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Biomedical subjects

W Alemayehu

Publications and source records attributed to W Alemayehu.

At least 19 recordsLinked to original sources
PubMed2006

The association between epilation and corneal opacity among eyes with trachomatous trichiasis.

AIM: To examine the association between epilation and corneal opacity (CO) among trichiasis patients presenting for surgery. METHODS: Cross sectional data from the STAR trial were utilised. Patients presenting for trichiasis surgery in Wolayta Zone, Ethiopia, were evaluated for current trichiasis status. Number of inturned lashes, evidence of epilation, level of entropion, trichiasis duration, and CO were collected. The primary outcome was prevalence of CO, stratified by entropion and epilation status. RESULTS: Approximately 10% of eyes with mild entropion had CO, regardless of epilation status. Among eyes with moderate entropion, epilated eyes were less likely to have CO than non-epilated eyes (21% v 34% p = 0.002). The same association was seen in eyes with severe entropion: 43% of epilated eyes while 74% of non-epilated eyes had CO (p<0.0001). Presence of CO increased with age. Adjusted models showed a protective effect of epilation in eyes with moderate or severe entropion (OR: 0.51; 95% CI: 0.32 to 0.83 and OR: 0.24; 95% CI: 0.13 to 0.45, respectively). Among eyes with mild entropion there was no difference in the prevalence of CO comparing eyes that were epilated with those that were not epilated. CONCLUSION: Entropion was the most significant predictor of CO. Cross sectional associations suggest that epilation may not be helpful for eyes with mild entropion, but may offer protection against CO in eyes with moderate to severe entropion. Epilation should not be a substitute for trichiasis surgery, however, as 43% of eyes with severe entropion that were epilated still had CO.

Corneal Opacity↗
PubMed2005

Characteristics of trichiasis patients presenting for surgery in rural Ethiopia.

AIMS: To determine the characteristics of trichiasis patients presenting for surgery in Wolayta Zone of Ethiopia. METHODS: Patients referred for trichiasis surgery by community health agents were evaluated by trained integrated eye care workers (IECWs) for the presence of trichiasis, locations of inturned lashes, severity of trichiasis, corneal opacity, and visual acuity. RESULTS: 1635 individuals with trichiasis presented for surgery. 82% had bilateral trichiasis; 91% of patients reported trichiasis duration of >2 years. Epilation was practised by over three fourths of the study subjects. A high proportion of patients tested positive for ocular Chlamydia trachomatis at presentation. 17% had monocular blindness and 8% were binocularly blind. Corneal opacity was highly associated with the trichiasis duration and severity and visual loss was associated with corneal opacity. CONCLUSION: Severe trichiasis reflects the magnitude of the trachoma problem in Ethiopia. Visual impairment due to trichiasis is highly associated with disease severity and duration. Early intervention to correct trichiasis before it become severe is recommended to prevent visual impairment.

Adult↗
PubMed2004

Pesky trachoma suspect finally caught.

AIM: Face seeking flies have long been thought to transmit Chlamydia trachomatis, the causative agent of trachoma, but this has never been proven. The four criteria proposed by Barnett, previously used to incriminate other arthropods suspected of transmitting disease, were examined. One of these criteria remains unmet: the repeated demonstration of the presence of C trachomatis on flies. The authors used polymerase chain reaction (PCR) to look for the presence of C trachomatis DNA on flies in the Gurage Zone of Ethiopia. METHODS: Using sticky paper, one fly was collected from the face of each of 103 children aged 1-10 years. The piece of fly paper to which the fly was attached was cut out, followed by the collection of an empty piece from an arbitrary area of the fly paper, which served as control. Roche Amplicor PCR kits were used to detect C trachomatis DNA. RESULTS: Evidence of C trachomatis by PCR was found on 15 of 103 flies versus 0 of 103 controls (p = 0.0001). CONCLUSION: These results meet the final criterion needed to incriminate flies as a vector of trachoma. However, interventional studies will be needed to show the importance of fly control.

Animals↗
PubMed2003

Low vision and blindness in adults in Gurage Zone, central Ethiopia.

AIM: To determine the magnitude and causes of low vision and blindness in the Gurage zone, central Ethiopia. METHODS: A cross sectional study using a multistage cluster sampling technique was used to identify the study subjects. Visual acuity was recorded for all adults 40 years and older. Subjects who had a visual acuity of <6/18 were examined by an ophthalmologist to determine the cause of low vision or blindness. RESULTS: From the enumerated population, 2693 (90.8%) were examined. The prevalence of blindness (<3/60 better eye presenting vision) was 7.9% (95% CI 6.9 to 8.9) and of low vision (6/24-3/60 better eye presenting vision) was 12.1% (95% CI 10.9 to 13.3). Monocular blindness was recorded in 16.3% of the population. Blindness and low vision increased with age. The odds of low vision and blindness in women were 1.8 times that of the men. The leading causes of blindness were cataract (46.1%), trachoma (22.9%), and glaucoma (7.6%). While the prevalence of vision reducing cataract increased with age, the prevalence of trachoma related vision loss did not increase with age, suggesting that trichiasis related vision loss in this population might not be cumulative. CONCLUSION: The magnitude of low vision and blindness is high in this zone and requires urgent intervention, particularly for women. Further investigation of the pattern of vision loss, particularly as a result of trachomatous trichiasis, is warranted.

Adult↗
PubMed2001

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.

Adolescent↗
PubMed1999

Loss of vision from distant haemorrhage: report of four cases.

To describe the occurrence of visual loss from ischaemia of the optic nerve following distant haemorrhages. Four patients who sustained vision loss following distant haemorrhage, presenting to the neuro-ophthalmic clinic of the department of Ophthalmology, Addis Ababa University, from 1995 to 1997 were evaluated. The clinical presentation, management and prognosis are discussed. Post-haemorrhagic vision loss, other than being a rare occurrence, is under-reported due to the fact that these patients are very sick with massive blood loss and hence little attention is given to the vision loss by attending physicians and sometimes even the patients themselves. It is hoped that this paper will increase awareness about this condition among physicians attending to patients with severe bleeding and thus facilitate early diagnosis and referral.

Abortion, Spontaneous↗
PubMed1997

Clinical profile of herpes zoster ophthalmicus in Ethiopians.

We conducted a prospective study of 100 consecutive Ethiopian patients with herpes zoster ophthalmicus (HZO); this study revealed a high incidence of HZO among the young (mean age, 35 years). Eighty-one (95%) of 85 patients who underwent serological testing were seropositive for antibodies to human immunodeficiency virus (HIV). Unlike previous investigators, we found a marked increase in the incidence and severity of eyelid (25%) and ocular (78%) complications as well as postherpetic neuralgia (55%). Visual loss occurred in 56% of the cases. Lack of medication, delay in presentation, severity of HIV-related HZO, and application of herbal medications adversely affected the outcomes for these patients. We conclude that all patients with HZO, especially those younger than 45 years of age, should be screened for HIV infection. Because HZO is a vision-threatening problem, all health care workers should become aware of its management.

Acyclovir↗
PubMed1997

Pattern of neuro-ophthalmic disorders in a tertiary eye care centre in Addis Ababa.

A neuro-ophthalmic subspeciality clinic was established in Ethiopia for the first time in September 1993. A total of 700 patients attended this clinic over a period of two years. Optic nerve lesions (22%), herpes zoster ophthalmicus (18%), ocular motor palsies (17%), facial palsy (10%) and papilloedema (7%) were the leading neuro-ophthalmic disorders observed. Myasthenia gravis and muscular dystrophies were not rare diseases as well. HIV infection manifested in a variety of neuro-ophthalmic disorders. In a significant number of the patients, precise diagnoses could not be made due to lack of diagnostic facilities. Most patients presented in advanced and irreversible state. Increased awareness on the part of patients as well as health care providers is thus of paramount importance in order to avert unnecessary death and blindness, also is underlined the need for improved diagnostic facilities like magnetic resonance imaging and computerized tomography.

Adolescent↗
PubMed1996

A population-based study of xerophthalmia in the extreme North Province of Cameroon, West Africa.

OBJECTIVE: To obtain cross-sectional data on clinical and nutritional vitamin A deficiency from which to design appropriate intervention strategies. DESIGN: A population-based survey using multistage, cluster sampling. SETTING: Extreme North Province of Cameroon, West Africa. PARTICIPANTS: Children aged 0 to 5 years. MAIN OUTCOME MEASURES: Clinical signs of active xerophthalmia and dietary vitamin A intake. RESULTS: Of 5352 children examined, signs of active xerophthalmia were noted in 0.62%. Bitot's spots, corneal xerosis, and corneal ulceration were noted in 0.47%, 0.06%, and 0.12% of the subjects, respectively. Children with xerophthalmia had lower vitamin A intake scores when compared with age-matched controls and with a 20% systematic subsample of children. CONCLUSION: Xerophthalmia is a major public health problem in this region.

Cameroon↗
PubMed1996

Prevalence and causes of low vision and blindness in the Extreme North Province of Cameroon, West Africa.

A survey to determine the prevalence and causes of blindness and visual impairment in the Extreme North Province of Cameroon was conducted in the Spring of 1992. A total of 10,647 people age 6 years and older was selected from a multi-stage, clustered sample stratified by ecological zone. The subjects were examined by ophthalmologist-led teams for visual acuity and ocular diseases. Approximately 1.2% of the sample was bilaterally blind by the World Health Organization classification (Category 3) of vision less than the ability to count fingers at 3 meters. Similarly to results found in other developing countries, senile cataract was the most common diagnosis encountered and the most frequent principal cause of low vision and blindness.

Adolescent↗
PubMed1996

Perceptions of blindness.

A study in a mainly rural area of Ethiopia has revealed that sighted, unilaterally blind and totally blind people have many misconceptions about blindness. The work of cure and prevention demands that widespread ignorance about the causes and implications of blindness be overcome.

Blindness↗
PubMed1996

Ocular manifestations of leukaemia in Ethiopians.

A prospective ophthalmic evaluation of 74 newly diagnosed and 34 old (on follow-up) leukaemic patients, carried out from March 1990 to December 1995 is described. Primary ocular involvement, that is leukaemic retinal infiltrates, were detected in 32% of the newly diagnosed. In contrast, none of the old leukaemic patients had this lesion. In 69% of the new and 21% of the old cases, secondary ocular manifestations of leukaemia were observed. The major secondary ocular manifestation of leukaemia in both groups was intra-retinal haemorrhage. A variety of miscellaneous ocular findings, such as cataract, pterygium, pingeculae, etc. were detected in 36% of all leukemics. These findings indicate the importance of a complete ophthalmologic evaluation in the diagnosis, follow-up and management of leukaemic patients.

Adolescent↗
PubMed1995

Causes of visual impairment in central Ethiopia.

A survey conducted on a stable, mainly rural population of 60,820 in Central Ethiopia revealed an overall blindness prevalence of 1.1%. A follow up study was carried out to accurately determine the etiologies and causes of visual loss and impairment. A detailed ophthalmic evaluation was done on 523 out of 872 individuals identified as being visually impaired. The results showed that 194 (37%) were blind (Categories 3, 4, and 5 = maximum visual acuity less than 3/60 in the better eye). One hundred and seven (21%) (Categories 1 & 2 = maximum visual acuity better than 3/60 to less than 6/18 in the better eye using the WHO categories of visual impairment). The rest 222 (43%) were blind in one eye only. The commonest anatomical cause of blindness is corneal (32%). Cataract (25%), atrophied globe(s) (20%) and glaucoma (17%) follow as the other leading causes. Trachoma (35%), degenerative conditions (35%) and other infections (9%) were the major etiologies of blindness. Similar pattern of anatomical causation was observed in those classified under categories of visual impairment 1 and 2, referred to as "low vision". The most important etiologies of low vision were trachoma (30%), degenerative (24%), trauma (13%) and other infections (8%). Trauma was the most important etiology of monocular blindness (39%). Blindness was either preventable or curable in 74% of the cases.

Adolescent↗
PubMed1995

Pseudotumor cerebri (toxic effect of the "magic bullet").

A 10 year-old female patient presented to the outpatient unit of the ophthalmology department of Menelik II Hospital with complaints of inward deviation of the left eye, of three weeks' duration. The patient was on a mega dose of vitamin A 200,000 I.U. (the "magic bullet") daily for two months prior to the onset of the present illness. Physical examination revealed left sixth nerve palsy and bilateral papilloedema in an alert and oriented patient without localizing neurologic findings. The cerebrospinal fluid pressure ( > 250 mm water) was increased and skull X-ray findings were suggestive of increased intracranial pressure (IIP). This case meets the modified Dandy criteria except that a highly likely cause, hypervitaminosis A, is associated. Therefore, a diagnosis of Idiopathic Intracranial Hypertension (IIH) or Pseudotumor Cerebri was made. This disorder and its management is discussed and literature reviewed. The serious and potentially blinding toxic effect of Vitamin A, if consumed in excessive amounts, is emphasized.

Abducens Nerve↗
PubMed1995

Causes of removal of the eye in Ethiopia.

The causes of removal of the eye in 282 patients are presented. A decreasing linear trend with increasing age as causes of removal of the eye is observed. The most common causes of removal of the eye were: traumatic globe rupture (33%) malignancy (21%), ugly corneal staphyloma (11%) and panophthalmitis without external cause (11%). The M:F ratio was 2.2:1 and relative frequency of causes of removal of the eye in males and females is shown to be different. Findings on other demographic data, duration of clinical history, causes of trauma and mode of surgery is reported. The need for early presentation is discussed and preventive measures are suggested.

Adolescent↗