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Nassarawa, Nigeria

Babalola O.E.,Rachel Eye Center | Babalola O.E.,Bingham University
Clinical Ophthalmology | Year: 2015

Introduction: The term micropulse laser trabeculoplasty suggests that only a fraction of the laser power is applied to the trabeculum to effect pressure lowering. It has not yet been exclusively used in Negroes, and we wish to report on our experience in Nigerian patients. Methods: The study design is a retrospective chart review of our patients at the Rachel Eye Center in Abuja. The 810 diode Optos FastPulse laser was used to apply 34 cycles of treatment to 30 eyes of 16 individuals. Patients were selected based on the failure of maximal medical therapy. One patient had two extra rounds of treatment, while two patients were treated in only one eye. The pressure change at 1 hour after the treatment was analyzed. Patients were followed up for a mean period of 160 days with continuous monitoring of pressure changes. Patients’ original therapy was not disturbed. Results: Postlaser immediate drop in intraocular pressure (IOP) averaged 3.2 mmHg (CI 1.6–4.7, P,0.0001) representing 17.2% drop from baseline prelaser IOP. The drop in IOP was sustained over varying periods, from a few weeks to several months. There was a temporary spike in three instances. No serious side effects were noted. Conclusion: Micropulse diode laser trabeculoplasty is a useful adjunct in the management of open-angle glaucoma in Nigerians. This corroborates the findings of other researchers in western populations. © 2015 Babalola. Source

Babalola O.E.,Bingham University
African journal of medicine and medical sciences | Year: 2011

To describe the challenges peculiar to Nigeria in the implementation of vision 2020: the right to sight and to proffer solutions as to the way forward A review of the recently completed national blindness survey, current literature, and the advocacy experience of the Ophthalmological Society of Nigeria. The prevalence of blindness in Nigeria is 0.78%. Over 43% of these are blind from cataracts and a further 9% from uncorrected aphakia or complications of couching. 50% of all cataract interventions are carried out by itinerant couchers. Other major causes of blindness are glaucoma (16%) corneal opacities (12%), trachoma (4%), optic atrophy (3%) onchocerciasis (1%) and macular disease (1%). 70% of these are either preventable or reversible. Nigeria has a relatively favourable ophthalmologist/population ratio of about 2.8 per million, but has a low Cataract surgical rate of 300 per million per year. The reasons for this include a lack of ownership of blindness prevention programs, a lack of political will and parlous state of funding for vision 2020. There is an abdication of responsibility for both training and services on the part of government to the International NonGovernmental organisations. Teaching hospitals no longer generate enough patient surgical load to support training. We estimate it would cost N8.5 billion ($56.8 million) to sustain the WHO recommended Cataract Surgical Rate of 3000 per million per year in Nigeria. Nigeria is not headed in the direction of meeting Vision 2020 targets. Advocacy involving funding through the MDGs, needs to be intensified. Source

Babalola O.E.,Bingham University
Clinical Ophthalmology | Year: 2011

This paper reviews the current management of onchocerciasis and its future prospects. Onchocerciasis is a disease affecting millions of people in Africa, South and Central America, and Yemen. It is spread by the blackfly as a vector and caused by the filarial nematode, Onchocerca volvulus. A serious attempt was made by the Onchocerciasis Control Program between 1975 and 2002 to eliminate the vector in eleven of the endemic countries in West Africa, and with remarkable success. Formerly, the treatment was with diethyl carbamazine for the microfilaria and suramin for the adult worm. These drugs are now known to be toxic and unsuitable for mass distribution. In particular, they precipitate optic nerve disease. With the discovery of ivermectin, a much safer microfilaricide, and the decision of Merck to distribute the drug free of charge for as long as needed, the strategy of control switched to mass drug administration through community-directed treatment with ivermectin. So far, millions have received this annual or biannual treatment through the African Program for Onchocerciasis Control and the Onchocerciasis Elimination Program for the Americas. However, the problem with ivermectin is that it is a monotherapy microfilaricide which has limited effect on the adult worm, and thus will need to be continued for the life span of the adult worm, which may last up to 15 years. There are also early reports of resistance. Serious encephalopathy and death may occur when ivermectin is used in subjects heavily infested with loiasis. It seems unlikely that a break in transmission will occur with community-directed treatment with ivermectin in Africa because of population migrations and the highly efficient vector, but in the Americas some countries such as Columbia and the Oaxaca focus in Mexico have reported eradication. Vector control is only now applicable in selected situations, and particularly to control the nuisance value of the blackfly. Trials are ongoing for alternatives to ivermectin. Candidate drugs include moxidectin, a macrofilaricide, doxycycline which targets the Wolbachia endosymbiont, and flubendazole, which shows promise with the newer oral cyclodextrin formulation. © 2011 Babalola, publisher and licensee Dove Medical Press Ltd. Source

Mpyet C.,University of Jos | Lass B.D.,Bingham University | Yahaya H.B.,Murtala Mohammed Specialist Hospital | Solomon A.W.,London School of Hygiene and Tropical Medicine
PLoS ONE | Year: 2012

Background: In northern Nigeria, trachoma is an important public health problem, but there are currently few population-based data on prevalence of disease and no formal trachoma control programs. Methodology/ Principal Findings: In Kano state, Nigeria, we conducted a population-based cross-sectional survey using multistage cluster random sampling, combining examination for clinical signs of trachoma and application of questionnaires assessing potential household-level risk factors. A total of 4491 people were examined in 40 clusters, of whom 1572 were aged 1-9 years, and 2407 (53.6%) were female. In 1-9 year-olds, the prevalence of trachomatous inflammation-follicular (TF) was 17.5% (95% CI: 15.7-19.5%). In a multivariate model, independent risk factors for active trachoma were the presence of flies on the face (OR 1.98, 95% CI 1.30-3.02); a dirty face (OR 2.45, 95% CI 1.85-3.25) and presence of animal dung within the compound of residence (OR 3.46, 95% CI 1.62-7.41). The prevalence of trachomatous trichiasis in persons aged ≥15years was 10.9% (95% CI: 9.7-12.2%). Trichiasis was significantly more common in adult females than in adult males. Conclusion/Significance: There is an urgent need for a trachoma control program in Kano state, with emphasis given to provision of good quality trichiasis surgery. Particular effort will need to be made to identify women with trichiasis and engage them with appropriate services while also taking steps to secure azithromycin for mass treatment and ensuring personal and environmental hygiene. © 2012 Mpyet et al. Source

Anzaku A.S.,Bingham University | Musa J.,University of Jos
Archives of Gynecology and Obstetrics | Year: 2013

Objective: The study aimed at determining the prevalence and associated risk factors for gestational diabetes mellitus (GDM) among antenatal women attending the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Methods: A cross-sectional study was done between February and April 2009 among 265 pregnant women enrolled from the antenatal clinic of JUTH. Screening was done between 24 and 28 weeks' gestation with a 50 g, 1-h glucose challenge test (GCT). Those with plasma glucose concentration >7.8 mmol/l were then given 75 g oral glucose tolerance test (OGTT) to confirm the diagnosis of GDM. Plasma glucose measurements were performed with glucose oxidase method. GDM was diagnosed according to the WHO criteria. All relevant data including demographic information, obstetric history, and risk factors for GDM, GCT and OGTT results were collected and analyzed using Epi Info version 3.5.1, CDC, Atlanta, USA. Results: Of the 265 pregnant women enrolled, 253 subjects were eligible for screening out of which, 28 (11.1 %) had positive GCT >7.8 mmol/l. The prevalence of GDM was 8.3 % (21/253); 95 % CI 5.2-12.4. The pattern of glucose tolerance in the study population indicated that 232 (91.7 %) had normal glucose tolerance, 6.7 % had impaired glucose tolerance (IGT) while 1.6 % had overt diabetes. Previous history of fetal macrosomia was independently associated with GDM (adjusted OR 11.1; 95 % CI 2.93-42.12, P = 0.0004). Conclusion: The prevalence of GDM was relatively high among our antenatal population. Women with previous history of fetal macrosomia have a higher likelihood of having GDM and should be screened. © 2012 Springer-Verlag Berlin Heidelberg. Source

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