland quality (rs = 0.080; P < 0.244) showed no significant association with OSDI. The correlation coefficients range from -0.006 to 0.263 showed low to moderate correlation between dry eye symptoms and the results of clinical test. CONCLUSION: Associations between dry eye symptoms and clinical examinations are low and inconsistent, which may have implications for the diagnoses and treatment of dry eye disease.