Prevalence of Ocular Anomalies among Schoolchildren in Ashaiman, Ghana.

PURPOSE: Information on ocular anomalies can help in developing specific interventions to prevent visual impairment especially among children. The aim of this study was therefore to determine the prevalence, the causes of ocular anomalies, and their impact on vision of schoolchildren in Ghana. METHODS: A cluster random sampling technique was used to select four government primary schools in Ashaiman Municipal for this study. Each pupil underwent ocular examination involving visual acuity, external examination, anterior and posterior segment examination, and objective and subjective refraction. They also answered questions relating to ocular problems affecting them. RESULTS: A total of 811 pupils were sampled, with ages ranging from 6 to 16 years. The mean age of the sampled population was 10.6 years (95% confidence interval, 10.4 to 10.8). Prevalence of ocular anomalies was 27.3% (95% confidence interval, 24.2 to 30.5). Allergic conjunctivitis (17.3%) and refractive errors (6.8%) were the main causes of ocular anomalies. Others include pinguecula (1.2%), pterygia (0.9%), infectious conjunctivitis (0.3%), corneal opacity (0.1%), lens opacity (0.1%), and retinal degeneration (0.1%). Ocular anomalies and refractive errors were significantly associated with sex (p = 0.04 and p = 0.01, respectively). Presenting visual acuity in the better eye 20/40 or worse was identified in 5.3% of schoolchildren, and 0.5% had moderate visual impairment. Only 11.8% of schoolchildren with ocular anomalies had been treated for their ocular problems before the study. CONCLUSIONS: The prevalence and causes of ocular anomalies found in this study suggest a need for more targeted eye health interventions such as school eye screening for early diagnosis and treatment of any presenting conditions among schoolchildren.

Reduced Bacterial Counts from a Sewage Treatment Plant but Increased Counts and Antibiotic Resistance in the Recipient Stream in Accra, Ghana-A Cross-Sectional Study.

Wastewater treatment plants receive sewage containing high concentrations of bacteria and antibiotics. We assessed bacterial counts and their antibiotic resistance patterns in water from (a) influents and effluents of the Legon sewage treatment plant (STP) in Accra, Ghana and (b) upstream, outfall, and downstream in the recipient Onyasia stream. We conducted a cross-sectional study of quality-controlled water testing (January-June 2018). In STP effluents, mean bacterial counts (colony-forming units/100 mL) had reduced E. coli (99.9% reduction; 102,266,667 to 710), A. hydrophila (98.8%; 376,333 to 9603), and P. aeruginosa (99.5%; 5,666,667 to 1550). Antibiotic resistance was significantly reduced for tetracycline, ciprofloxacin, cefuroxime, and ceftazidime and increased for gentamicin, amoxicillin/clavulanate, and imipenem. The highest levels were for amoxicillin/clavulanate (50-97%) and aztreonam (33%). Bacterial counts increased by 98.8% downstream compared to the sewage outfall and were predominated by E. coli, implying intense fecal contamination from other sources. There was a progressive increase in antibiotic resistance from upstream, to outfall, to downstream. The highest resistance was for amoxicillin/clavulanate (80-83%), cefuroxime (47-73%), aztreonam (53%), and ciprofloxacin (40%). The STP is efficient in reducing bacterial counts and thus reducing environmental contamination. The recipient stream is contaminated with antibiotic-resistant bacteria listed as critically important for human use, which needs addressing.