Eye Care Workers Research Articles

Task-shifting and the recruitment and retention of eye care workers in under-served areas: a qualitative study of optometrists' motivation in Ghana and Scotland.

To assist policy-makers in improving access to eye care in under-served areas by analysing the relationship between motivational factors affecting the uptake of task-shifting in eye care and the recruitment and retention of optometrists in remote and rural areas. The World Health Organization recommends two key strategies in tackling preventable blindness in under-served areas: improving human resources for health and task-shifting. The relationship between task-shifting and recruitment and retention of eye care workers in under-served areas is unknown. Ghana and Scotland are two countries from different levels of economic development that have notably expanded the roles of optometrists and struggle with rural recruitment and retention. Motivation was explored through semi-structured interviews with 19 optometrists in Ghana and Scotland with experience in remote and rural practice. Framework analysis was used to analyse interviews, explore the relationship between task-shifting and recruitment and retention and create recommendations for policy. The main motivational considerations included altruism, quality of life, learning and career opportunities, fulfilling potential, remuneration, stress of decision-making and collaboration. Motivational and demotivational factors for task-shifting and recruitment/retention shared many similar aspects. Recruitment and retention in remote and rural areas require staff be incentivised to take up those positions, motivated to remain and given the adequate resources for personal and professional fulfilment. Task-shifting also requires incentivisation, motivation to continue and the resources to be productive. Many motivational factors influencing recruitment/retention and task-shifting are similar suggesting these two strategies can be compatible and complementary in improving access to eye care, although some factors are culture and context specific. Understanding optometrists' motivation can help policy-makers improve rural recruitment and retention and plan services.

Postoperative trachomatous trichiasis and associated factors among adults who underwent trachomatous trichiasis surgery in Ambassel District, North-East Ethiopia.

In Trachoma endemic countries, many people who underwent Trichiasis surgery faced a recurrence of the disease. Postoperative Trichiasis is a significant problem for patients and health care providers because it puts the eye at renewed risk of sight loss. Despite the low utilization of Trachomatous Trichiasis surgery and the high recurrence rate, evidence that elucidate why it recurs after surgery is limited. This study was aimed to assess the magnitude and associated factors of postoperative Trichiasis among 18 years and above individuals who underwent Trachomatous Trichiasis surgery between 2013 and 2019 in Ambassel District, Northeast Ethiopia, 2020. The community-based cross-sectional study design was conducted from March 10 to March 23/2020 in selected kebeles of Ambassel District. The required sample size (506) was calculated using EPI-INFO Version 7. A multi-stage sampling technique was used to employ study participants. Data were collected through the interviewer-administered structured pre-tested questionnaire and entered into EpiData version 3.1 and then exported to SPSS version 23.0 for analysis. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of Postoperative Trachomatous Trichiasis. Four hundred ninety two individuals participated in this study with a response rate of 97.2%. In Ambassel district, the prevalence of postoperative Trichiasis was 23.8% (95% CI = 19.9-27.8). Among associated factors of postoperative Trachomatous Trichiasis: age 50-59 (AOR = 3.34, CI = 1.38-8.1), 60-69 (AOR = 3.24, CI = 1.38-7.61), ≥70 years (AOR = 6.04, CI = 2.23-16.41), duration since surgery (AOR = 1.7, CI = 1.35-2.14), complication (AOR = 2.98, CI = 1.24-7.2), washing the face two times (AOR = 0.25, CI = 0.13-0.47), washing the face three and more times (AOR = 0.1, CI = 0.41-0.25), taking Azithromycin following surgery (AOR = 0.19, CI = 0.09-0.41), pre-operative epilation history (AOR = 2.11, CI = 1.14, 3.9) and having a knowledge about TrachomaTtrichiasis (AOR = 0.21, CI = 0.08-0.58) showed a statistical significant association. The prevalence of postoperative Trichiasis in Ambassel District was higher than most Ethiopian studies. Age, frequency of face washing, medication following surgery, duration since the last surgery, knowledge about trachoma, pre-operative epilation history, and complication after surgery were identified to be independent factors. To minimize postoperative Trachomatous Trichiasis stakeholders need to consider health education for patients, provision of Azithromycin after surgery, and proper training for integrated eye care workers.

Keratoconus in the West Region of Cameroon: Stakeholder knowledge and management

Background: Adequate knowledge and skills by eyecare personnel and administrators are essential for the early diagnosis and prompt management of keratoconus (KC).Aim: This study aimed to determine the knowledge and skills of key stakeholders on KC management in eyecare facilities of Bafoussam, West Region of Cameroon.Setting: Eyecare facilities in the West Region of Cameroon.Methods: A qualitative study, using a purposive (non-probability) sampling technique, was applied to collect data relevant to this study. In-depth interviews were used to collect data from eyecare personnel and administrators. Eyecare personnel in this study comprised optometrists, ophthalmic nurses and optometric technicians, who are trained to World Council of Optometry (WCO) competency level one or two. There were no ophthalmologists working at the study sites. Data obtained were captured, de-identified and stored in a password-protected electronic file. Data were coded and analysed applying a deductive thematic analysis approach.Results: There were 21 participants (five administrators and 16 eyecare professionals) from five facilities. Fourteen (66.6%) were males; 10 (47.6%) had 11–20 years of work experience. The majority of the participants had limited or no knowledge of KC. They reported an undersupply of KC diagnostic equipment and consumables at facilities, resulting in poor diagnosis and management of KC patients.Conclusion: The study revealed inadequate knowledge, training and skills of eyecare practitioners and administrators on KC. Deficiencies in KC diagnosis and management could cause visual impairment with a potential negative impact on the quality of life (QoL) of KC patients.Contribution: This study illustrates the need to procure basic equipment, capacitate eyecare workers with knowledge of KC and establish standard clinical protocols for the diagnosis and management of KC, including referral pathways.

Knowledge and Attitude of Eye Care Workers towards Electronic Medical Records in a Tertiary Eye Facility in South-East Nigeria

Electronic Medical Records (EMR) has been an integral part of patient management in the developed world but still gradually gaining popularity in the developing world. It was met with resistance by health workers in Nigeria though this is changing in the post COVID era. However, there still appears to be some resistance to its acceptance for different and sometimes justifiable reasons. The aim is to determine the knowledge and attitude towards EMR among eye health workers in a teaching hospital in South East Nigeria. This cross-sectional quantitative study was conducted among consenting consecutive eye care workers at Guinness Eye Centre, Onitsha aged≥ 18years from July to September, 2023. A pretested semi structured self-administered questionnaire was used. Information of interest were biodata, knowledge and attitude towards EMR. They were summarized into simple frequencies and percentages. Knowledge scores were grouped into good and poor using the blooms cut off for knowledge attitude and practice. Univariate and bivariate analysis were done and results represented in tables and charts with levels of significance placed at p<0.05. There was a total of 135 respondents; the mean age was 32.6 years ± 10 SD, male to female ratio of 1:1.1. The result showed good knowledge and positive attitude towards EMR (85.2% and 73.2% respectively) with younger age group, professional cadre and computer literacy found to be associated with good knowledge and positive attitude towards EMR in the population. The hospital/ clinic were the most common sources of EMR information. This study showed good knowledge and positive attitude toward EMR in the study population. It also suggested an association with younger age group, professional cadre and computer literacy.

Topical review: Task shifting and the recruitment and retention of eye health workers in underserved areas.

The global burden of blindness is unequally distributed, affects rural areas more, and is frequently associated with limited access to eye care. The World Health Organization has specified both task shifting and increasing human resources for eye health as instruments to improve access to eye care in underserved areas. However, it is uncertain whether these two instruments are sufficiently compatible to provide positive synergic effects. To address this uncertainty, we conducted a structured literature review and synthesized relevant evidence relating to task shifting, workforce recruitment, retention, and eye care. Twenty-three studies from across the globe were analyzed and grouped into three categories: studies exploring recruitment and retention in human resources for eye health in general, studies discussing the relationship between task shifting and recruitment or retention of health workers in general, and studies specifically discussing task shifting and recruitment or retention in eye care workers. Our findings demonstrate that incentives are effective for initiating task shifting and improving recruitment and retention in rural areas with a stronger effect noted in midlevel eye care professionals and trainees. Incentives can take various forms, e.g., financial and nonfinancial. The consideration of context-specific motivational factors is essential when designing strategies to facilitate task shifting and to improve recruitment and retention.

Prevalence oftrachomatous inflammation-follicular and associated factors among children aged 1-9 yearsin northeastern Ethiopia.

Trachoma is the most prevalent eye disease in Ethiopia, especially among children aged 1-9 years and continues to be a public health concern. Nevertheless, in Ethiopia's rural Jamma district in South Wollo Zone of Amhara Regional State, factors associated with trachomatous inflammation-follicular (TF) among children aged 1-9 yearshave not yet been studied. A community-based cross-sectional study was conducted among 616 children aged 1-9 years in rural Jamma district in Ethiopia from January-March, 2019. Data were collected using a pre-tested structured questionnaire, an observation checklist and clinical examination of study participants for active trachoma. The presence of TF and trachomatous inflammation-intense (TI) was clinically assessed by integrated eye care workers using the World Health Organization simplified grading system. Data were analysed using SPSS (Statistical Package for Social Sciences) Version 25.0. A logistic regression model with 95% CI was used. From the multivariable analysis, variables with p-value < 0.05 were declared as associated factors of TF. The prevalence of TF was 10.9% (95% CI [8.6 - 13.6%]) among the rural children aged 1-9 years.The mean family size was 5.5 ± 1.9 persons. About one-fifth (20.6%) of households kept domestic animals overnight in the same room as family. Almost one-sixth (17.5%) of the children involved in this study had an ocular discharge. Two-thirds of the children (68.8%) washed their hands once per day and just over half (55.8%) washed their faces once per day. From multivariable analysis, we found that the presence of domestic animals kept overnight in the same room as the family (adjusted odds ratio [AOR] = 4.32; 95%CI [2.49-9.52]), mother's/caregiver's illiteracy (AOR = 2.01; 95%CI [1.11-4.67]), household size (> 7 persons) (AOR = 3.50; 95%CI [1.66-8.50]), washing of children's hands and face without soap (AOR = 2.41; 95%CI [1.29-5.18]), feces observed in the compound (AOR = 5.10; 95%CI [2.01-10.14]), presence of ocular discharge (AOR = 7.23, 95%CI [4.10-12.51]) and nasal discharge (AOR = 4.54, 95%CI [1.95-9.26]) were significantly associated with TF. The prevalence of TF among rural children aged 1-9 years in this study was almost two times higher than the WHO-recommended threshold (TF < 5%) for trachoma elimination and beyond the trachoma control target (TF < 10%). Presence of domestic animals kept overnight in the same room as the family, mother's/caregiver's illiteracy, household size (> 7 persons), washing of children's hands and face without soap, feces observed in the compound, presence of ocular and nasal discharge were significantly associated with TF. We recommended interventions that will help household income to be improved to enable families to be able to construct separate rooms in which to keep animals overnight. Furthermore, we also recommend to policy makers to design mechanisms for enhancement of behavioural change among householdersto keep household compounds clean and creating awareness among mothers/caregivers about prevention of trachoma.

Development of the WHO eye care competency framework

BackgroundThe eye care workforce, particularly in lower resource settings, face challenges of limited integration into the health system, limited workforce capacity, mismatch of workforce to population need and poor quality of care. In recognition of these challenges, coupled with a gap in existing tools, provides a strong rationale for the development of the Eye care competency framework (ECCF).MethodsA mixed methods approach was utilised to develop and validate the ECCF. Content was developed by extracting relevant components of existing frameworks used both within and outside of eye care. A diverse technical working group provided feedback and guidance on the structure, design, and content to create a preliminary draft. Competencies and activities were validated using a modified-Delphi study, and the framework was then piloted at four sites to understand how the tool can be implemented in different settings.ResultsThe final version of the ECCF included eight outcomes, nine guiding principles, and content of each of the key elements, including the six domains, 22 competencies, 21 activities, 193 behaviours and 234 tasks, and the knowledge and skills that underpin them. 95/112 participants from the six WHO regions completed the modified-Delphi study, yielding an average of 96% agreement across the competencies and activities in the ECCF. The pilot showcased the versatility and flexibility of the ECCF, where each of the four sites had a different experience in implementing the ECCF. All sites found that the ECCF enabled them to identify gaps within their current workforce documentation.ConclusionsThe ECCF was developed using a collaborative approach, reflecting the opinions of participants and stakeholders from all around the world. The comprehensive competencies and activities developed in the ECCF encompass the diverse roles of eye care workers, and thus encourage multi-disciplinary care and better integration into the health system. It is recommended that eye care workforce planners and developers use the ECCF, and adapt it to their context, to support workforce development and focus on the quality and scope of eye care service provision.

What do eye care workers do when their patients go blind?

Sometimes even with the best efforts by the eye care worker (ECW), patients cannot be stopped from losing vision even in the best of centers anywhere in the world. However, in developing countries, most vision loss happens in rural and suburban areas away from where ECWs are majorly located due to poor facilities, adverse living conditions, and poverty. Once irreversible blindness happens, rehabilitation should follow. However, the numbers of those who are not referred for rehabilitation by far outstrips those who are, for various reasons. To find out why this is so, 150 ECWs with 1:2 M:F ratio were contacted through Google links sent through WhatsApp groups. Glaucoma was statistically the commonest cause of irreversible blindness (χ2 = 66.17, p-value &lt; .0001) mostly from late presentation ( n = 146 of 150 responses, 97.7%). When patients go blind, most ( n = 132, 87.4%) of the ECW advise them to go to a blind school (81.2%). Only about a quarter of the respondents properly ensure that they go. A third admitted ( n = 78, 39%) that knowing the patients personally improved their willingness to refer. Many do not think the government is doing enough to help the blind ( n = 118, 78.7%). Even though many ECWs have given sensitization talks on blindness (124 of 164 responses), very few focus on what happens after blindness occurs (42.4% of respondents). A third of the ECW admitted to not doing enough for the blind in their practice ( n = 51, 34%). Majority have, however, heard about The Lens Eye Clinic (TLEC) rehab center, one of the foremost rehabilitation centers for the blind in Nigeria ( n = 103, 68.7%). ECW should ensure those who live in rural areas have poor socioeconomic background, less educated, female, elderly, or born blind should have regular screening and awareness programs in the areas of practice to catch the condition on time with provision made for early counseling and support services.

Perception of Hand Hygiene Practice among Eye Care Workers in Onitsha, Nigeria

Objectives: To determine the perception of hand hygiene practice by eye care workers of a tertiary hospital in Nigeria. Methods: This was a cross-sectional study of eye health workers at a tertiary hospital in Nigeria using the WHO Hand Hygiene Perception questionnaire to obtain information on different aspects of hand hygiene perception. Responses were graded as good (≥75%); moderate (50–74%); poor (&lt;50%). Information obtained was analyzed. Results: Fifty-three eye care workers comprising 11 (20.8%) males and 42 (79.2%) females with age range 28 to 68 years; mean of 43.8 ± 9.0 years. Average work experience was 18.5 ± 9.6 years. Nurses and doctors constituted 47 (88.7%) participants. Mean overall perception score was 36.2 ± 9.0 (or 61.4%). Hand hygiene practice perception was good in 11 (20.7%), moderate in 32 (60.4%), and poor in 10 (18.9%) participants. Doctors had significantly higher mean score (39.7 ± 8.0) than nurses (33.5 ± 8.0) (P = 0.04). Fifty-one (96.2%) had soap and water at the service point but these were not always available all the time to 40 (75.5%) participants. Alcohol-based hand sanitizer was unavailable to 41 (77.4%); 13 (24.5%) participants had posters of hand washing at their service points. Fifty (94.3%) participants would want hospital management to lend greater support to hand hygiene practice. Conclusions: Hand hygiene practice perception was only moderate among the participants. Institutional support via frequent training and reminders on hand hygiene, and steady water and soap supply at service points would help to improve hand hygiene perception and practice among eye care workers.

Hand Hygiene Knowledge Among Eye Care Workers at an Eye Hospital in Nigeria.

The aim of this article is to determine the knowledge of hand hygiene (HH) practices among eye care workers in a tertiary eye hospital in Nigeria. This was a cross-sectional study of eye care workers at a tertiary eye hospital in Nigeria. Eye care workers, involved with clinical duties, responded to the WHO Hand Hygiene Knowledge questionnaire containing 24 multiple choice questions on HH knowledge. Each correct answer earned one point; zero was given for a wrong answer. Overall scores were expressed in percentage. An overall score of ≥75% was considered as good; 50-74% moderate; and <50% poor knowledge. Data analysis was with SPSS version 23. Fifty-eight workers participated. Thirty-nine (67.2%) were females and 19 (32.8%) were males; the age range was 25-68 years; mean 39.6 ± 7.4 years. The average work experience was 15.3 ± 8.9 years; range 1-40 years. The mean knowledge score was 12.0 ± 2.9 (50%) which is moderate knowledge; range 3-18. Workers who had received training in HH had a significantly higher mean knowledge score than those who did not receive training (12.8 ± 2.3 vs. 11.3 ± 3.2; P = 0.04). There was no statistically significant association between knowledge of HH and age, sex, work experience, and professional category (P > 0.05). HH knowledge of the eye care workers studied is sub-optimal. This has negative implication for hospital infection control. Eye care workers' knowledge of HH can be improved through formal training and frequent rehearsals.

Prevalence and risk factors associated with dry eye disease among adults in a population-based setting in South-West Nigeria.

Dry eye disease (DED) occurs as a result of an abnormality in tear production, tear consistency, and tear evaporation. The aim of this study is to determine the prevalence and risk factors associated with dry eye disease in a population-based setting in Southwest Nigeria. A cross-sectional study was conducted at a medical outreach at Iperu Remo in Nigeria. A systematic random sampling technique was used to select 415 participants. Symptoms of dry eye were evaluated using the Ocular Surface Disease Index questionnaire. Tear film break-up time (TBUT), fluorescein staining, Schirmer test with anesthesia, and meibomian gland were evaluated. The diagnosis of DED was confirmed when the OSDI score is ≥13 and TBUT is less than 10 seconds. Data were analyzed using descriptive statistics, Chi-square, and logistic regression analyses at a 0.05 level of significance. The overall prevalence of DED was 28.2%. Adults aged between 31 and 40 years were 23 times more likely to be diagnosed with dry eyes (aOR = 23.13; 95% CI: 1.32 - 405.99; P = 0.032) compared to those between 16 and 20 years. Female adults were about four times more likely to be diagnosed with dry eyes (aOR = 3.59; 95% CI: 1.44 - 8.94; P = 0.006). The use of drugs was also significantly associated with dry eyes. This study shows a fairly high prevalence of DED among adults in a semi-urban area in Southwest Nigeria. Ophthalmologists and other eye care workers need to be cautious about the DED and offer appropriate treatment options to patients.

165 Cataract Surgery: What Intraoperative Factors Impact Surgical Outcomes in Low- and Middle- Income Countries (LMICs)

Abstract Aim To describe what intraoperative factors affect the outcomes of cataract surgery in LMICs. Method The following databases were screened to find relevant articles: EMBASE (1974–2019), MEDLINE (1946–2019), Global health (1973–2019), PubMed, Cochrane library and Cumulative Index to Nursing and Allied Health Literature. Following this, duplicates were removed, and articles underwent screening. Results Perioperative checks – It has been recommended for LMICs to implement similar surgical checklists to what is used in the UK, to reduce the chance of surgical complications. Having the right team - The cataract surgery team may vary in different countries. For example, in Ethiopia the staffing model includes ophthalmologists, non-physician cataract surgeons (NPCS), ophthalmic officers, ophthalmic nurses, operating room nurses and integrated eye care workers. It is common in LMICs for NPCS to outnumber ophthalmologists. Adequately skilled professionals – It’s important to consider having vitreoretinal surgical input available should surgical complications arise. This will help to optimise outcomes. Surgical technique – Techniques performed in LMICs include ICCE (intracapsular cataract extraction), ECCE (extracapsular cataract extraction and MSICS (manual small incision surgery) and phacoemulsification. ECCE and MSICS is the most commonly used in LMICS due to comparable outcomes with phacoemulsification and cost effectiveness. Surgical training and skills transfer – Various international training programmes such as the HelpMeSee programme is designed to help train ophthalmologists and NPCS in MSICS via simulation. Conclusions The above factors are important considerations which influence surgical availability and success. LMICs have an increasingly aging population and cataract services will be required to adapt to the increase demand.

COVID-19 Pandemic: A Survey of Safety Practices among Eye Care Workers in Nigeria

Abstract Objective: To assess safety practices among eye care workers in Nigeria during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This research was a cross-sectional study. A structured electronic questionnaire was distributed among eye care workers (ophthalmologists, optometrists, ophthalmic nurses) across the six geographical zones of Nigeria. Information on socio-demographics, COVID-19 infection, current working conditions and safety practices were obtained. Data analysis was done using Statistical Package for Social Sciences (SPSS Inc. Chicago Illinois, USA) for windows, version 22. Results: A total of 236 eye care workers participated in the study; their mean (±SD) age was 37.13 (±8.141) years, 125 (53%) were females, and 145 (61.4%) worked in a tertiary care hospital. All participants described COVID-19 as a viral disease and 98.3% agreed that the disease can affect the eyes. Outpatient clinic consultation was recorded as the highest (77.7%) service provided during the pandemic. Regarding preventive practices, 95% of eye care workers wore facemasks, 82.4% wore gloves during ophthalmic examination and Hazmat suit was the least used protective device (2.5%). About three-quarters (77.5%) reported feeling unsafe in their working environment and 63.9% were dissatisfied with the personal protective device provided by hospitals to eye care workers. Conclusion: COVID-19 pandemic presented an unprecedented challenge for eye care workers; with the practice of ophthalmology posing a high risk of transmission of the virus. Efforts should be made to provide the required personal protective devices needed for optimum protection of eye care workers in healthcare settings.

Comparative evaluation of a new frugal binocular indirect ophthalmoscope

ObjectivesWe compare the optical quality and design characteristic a new low cost solar powered binocular indirect ophthalmoscope (BIO), Holo, to Keeler BIO.MethodsTwenty-four participants each examined 10 simulation eyes using both the Holo and the Keeler BIO with a 30-diopter condensing lens. Number of Lea symbols printed on the retina of simulation eyes seen and time taken to identify them was recorded. Stereoacuity of 12 participants was tested while using the BIOs. Using 7-point Likert scale, participants gave feedback on design characteristic of both BIOs.ResultsThere was no statistical difference in number of Lea symbols correctly identified (15.63/20 for Holo vs. 15/20 for Keeler BIO, p = 0.366, paired t test) or time taken to correctly identify each symbol (Holo 0.39 s faster; 95% confidence interval −2.24 to 3.03 s, p = 0.763) using each device. 12 out of 12 participants achieved stereoacuity of 60 arcsec using the Holo while with the Keeler BIO 11 achieved 60 arcsec and one 90 arcsec. There was no statistically significant difference in the scores for clarity of view, quality of illumination, field of view, binocularity, eye strain and robustness between the two devices. The Holo, scored higher for ease of use (6.5 vs. 6, p = 0.00488, Wilcoxon signed-rank test), comfort of wear (6 vs. 5, p = 0.000337) and portability (7 vs. 6, p = 0.000148).ConclusionThe Holo has the potential to be a clinically useful yet affordable diagnostic tool suitable for the first time of equipping eye care workers in low resource settings with a BIO at volume.

Exploring barriers for trachomatous trichiasis surgery implementation in gamo zone, Southern Ethiopia.

Trachomatous trichiasis is the leading infectious cause of blindness worldwide. The World Health Organization recommends eyelid surgery to reduce the risk of visual impairment from trichiasis. Unfortunately, the number of cases operated has grown less than expected. An understanding of barriers is fundamental for instituting measures to increase surgical uptake. Therefore, the aim of this study was to explore barriers of TT surgery implementation. A qualitative study design was employed in December 2019. Purposive sampling technique was used to select three districts from Gamo zone, Southern Ethiopia. We conducted 9 FGDs and 12 in-depth interviews. Data was collected by audio tape recorder in Amharic and Gamogna languages and then transcribed to English language. The recorded interviews and focus group discussions were transcribed to verbatim (written text) and thematic analysis was done manually and reported accordingly. we explored a number of barriers that hindered implementation of trichiasis surgery. The recurrence of trichiasis after surgery was the main challenges faced by operated individuals. The other barriers reported are negative perception towards trichiasis surgery, lack of logistic and supplies, transportation access problem for remote communities, inadequate trained health professional, less commitment from higher officials, lack of interest of integrated eye care workers due to incentive issues, believes of patients waiting supernatural power for healing service and carelessness of patients to undertake operation. Post-surgical trichiasis, lack of commitment from government officials and negative perception of patients towards the disease were considered as the reported barriers for implementation of trachomatous trichiasis. Closely supervising the integrated eye care workers would be the first task for district health offices to increase the uptake and improve the quality of service. Logistics and supplies should be made available and adequate to address all affected people in the community.

Seroprevalence of SARS-CoV-2 specific IgG antibodies among eye care workers in South India

PurposeHealth care workers are at higher risk of acquiring the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This study aims to understand the seroprevalence of anti-SARS-CoV-2 IgG antibody among the eye care workers in South India. MethodsThe participants included eye care workers from the nine eye care centres. All the participants were interviewed with a questionnaire to obtain essential information about socio-demographics, past contact with COVID-19 patients and additional information as recommended by Indian Council of Medical Research, India. Serum samples were tested for anti-SARS-CoV-2 IgG antibodies by ELISA. ResultsA total of 1313 workers were included and 207 (15.8%) were positive for the SARS-CoV-2 IgG antibody. The seropositivity was higher in the moderate risk group (19.5%) followed by low (18.6%) and high risk (13.7%) groups. The seropositivity was significantly higher among i) day scholars compared to hostellers (OR - 2.22, 1.56 to 3.15, P ​< ​0.0001), ii) individuals with history of flu-like illness (4.57, 3.08–6.78, P ​< ​0.001) or who were symptomatic or in contact with COVID 19 positive cases (2.2, 1.02–4.75, P – 0.043) and iii) individuals with history of systemic illness (2.11, 1.39–3.21, P ​< ​0.001). Individuals (11.97%) who had no history of contact or any illness were also seropositive. ConclusionsThe effectiveness of the protective measures taken against COVID infection was evident from the lower percentage of seropositivity in the high risk group. The study highlighted the need to create awareness among individuals to follow strict safety measures even in non-work hours and also in social circles.

Utilization of Vision Corridor for Self-evaluation of Vision Among Secondary School Students in Igbo-Ora, Southwest Nigeria

Introduction: Uncorrected refractive errors have been identified as a major cause of visual impairment with a high magnitude in developing countries, due to the paucity of eye care workers. To overcome this, different approaches like screening by non-eye care workers and self-assessment have been explored. This study aims to determine the utilization, reliability, and factors affecting the utilization of vision corridors among secondary school students. Material and Methods: An observational cross-sectional study conducted among students of Lasogba High School, Igbo-Ora, Southwest Nigeria. All the students received training on visual acuity assessment with the 6-meter Snellen’s chart. Thereafter, the chart with graphic instruction “Vision Corridor” was provided with a 4-week exposure period. All students who utilized the vision corridor recorded visual acuity in a register maintained by a community health extension worker. The utilization and factors that may have affected utilization were assessed after the exposure. Data were analyzed with the Statistical Package for Social Science version 15. Results: A total of 373 students completed the study; males accounted for 48.8% and females 51.2%. The mean age of the students was 15.2 (±2.2) years. A total of 151 (40.5%) students utilized the vision corridor and factors associated with utilization included being female, age ≤15 years, and being in a junior class, all of which were statistically significant. Conclusion: A moderate proportion of the students utilized the vision corridor. This approach to refractive error screening appears promising, as self-evaluation may reduce the need for skilled manpower in refractive error screening in secondary school students. Therefore, this may effectively utilize skilled eye care manpower for other eye care services in developing countries where there is a paucity of eye care workers.

Бюджет часу, стрес і задоволеність працею у медичних працівників офтальмологічного профілю

Бюджет часу, стрес і задоволеність працею у медичних працівників офтальмологічного профілю

Prevalence and associations of active trachoma among rural preschool children in Wadla district, northern Ethiopia

BackgroundTrachoma is a neglected eye disease and an important cause of preventable corneal blindness. In endemic areas, initial infection can occur in early childhood and following a recurrent episodes, it progresses to scarring and visual impairment. Trachoma disappeared from high income countries through enhancements of hygiene and sanitation but the disease is still a challenge in developing countries. In Ethiopia, data indicate that Amhara is the region with the highest prevalence of active trachoma. The aim of this study was to assess the prevalence and associations of active trachoma among rural preschool children in Wadla district, Amhara region, Ethiopia.MethodsIn this study, 596 children were screened for signs of active trachoma by using cluster-sampling technique. Following pre-testing of the survey instrument in a different district, questions about socio-demographic status were delivered for heads of households. Integrated eye care workers, previously trained to undertake trachoma screening for one month, performed eye examination. The logistic regression model was used to look for associations of active trachoma.ResultsThe prevalence of active trachoma among rural preschool children in Wadla district was 22%. Low economic status (adjusted odds ratio [AOR]3.8 (95%CI 1.3–11.4), being 37–48 months old (4.2;1.5–12.0), living in a house with thatched roof (4.4;1.4–13.6), presence of flies in a home (4.6;2.1–9.9), once-weekly face-washing frequency (8.6;2.5–29.3), having a face that had not been washed for longer than a week (10.6;2.9–37.7), and not using soap (4.5;1.8–11.3) had association to active trachoma.ConclusionThe prevalence of active trachoma among rural pre-school children in Wadla district was high. This indicates that Trachoma is still a public health problem in the district. This high prevalence calls for further interventions to prevent future trachomatis blindness.

Low vision evaluation training in Nigeria: Time to improve human resource in developing countries

Routine low vision care is a rarity in Nigeria and in most developing countries. The reason for the widespread apathy and lack of human resource development in this area is myriad. The Center for Vision, The Lens Rehabilitation Center for the Blind located in Portharcourt, Nigeria sought to correct this by working to revive interest and thus improve human resource available through provision of quality hands on training with world renowned scholars and faculty . Records of all who registered for two separate Low vision training courses at TLEC re(Hab) Nigeria between 2018 and 2019 were audited. Number of courses taught, participating faculty, gender and age distribution of trainees, previous training accessed by trainees, pretest scores and post test scores were compared. Numbers actually practicing low vision after 3 months of conclusion of the training and outcome of feedback questionnaires were also evaluated using a simple calculator. Fifty eyecare workers (42 in one day training and 8 over 2 weeks) with mean age of 33.6years and gender ratio of 1:2.3 were trained in two batches. There were 26 faculty available to teach both online and physically. Previous exposure to training was absent in the one day group while the two week group had just one. The courses taught were mainly on low vision evaluation(50% in the one day , 44.29% in the 2 week course) with additional courses on early intervention, rehabilitation of the blind and evaluation in special kids with additional problems. The hands on sessions were significantly better in the two week training with a third of the periods available dedicated to stepwise approach in low vision evaluation. A comparison of pretest and post test scores showed there was an exponential improvement in understanding between the one day and the two week training of up to 50 % increase which reflected in the numbers able to refer appropriately and evaluate low vision patients in the country when the one day and 2 week groups were compared. There was a general consensus that the two week training was more preferred. Empowerment with relevant low vision charts and device equipment significantly improved the numbers still practicing 3 months after training ended when compared with those who were not given any by as much as 400%. In conclusion, low vision needs dedicated and well trained staff who compulsorily need to be empowered to function with provision of required equipment especially in developing countries where the majority of the need for low vision aids and assistive devices appear to be.