Ocular injuries in a rural Ethiopian community.

OBJECTIVE: To assess the causes, magnitude, risk factors and visual impact of ocular injury. DESIGN: Community-based cross sectional study. SETTING: Goro District Central Ethiopia between November 2002 and January 2003. SUBJECTS: Sixty four peasant associations, with 1,566 people per peasant association. RESULTS: Out of a total of 1027 people interviewed, 52 (5.1%, 95% CI: 3.8, 6.4) cases with history of ocular trauma, 24 (46.2%) males and 28 (53.8%) females, were examined. The mean age was 29.5 years. Of them, 18 (34.6%) were visually impaired in the affected eye. Ocular injury occurred most commonly among farmers 39/52 (75.0%). The difference between the number of males and females was not statistically significant (p = 0.5). But the relative risk (RR) of females (28/515 = 5.44) sustaining ocular injury compared to males (24/512 = 4.69) was 1.16 indicating that females had a 16% excess risk of having ocular injury than males. The leading cause of ocular injury in this community was by stick (35/52 = 67.3%). CONCLUSION: Ocular injury is significant (5.1%) in the community and causes monocular visual impairment in about one third (34.6%) of cases. Females are relatively at higher risk of having an eye injury (RR = 1.16) and this is mostly work related injury with stick during local food processing. Activities directed to improving the technology of food processing will ultimately reduce the rate of ocular injury in this community.

Prevalence of Pterygium in a Rural Community of District; Southern Ethiopia

Background: Pterygium is principally prevalent in tropical Africa. Though Ethiopia is located in the tropics; the prevalence of pterygium has not been well studied previously. Aim: To determine the prevalence of pterygium among people older than 20 years and its association with age; sex; smoking and exposure to ultraviolet light (UVL) in Meskan District of Gurage zone; Southern Ethiopia. Methods: This cross-sectional study was conducted from March 15 to May 15; 2006. Two peasant associations (PA) were randomly selected from the total of 42 in the district. Based on the sampling fraction; every third household in the selected peasant associations was included in the study. All individuals above 20 years of age in the selected households were interviewed and examined for the presence of pterygium. Measurements of pterygium were made with ruler. Visual acuity was taken for those individuals with pterygium and checked with pinhole if found to be less than 6/18. Results: A total of 922 individuals; 400 (43.4) males and 522 (56.6) females; were involved in the study. The mean age was 38.2 ranging from 21-95 years. Pterygium was found in 81 (8.8; 95CI: 7.0;10.6) of the study subjects. For those individuals whose age was above 40 years; the prevalence was found to be 17.4indicating an increased risk with age (p0.001). It also occurred among 50 (12.5) males and 31 (5.9) females and the difference was statistically significant (p0.001). Males have about twice the risk of developing pterygium compared to females. Conclusion: The prevalence of pterygium obtained (8.8) from this study was relatively low compared to many other reports from tropical areas. However; in agreement with other reports; advancing age and males have been identified as risk factors for the development of pterygium. Pterygium was associated with visual impairment in 13.1of cases

Prevalence of trachomatous trichiasis in the community of Alaba District, Southern Ethiopia.

BACKGROUND: Until the burden of active trachoma is reduced for a sustained period, trachomatous trichiasis (TT) will remain one of the major causes of blindness in Ethiopia. The magnitude of trichiasis as well as knowledge, attitude and practice of people with this condition in Alaba District is not known. OBJECTIVES: To assess the prevalence of trachomatous trichiasis in the community and evaluate the knowledge, attitude and practice (KAP) of these cases. DESIGN: A community based cross-sectional study. SETTING: Alaba District, 365 Km from Addis Ababa, Ethiopia. RESULTS: Out of 3850 people who were screened, 104 (2.7%, 95% confidence interval (CI): 2.2-3.2) cases were found to have trichiasis of which females and males accounted for 79.8 % (83/ 104) and 20.2%, (21/104) respectively. While all cases didn't know the cause and risk factors for trichiasis, nearly all of them, 102 (98.1%), knew that surgical treatment could prevent blindness from trichiasis. Previously operated patients were reported to be the most important source of information regarding its management. Eighty two (78.8%) of them epilate the misdirected cilia. The cost of surgery and distance from eye care service were found to be the two main barriers preventing the cases from having surgery. CONCLUSION: The prevalence of trichiasis greater than 1%, according to WHO, indicated that the community of Alaba District is facing a blinding trachoma. An increased public awareness regarding this common blinding disorder is required through health education. In addition, affordable and accessible surgical facility for trichiasis is needed in the area in order to prevent blindness.

Prevalence of trachoma and its determinants in Dalocha District, Central Ethiopia.

AIM: This community-based cross-sectional study was conducted to determine the prevalence of trachoma in Dalocha District, Central Ethiopia. METHODS: A multistage sampling method was used to identify the peasant associations and households included in the study. The WHO clinical grading method for trachoma was used. RESULTS: Of the 619 sampled persons, 302 (48.8%) males and 317 (51.2%) females, 564 people were available for examination, yielding a response rate of 91.1%. More than half (51.1%) of the children aged 10 years or less had active trachoma (trachomatous inflammation, TI, in 16.5% and trachomatous follicles, TF, in 34.6%). On the other hand, active trachoma and trachomatous trichiasis (TT) were each found in 5.5% of individuals older than 10 years of age. CONCLUSIONS: According to the WHO, the findings of TI and TF in more than 5% and 20%, respectively, of children aged 10 years or less and TT in more than 1% of older individuals indicate that trachoma is a major public health problem in Dalocha community.

Embryonal rhabdomyosarcoma of the orbit in a 38-year-old woman.

Primary embryonal rhabdomyosarcoma of the orbit is an extremely rare tumor in adults. A 38 year old female patient with immunohistochemically proved embryonal rhabdomyosarcoma of the right orbit is reported. The histologic types, diagnosis, management and out come of rhabdomyosarcoma is discussed.

Free conjunctival autograft in the management of advanced primary and recurrent pterygia.

OBJECTIVES: To evaluate the outcome of free conjuctival autograft in patients with grades III and IV pterygia and to determine the post-operative recurrence rate. DESIGN: A prospective descriptive study. SETTING: Menelik II Hospital, Addis Ababa, Ethiopia. PARTICIPANTS: Thirty four patients, 32 with primary and two with recurrent pterygia. INTERVENTION: A superficial Keratectomy extending beyond the corneal lesion all around and sufficiently deep to Bowman's layer to produce a perfectly clear cornea in the excised area followed by suture a free conjuctival autograft on the excised area. MAIN OUTCOME MEASURES: Improvement in visual acuity and recurrence rate of pterygia at follow up. RESULTS: Of the 32 patients followed up, the visual acuity remained the same on eight and improved in 24 cases. There were no intraoperative complications. Pterygia recurred in two patients between three and four months postoperatively. CONCLUSION: This study suggests that a free conjuctival autograft in the management of stage III and IV pterygia is a useful operation resulting in a very low recurrence rate of the pathology.