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Biomedical subjects

M C Chirambo

Publications and source records attributed to M C Chirambo.

10 recordsLinked to original sources
PubMed1992

The role of Western ophthalmologists in dealing with cataract blindness in developing countries.

Of the estimated 35-40 million blindness worldwide, 17 million is caused by cataract and this proportion will double by year 2025. In Africa alone, it is estimated that there are about 3 million cataract blind. As life expectancy in Africa increases so will the incidence of cataract blindness. Existing resources of manpower and services cannot cope adequately with the present backlog of cataracts, let alone the anticipated increased load. The deployment of local ophthalmologists to deal with cataract load would be cost-effective in delivering appropriate eye care but the scarcity of ophthalmologists makes the option ineffective. The role of Western ophthalmologists will be considered in the provision of cataract surgical services and training of ophthalmic assistants, cataract surgeons and ophthalmologists.

Africa↗
PubMed1991

Assessment of vitamin A deficiency in Republic of Malawi by impression cytology method.

During a countrywide survey, we assessed the prevalence of vitamin A deficiency by impression cytology method with transfer in a randomized sample of 650 representative of the children's population of the Republic of Malawi. A vitamin A deficiency was indicated by the results of the ophthalmic examination (XN = 1,4%; X2 = 0,2%) and the ICT test (22% with deficient cytology). Results of ICT were related to age. Vitamin A deficiency seems to be a public health problem in the Republic of Malawi.

Child↗
PubMed1979

Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi.

The histological features of 234 conjunctival biopsies from Africans in Malawi have been re-examined. The appearances of solar keratosis, pinguecula, and pterygium are presented as part of a continuous spectrum of the same pathological process and aetiology, which may lead to carcinomatous change. The results are discussed with regard to the specific geographical distribution of such lesions found by other workers, with particular emphasis on ultraviolet radiation as the main aetiological factor.

Carcinoma, Squamous Cell↗
PubMed1978

Bilateral versus unilateral cataract extraction: advantages and complications.

Cataract extraction was performed on 734 patients. These were followed up postoperatively for up to 1 year. In 448 cases the extraction was performed in both eyes during 1 operating session (896 eyes) and in 1 eye in 286 cases, a total of 1182 cataract extractions. Preoperatively more than 75% of the eyes in both groups had perception of light only. Postoperatively more than 85% of eyes in both groups achieved a visual acuity of 6/30 or better. The postoperative visual performance of an eye was not influenced by the mode of operation, bilateral or unilateral. The overall incidence of complications among the 1182 operated eyes was: accidental extra-capsular cataract extraction 10.2%, vitreous loss 11.0%, hyphaema 1.4%, flat anterior chamber 0.9%, dehiscence of the wound 0.5%, uveitis 1.2%, endophthalmitis 0.3%, secondary glaucoma 0.9%, severe bullous keratopathy 1.4%, oedema of the macula 0.5%, and retinal detachment 0.3%. The complications in both groups of patients were comparable. Only in 1 case operated in both eyes vision was not restored following a bilateral endophthalmitis.

Cataract Extraction↗
PubMed1978

Trabeculectomy.

Trabeculectomy as first choice of treatment has been performed on 100 consecutive cases in Africans. During the follow-up period ranging from 2 to 12 months, 79 eyes had a postoperative intraocular pressure of less than 21 mm Hg without any antiglaucomatous medications. Fourteen eyes operated upon (14%) had a postoperative intraocular pressure between 22 and 26 mm Hg. Seven cases (7%) showed an intraocular pressure higher than 28 mm Hg. Hypotony and hyphema encountered in 8 cases were a minor postoperative complication. Protrusion of the iris in the surgical wound occurring in 2 cases was a major complication. A correlation between the intraocular pressure one week and 28 weeks postoperatively showed that in most cases the intraocular pressure was higher after the longer follow-up. However, out of a group of 25 eyes operated upon showing an intraocular pressure of 14 mm Hg or less, one week postoperatively, only one eye (4%) showed an intraocular pressure higher than 20 mm Hg on the longer follow-up.

Adult↗
PubMed1978

Vitreous loss during intracapsular cataract extraction.

Among 448 patients operated upon for bilateral cataracts (896 eyes), vitreous was lost in 96 eyes, an incidence of 10.7%. The most striking difference between the whole group of eyes without vitreous loss (800 eyes) and those with vitreous loss is in the percentage of eyes able to perform a very good visual acuity postoperatively. An analysis of 50 cases losing vitreous unilaterally shows the following: (a) more than 80% of eyes with vitreous loss achieved a vision comparable to their fellow eyes; (b) 12% of eyes with vitreous loss achieved a poorer vision than their fellow eyes; and (c) fewer eyes with vitreous loss achieved a very good visual acuity as compared to their fellow eyes (8.7% to 11.1% in eyes with vitreous loss as compared to 21.5% to 22.2% of fellow eyes). The combination of vitreous loss with an accidental extracapsular cataract extraction had a worsening effect on the expected postoperative visual performance.

Cataract Extraction↗
PubMed1977

Incidence and causes of blindness among the under 5 age group in Malawi.

The expected incidence of blindness among children under 5 years of age in Malawi is 34 cases per 100 000 children. Direct ocular infections were responsible for the blindness in 32% of the cases (bacterial infections 20% and measles 12%). The instillation of traditional medicine in these cases worsened the ocular condition and induced in all of the cases a "hopeless" situation of total melting of the cornea and protrusion of the uvea. Congenital factors (excluding retinoblastomas) were responsible for 30-8% of the blind cases. Among these, 11 cases of congenital cataracts were successfully treated and will not appear as blind in future. A high incidence (9-3%) of cortical blindness was recorded. Trauma was implicated in 5-3%, while retinoblastoma was found in 8%. It is believed that adequate preventive measures should be able to lower the incidence of blindness among this age group to 5 cases instead of 34 per 100 000 children.

Bacterial Infections↗
PubMed1976

Causes of blindness among students in blind school institutions in a developing country.

Out of 270 students in 17 blind school institutions in Malawi 73 per cent were blind before the age of three. The most common cause for the blindness was ocular infection (75-2 per cent). Meales, as a single cause, was responsible for 43-7 per cent of the cases and smallpox for 5-2 per cent. Bacterial infections were incriminated in 26-3 per cent of the cases. Most of these had received traditional medicine during the acute phase of the disease. Hereditary factors as causes of blindness were found in 7-8 per cent of the cases. These included congenital cataracts (2-6 per cent), optic atorphy of unknown origin (3-0 per cent), microphthalmos (1-5 per cent), and macular degeneration (0-7 per cent). Careful ophthalmological examination showed that in 37 cases an intervention could be attempted in order to improve the vision. In the 11 most favourable cases this was attempted, with the result that nine cases gained a useful vision of 4/60 to 6/18 in the better eye.

Adolescent↗
PubMedDate not supplied

Incidence of retinoblastoma in Malawi.

The annual incidence of retinoblastoma in Malawi seems to be two cases per 100,000 children under five or one case per 10,000 live births. A higher frequency of one case per 21,700 to 17,900 children under five or one per 4,340 to 3,580 live births has been found in the Zomba and Mangochi districts. Analyzing the cases according to sex and laterality, 61.1 percent of the unilateral cases were girls and 58.3 percent of the bilaterals were boys. Among boys, 33.3 percent were bilateral while unilateral involvement of the left eye was found in 19.1 percent. Among the girls, the frequency of bilateral cases was 18.5 percent while the unilateral involvement of right and left eye was nearly similar.

Age Factors↗