Prevalence and Determinants of Ocular Disorders among in-School Children with Physical and Mental Disabilities in Osun State, South West Nigeria.

PURPOSE: This study set out to determine the prevalence and the factors contributing to ocular disorders among children with physical and mental disabilities, who represent a vulnerable group in Osun State. METHODOLOGY: This was a cross-sectional study among children with physical and mental disabilities aged 5-17 years using a multistage sampling technique. Demographics, presence of ocular symptoms and determinants of ocular disorders were noted. Distant visual acuities were measured; refraction and ocular examination were performed. Appropriate drug treatment, prescribed spectacle or low vision aids were dispensed as necessary, at subsidized rates. RESULTS: Of 189 children enrolled, 103(54.5%) were males and 86(45.5%) were females, with male to female ratio of 1.2:1. Mean age was 14.7 ± 0.45 years and 28/189 (14.8%) had ocular disorders in either eye. Some of the participants had multiple pathologies. The commonest identified visual disorder was refractive error (11.1%). There was a statistically significant ocular disorder determinant among most mothers of respondents (82.1%) who had ocular disorders and did not receive antenatal care in the hospital, p<0.05. Only 28.6% of children who had ocular disorders were fully immunized. CONCLUSION: The majority of mothers of children with ocular disorders did not receive antenatal care in the hospital. Health education on the importance of early antenatal care in the hospital is advocated to reduce the occurrence of ocular disorders. Early assessment and correction of ocular problems will prevent unnecessary visual impairment in these vulnerable children.

OBJECTIF: Cette étude visait à déterminer la prévalence et les facteurs contribuant aux troubles oculaires chez les enfants présentant des handicaps physiques et mentaux, qui représentent un groupe vulnérable dans l'État d'Osun. MÉTHODOLOGIE: Il s'agissait d'une étude transversale menée auprès d'enfants atteints de handicaps physiques et mentaux âgés de 5 à 17 ans, utilisant une technique d'échantillonnage à plusieurs niveaux. Les données démographiques, la présence de symptômes oculaires et les déterminants des troubles oculaires ont été notés. Les acuités visuelles à distance ont été mesurées ; la réfraction et l'examen oculaire ont été effectués. Un traitement médicamenteux approprié, des lunettes prescrites ou des aides à la basse vision ont été délivrés au besoin, à des tarifs subventionnés. RÉSULTATS: Sur 189 enfants inscrits, 103 (54,5 %) étaient des garçons et 86 (45,5 %) étaient des filles, avec un ratio garçons/filles de 1,2:1, âge moyen de 14,7 ± 0,45 ans ; tandis que 28/189 (14,8 %) présentaient des troubles oculaires dans l'un ou l'autre des yeux. Certains participants avaient plusieurs pathologies. Le trouble visuel le plus fréquemment identifié était l'erreur réfraction (11,1 %). Il y avait un déterminant de trouble oculaire statistiquement significatif chez la majorité des mères des répondants (82,1 %) qui avaient des troubles oculaires et n'avaient pas reçu de soins prénatals à l'hôpital p<0,05. Seulement 28,6 % des enfants présentant des troubles oculaires étaient entièrement immunisés. CONCLUSION: La plupart des mères d'enfants atteints de troubles oculaires n'ont pas reçu de soins prénatals à l'hôpital. Une éducation sanitaire sur l'importance des soins prénatals précoces à l'hôpital est préconisée afin de réduire l'occurrence des troubles oculaires. L'évaluation précoce et la correction des problèmes oculaires préviendront une atteinte visuelle inutile chez ces enfants vulnérables. MOTS-CLÉS: Trouble oculaire, Prévalence, Enfants en âge scolaire, Handicaps physiques et mentaux.

Cluster survey for poliomyelitis and neonatal tetanus in Ilorin, Nigeria.

The incidence of poliomyelitis and neonatal tetanus in Ilorin Local Government Area was estimated using a 40-cluster, retrospective survey of neonatal tetanus deaths and lameness from poliomyelitis in March and April 1988. The survey identified 19 neonatal tetanus deaths among 1601 livebirths, giving an incidence rate of 14.9/1000 livebirths. Some 31 residual paralytic polio cases were identified among 4576 children aged five to nine years, giving a prevalence rate of 6.8/1000 children in this age group and an annual incidence rate of 38.3/100,000 general population. Immunization of pregnant women with tetanus toxoid, had a greater impact on mortality from neonatal tetanus than delivery in hospital or birth at home attended by a traditional birth attendant. Antenatal coverage with two doses of tetanus toxoid was 62.6%. Poliomyelitis and neonatal tetanus still constitute important causes of childhood morbidity and mortality in Ilorin and antenatal tetanus immunization coverage is not yet sufficient to control neonatal tetanus in this population. The target age for immunization with tetanus toxoid should be extended to include all women of childbearing age. Further retrospective surveys from other Nigerian states are needed to determine the magnitude of the neonatal tetanus problem throughout the country.

The application of operational research (OR) procedures to maternal mortality from puerperal sepsis in a rural community.

An operation research (OR) procedure on maternal mortality from puerperal sepsis was carried out in Irepodun Local Government Area of Kwara State of Nigeria. The study involved ten focus groups discussion (FGD) in two districts of the Local Government Area. The findings were analysed from three broad perspectives, that is, consumers' views, providers' views and community decision takers' views. In general, the analysis revealed that the community knowledge of puerperal sepsis is poor. In addition, limited access and prohibitive cost of orthodox health care services prevented the community from full utilization of the few available health care centres in the community. The study also revealed that there is urgent need to introduce three key interventions for an improved maternity care in the community. These interventions are community health education, health institutions development and community participation in provision of ancillary services such as transportation.

Prevalence of paralytic poliomyelitis in children of Kwara State, Nigeria: report of a house-to-house survey.

During March 1988, a house-to-house survey was carried out to determine the prevalence of poliomyelitis in Ilorin Local Government Area (LGA) of Kwara State, Nigeria. The survey identified 4576 children aged 5 to 9 years old in the households visited from forty randomly selected clusters in the area. Of the 41 lame children, lameness compatible with paralytic poliomyelitis was found in 31, of these 87% had their condition before the age of 3 years. Thirteen percent needed a stick support for walking while 16% were unable to walk even with support. The prevalence rate of residual polio paralysis was 6.8/1000 children 5-9 years old. When all cases of residual paralysis, deaths and recoveries are taken into account, this translates to an incidence of 8.4/1000 children aged 5-9 years old and an annual incidence of 38.3/100,000 general population.

'Leopard skin' as a rapid diagnostic index for estimating the endemicity of African onchocerciasis.

A study was made in five rural districts of Kwara State, Nigeria to assess the possible use of 'leopard skin' (Ls) as a rapid diagnostic technique for estimating the endemicity of African onchocerciasis. The findings revealed that there is a positive association between the percentage of subjects with skin microfilariae (mf) and the percentage with Ls. The prevalence of Ls less than 1% suggests communities with sporadic infection, 1-6% suggests hypoendemic communities and greater than 6% suggests meso- or hyperendemic communities, using mf rates of less than 10%, 10-39%, 40-69% and 70% or greater as the standard to classify sporadic, hypoendemic, mesoendemic and hyperendemic levels of the infection, respectively. The unique merits of Ls as a potential onchocercal index are presented.