JOURNAL OF OPTOMETRY AND HEALTH SCIENCES (JOHS)
The Journal of Optometry and Health Sciences (JOHS) is the official publication of the Department of Optometry, Imo State University Owerri, Nigeria. It is an International, peer-reviewed, open access journal, publishing manuscripts of original research works, systematic reviews, short communications, case reports, conference proceedings and meta-analysis within the versed and specialty areas of optometry and health sciences.
Comparison of Contact and Non-contact Pachymeters in the Measurement of Central Corneal Thickness (CCT)
The Central Corneal Thickness (CCT) examination assists in the diagnosis of ocular diseases such as glaucoma, keratoconus and Fuch’s dystrophy (FD). Several instruments used for the measurement of CCT include the ultrasound pachymeter, optical coherence tomography(OCT) machine, specular microscopy, A- Scan etc. The aim of this study was to evaluate the relationship and determine the repeatability of CCT measurements in an OCT machine and an ultrasound pachymeter. This was an observational study carried out in Sight Care Specialist Eye clinic, Benin City, Nigeria. CCT measurements were taken three times from each participant using both instruments and the average was noted. The data were analysed using Pearson Correlation and Analysis of Variance (ANOVA). Eighty participants (49 males and 31 females) with mean age of 43.1 ± 17.2years participated in the study. The mean CCT value for the ultrasound pachymetry for the right eye was 545.46±44.56mm and for the left eye was 546.45±49.35mm. The mean CCT value for the OCT machine in the right eye was 525.32±42.17mm and for the left eye was 524.95±46.43mm. There was also a strong positive significant relationship between OCT and Pachymeter (r = 0.92, p = 0.001) in both eyes. The OCT machine slightly underestimates the CCT values when compared to ultrasound pachymetry, however both CCT values were highly correlated. Therefore, the OCT machine can serve as an alternative for the measurement of CCT values due to the greater disadvantages associated with the use of ultrasound pachymetry.
central corneal thickness, ultrasound pachymeter, optical coherence tomography (OCT)
Ngozi P. Uwagboe; Oseleonomhen M. Odigie; Ayishetu O. Shuaibu; Holiness A. Ewanshiha
Comparative Study of Axial Length Estimation using A-Scan Ultrasound and Carl-Zeiss IOI Master in Benin City, Edo State, Nigeria
Axial length of the human eye is the distance from the anterior pole of the cornea to the posterior retina pole. It is an important element in evaluating the eye’s power of refraction. Innovations and advances in technology have greatly increased accurate measurements of axial length in the previous two decades. This study compared axial length measurements using A-scan ultrasound and the Carl Zeiss IOL master’s in human eyes in order to ascertain their repeatability and reliability. This research employed a cross-sectional design to study 80 eyes of participants aged 40 -- 80 (63+/-10.1) years selected using purposive random sampling techniques in two ophthalmology clinics located in Benin City, Edo State, Nigeria. SPSS version 23.0 was used to analyze the data. The independent-sample T-test and Pearson’s correlation coefficient were used to compare axial length and determine relationship between both instruments, respectively. Statistically significant level was taken as probability values P ˂0.05. The average axial length recorded by A-scan Ultrasound was 23.54mm ± 1.25 SD, and Carl Zeiss IOL Master was 23.62mm ± 1.25 SD. There was no significantly remarkable difference between average axial length recorded with both instruments (p = 0.7). Both Carl Zeiss IOL Master biometric instrument and the A-scan ultrasound biometric instrument could be used to measure axial length interchangeably only when there are no factors that negatively affect any of the instrument’s results.
A-Scan, Axial Length, Biometry, Carl-Zeiss IOL Master, Refractive Error
Ngozi P. Uwagboe; John E. Moyegbone; Kingsley N. Bazuaye; Benjamin O. Okpamen
Prevalence, Socio-Demographic and Driving Related Factors Associated with Visual Impairment in Commercial Drivers Routing Benin City, Edo State, Nigeria
Visual impairment (VI) is a loss of vision that cannot be fully corrected by standard means like glasses or surgery. It affects the cognitive, motor, and sensory skills including driving skills and prompt decision-making to executive visual functions required for safe driving. This survey aimed to evaluate the prevalence, socio-demographic, as well as driving related characteristics associated with visual impairment among drivers of commercial vehicles in Benin Metropolis, Edo State, Nigeria. This study adopts descriptive cross-section assessment of 341 commercial drivers of mean age 48.09 ± 11.21 years (range: 20 - 70 years) using purposive sampling technique. Data for the study were obtained using National Eye Institute Vision Functioning Questionnaire–25 modified for the study. Distance Snellen Chart was used to evaluate presenting visual acuity (PVA). IBM-SPSS version 29.0 was used in analysing the data, and factors associated with VI were tested with Chi-square statistics. An overall number of 341 commercial drivers were recruited of which males were 326 (95.6%). This study showed VI prevalence of 9.7%, with mild, moderate and severe VI of 2.1%, 7.3% and 0.3% respectively. Refractive error (39.2%) and cataract (21.6%) were the major determinants of VI. Senescence, lesser educational level and number of self-reported road traffic accidents were found to be statistically correlated with VI (P<0.05). The high prevalence of VI reported in this research could be a threat to safe driving if appropriate measures are not put in place to identify drivers with VI. We, therefore, recommend routine comprehensive eye evaluation of drivers preceding conferment and renewal of driving licence.
Cataract, Drivers, Refractive Errors, Traffic Accidents, Visual Impairment
John Esimaje Moyegbone; Eghonghon Ehianata Oronsaye; Prisca Onyema; Ngozi Precious Uwagboe; Patricia Tonbra Osunu; Aghafekokhian Bose Osaiyuwu; Jennifer Aleye Ebeigbe
Effect of Aerobic Exercise on Intraocular Pressure among Athletes and Non-Athletes
Background: Aerobic exercise has been shown to influence intraocular pressure (IOP), yet comparative data between trained athletes and untrained individuals remain scarce. This study characterised the gender and sex distribution of a cohort of athletes and non-athletes and compared their IOP during and after a standardised aerobic exercise session. Methods: Thirty-one athletes (16F, 15M; mean age 22.3 ± 2.4 years) and 28 non-athletes (14F, 14M; mean age 20.3 ± 1.5 years) were enrolled. IOP was measured in both eyes (OD and OS) using non contact tonometry during and after exercise, with groups compared statistically at each timepoint and adjusted for age and sex. Results: The overall sample was closely balanced for sex (50.8% female, 49.2% male), with no significant difference in sex distribution between athletes and non-athletes (chi-square p=1.000). Athletes demonstrated significantly lower IOP than non-athletes at both timepoints in both eyes (all p<0.05). Conclusions: Athletic training is associated with a sex-balanced sample showing consistently lower IOP than non-athletes during and after aerobic exercise, independent of age and sex, suggesting a genuine protective ocular adaptation associated with habitual physical training.
Intraocular pressure, Aerobic exercise, Athletes, Non-athletes, Gender distribution, Ocular hypertension, Tonometry
Ayodeji E. Ige; Ngozi P. Uwagboe; Oluwasola M. Ojo
Photostress Recovery Time among Commercial Drivers in Kano Metropolis, Kano State, Nigeria
Driving being a vision dependent task requires the drivers to have good vision. The essence of driver’s license is therefore contingent upon meeting visual standards for public safety. This study aimed at determining the photostress recovery time (PSRT) of commercial drivers of Kano metropolis. A prospective analytical cross-sectional study was conducted on 134 purposively sampled commercial drivers who have clear ocular media. Prior to the testing each subject were given 5 minutes to adapt to ambient illumination. The pre-bleach distant visual acuity of each eye was determined with the Snellen’s distance visual acuity chart. With one eye occluded, the other eye was dazzled for 10 seconds, measured by a stopwatch, with the light of a pen torch held at 2cm from the eye. The time required in seconds to read at least, three optotypes on the line directly above the baseline acuity was recorded as the PSRT. The 20-29 years age group recorded the least mean PSRT (12.2 seconds) for both eyes, while the 60-70 years category has the highest mean PSRT (41.8 and 41.1 seconds) for right and left eye respectively. Age associated significantly (p<0.05) with mean PSRT. The observed mean PSRT with glare sensitivity was statistically significant (p<0.05). Positive association between PSRT in relation to age and disability glare were found. This emphasizes the need to introduce photostress test as a requirement for issuance and renewal of driving license especially for older and visually impaired people.
Photostress test, Photostress Recovery Time (PSRT), Glare Sensitivity, Night Driving
Eme Okpo; Asmau Bello Kabara; Ikechukwu Peter Nwakuche; Hypolytus Chinonso Muoneke; Emmanuela Onyinyechi Mgbemena
A Comparative Study of Contrast Sensitivity among Hyperopic and Myopic Patients Visiting the Optometry Clinic in Aminu Kano Teaching Hospital Kano, Nigeria
Contrast sensitivity is an important component of visual function that affects real-world tasks such as driving, reading, and facial recognition, especially under low-light conditions. This study was a cross-sectional, hospital-based study to compare the contrast sensitivity performance between hyperopic and myopic adult participants attending the Optometry Clinic at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. A total of 130 adult participants aged 18–50 years were recruited through simple random sampling. Participants had their refractive error assessment with an auto-refractor. Contrast sensitivity was measured using the Pelli-Robson chart. Data were analyzed using SPSS version 25. Independent t-tests, ANOVA, and Pearson correlation were used to compare contrast sensitivity between groups and determine the effect of age and refractive error severity. Hyperopic patients had slightly higher contrast sensitivity scores across monocular and binocular assessments, but the differences were not statistically significant (p > 0.05). Specifically, binocular contrast sensitivity was 1.65 ± 0.09 in hyperopic patients and 1.60 ± 0.09 in myopic patients. In myopes, contrast sensitivity improved with decreasing myopia (e.g., r = 0.755 for RE OD vs CS OU, p < 0.001). In hyperopes, contrast sensitivity declined with increasing hyperopia (e.g., r = -0.713 for RE OS vs CS OU, p < 0.001). This study revealed slightly higher contrast sensitivity in hyperopic patients, a non-significant decline with age, a strong correlation between refractive error severity and contrast sensitivity. These findings emphasize the importance of including contrast sensitivity testing in routine eye examinations to enhance clinical decision-making and patient care.
Contrast sensitivity, Hyperopia, Myopia, visual function
Eme Okpo; Ahmad Lawan Abdulmumin; Ikechukwu P. Nwakuche; Hypolytus Chinonso Muoneke; Shemau Sanusi; Mary Ihuoma Nnenna Ademola
Knowledge of Drug Abuse among Students of Alvan Ikoku Federal University of Education Owerri, Nigeria
Drug abuse is the indiscriminate use of any substance which is capable of modifying the chemistry of the human body. Its consequences on the physical, social and psychological dispositions of humans cannot be over emphasized. The study investigated the knowledge of drug abuse among students of Alvan Ikoku Federal University of Education Owerri, Nigeria. The survey research design was adopted, and the sample size consisted of 500 students drawn using the multi stage sampling technique. Data were collected using validated questionnaires, and analyzed using the descriptive statistics of frequencies, means, and percentages. Results showed that 74.8% of the students were not knowledgeable of the intellectual effects of drug abuse; while 54.2% had knowledge of the social effects of drug abuse; 54% recognized cough syrup as the most abused drug, while 79.4% of the students had knowledge of the possible ways of reducing the problems of drug abuse.
Knowledge, Drug, Abuse, Students, University
Mariagoretti N. Nwizugbo, Augustine U. Akujobi, Chidera A. Akujobi, Priscilla O. Chinedu Eleonu, Emmanuel C. Nwizugbo
Urban–Rural Dynamics of Malaria Transmission in Imo State, Nigeria: Evidence from Temporal Trends, Migration, and Parasite Density Analysis
Malaria remains a major public health challenge in Nigeria, with rural–urban dynamics increasingly shaping transmission. This study examined temporal trends, gender and age variations, migration influences, and rural–urban differences in malaria prevalence across three urban centers of Imo State (Owerri, Orlu, and Okigwe). A hospital-based survey was conducted between 2022 and 2025, complemented with meta-analysis of published rural studies. Blood smears were examined for Plasmodium species, and data were analyzed using chi-square and ANOVA tests. Results showed a rising prevalence in Owerri (42% in 2022 to 62% in 2025) and Okigwe (>70%), with males and children <15 years disproportionately affected. Meta-analysis revealed higher parasite densities in rural communities (>70–80%) compared to urban centers (34–62%). Migration significantly contributed to parasite importation. These findings highlight intensifying malaria transmission in urban Imo, emphasizing the need for micro-stratified interventions that integrate urban vulnerabilities, rural hotspots, and population mobility into control strategies.
Malaria, Transmission, Migration, Parasite Density, Imo State
Chimara O. Ugonnanyere, Chigbo Ajero, A. I. Ogomaka
Urbanization and Malaria Transmission in Imo State, Nigeria: An Epidemiological Study
Malaria remains a major public health burden in sub-Saharan Africa, and the rapid pace of urbanization is reshaping its transmission patterns. This study investigated the relationship between urbanization and malaria prevalence in selected urban centers of Imo State, Nigeria—Owerri, Orlu, and Okigwe. A hospital-based cross-sectional survey was conducted among 600 randomly selected participants. Data were obtained through structured questionnaires assessing demographic and environmental variables, while venous blood samples were analyzed using rapid diagnostic tests (RDTs) and microscopy for malaria detection. The overall malaria prevalence was 38.7%, with males (41.5%) showing higher infection rates than females (36.0%). Age-specific analysis revealed that children under five years and young adults (20–39 years) were the most affected groups. Environmental risk factors such as poor drainage systems, stagnant water, and overcrowded living conditions were significantly associated with higher malaria incidence. The findings demonstrate that unplanned urban growth, coupled with inadequate sanitation and poor housing, contributes to sustained malaria transmission within urban settings.The study concludes that effective malaria control in urbanized areas requires a multidisciplinary approach that integrates urban planning, environmental management, and public health interventions. Strengthening community awareness and improving urban infrastructure are essential steps toward reducing malaria transmission and achieving sustainable disease control in Imo State and similar urban environments across Nigeria.
Urbanization, Malaria Transmission, Environmental Factors, Public Health, Imo State
Knowledge of Gastroenteritis in Owerri West Local Government Area, Imo State, Nigeria
The study examined the knowledge of gastroenteritis in Owerri West Local Government Area of Imo State, Nigeria. The descriptive survey research design was adopted and the population of the study consisted of 99, 265 individuals from the 15 communities in Owerri West Local Government Area. The sample size was calculated using the Taro Yamane’s formula and total of 385 respondents were surveyed using questionnaires validated with a Cronbach Alpha coefficient reliability of 0.76. Data collected were analysed using descriptive statistics of percentages and inferential statistics of Chi square. P˂0.05 was considered significant. The findings of the study showed that age, level of education, marital status and parity did not significantly (p>0.05) influence the knowledge of gastroenteritis.
Knowledge, Gastroenteritis, Demography, Owerri West
Mariagoretti N. Nwizugbo, Augustine U. Akujobi, Izuchukwu F. Eberendu, Chidera A. Akujobi, Joy N. Osuoji, Emmanuel C. Nwizugbo
Impact of Urbanization on Malaria Infection in Selected Urban Areas of Imo State, Nigeria
Malaria remains a major public health concern in Nigeria, with urbanization altering traditional transmission patterns. This study investigated the impact of urbanization on malaria infection in three urban centers of Imo State—Owerri, Orlu, and Okigwe. A cross-sectional hospital-based survey was conducted between April and July 2024, involving 600 participants (200 per zone). Venous blood samples were examined using Rapid Diagnostic Tests (RDTs) and microscopy to detect malaria parasites and estimate parasite densities. Structured questionnaires captured participants’ demographic, socioeconomic, and migratory backgrounds. Results showed an overall prevalence of 34.5%, with Orlu recording the highest (38.0%) and Okigwe the lowest (30.0%). Migrants exhibited higher infection rates and parasite densities compared to non-migrants, particularly among females and low-income groups. Environmental conditions such as poor drainage, stagnant water, and overcrowded settlements further sustained transmission within urban neighborhoods. Statistical analysis revealed significant associations between malaria prevalence and migration status (p < 0.05), while age and sex showed no significant effect. The study underscores the role of population mobility and inadequate urban infrastructure in maintaining malaria transmission cycles. Effective control requires integrated vector management, improved diagnostic coverage, and gender-sensitive interventions within urban health frameworks. These findings provide valuable baseline data for targeted malaria control and urban health policy in Imo State and similar rapidly growing cities in sub-Saharan Africa.
Urbanization, Malaria prevalence, Migration, Parasite density, Urban health
Chimara O. Ugonnanyere; Chigbo Ajero; A. I. Ogomaka
Factors Associated with Smoking among Youths in Owerri Municipal Council, Imo State, Nigeria
The cross-sectional study investigated the factors associated with smoking among youths in Owerri Municipal Council, Imo State, Nigeria. Structured questionnaires were administered on randomly selected participants, and the descriptive statistics of percentages and means were used to analyse the data. The study showed that smoking was influenced by various economic, environmental, emotional factors leading to difficulty in cessation and control. However, modern technological initiatives, community-based engagements, provision of welfare and infrastructural development, employment and good life, rehabilitation centers will help halt smoking as an unhealthy lifestyle.
Smoking, Tobacco, Youths, Owerri, Imo State
Stella C. Okoroafor, Augustine U. Akujobi, Priscilla O. Chinedu-Eleonu, Chidera A. Akujobi
Urban Malaria in Imo State, Nigeria: Prevalence, Spatial Distribution, Demographic Determinants, and Diagnostic Performance in Three Senatorial Zones
Malaria remains a major public health concern in Nigeria, including urban settings where its burden is often underestimated. This study assessed the prevalence and demographic determinants of malaria in three urban zones of Imo State—Orlu, Owerri, and Okigwe. A cross-sectional survey involving 400 participants was conducted between January and March 2024. Venous blood samples were analyzed using both rapid diagnostic tests (RDTs) and Giemsa-stained microscopy. Data were categorized and analyzed by age, sex, occupation, and parasite density. Microscopy confirmed an overall prevalence of 34.5%, with Orlu recording the highest rate (38.0%) and Okigwe the lowest (30.0%). Children aged 0–10 years were the most affected group (52.8%), and parasite densities ranged from 1,000 to 7,000/μL, indicating moderate infection levels. Females exhibited a slightly higher prevalence (35.0%) than males (33.9%). RDTs showed reduced sensitivity compared with microscopy, underscoring the need for accurate diagnostic tools in surveillance programs. The findings demonstrate that malaria transmission persists in urban areas of Imo State despite control efforts. Strengthening diagnostic accuracy, improving environmental management, and implementing targeted community interventions are crucial to reducing the urban malaria burden. Continuous monitoring of demographic and ecological risk factors is recommended to guide effective urban malaria control strategies.
Malaria, Urban transmission, Imo State, Diagnostics, Epidemiology
Chimara O. Ugonnanyere, Chigbo Ajero A. I. Ogomaka
Risk Factors Responsible for Caesarea Section among Pregnant Women Attending Imo State Specialist Hospital Umuguma, Owerri West Local Government Area, Imo State, Nigeria
The study investigated the risk factors responsible for caesarean section among 100 pregnant women attending Umuguma Specialist Hospital in Owerri West Local Government Area, Imo State, Nigeria. Respondents were selected using both purposive random sampling technique and simple random sampling technique. The reliability index of the questionnaires (0.88) was calculated using the Cronbach Alpha. The data collected were analyzed using Spearman Rank Order Correlation Coefficient and IBM-SPSS (Version 21) software.. The findings revealed weak positive and significant correlation (r = 0.475; p 0.000) between pre-existing medical factors and the decision for a Caesarean section. There was a strong positive and significant correlation (r = 0.707; p 0.000) between socioeconomic factors and likelihood of undergoing a caesarean section. Health equity should be emphasized to ensure that all women have equal opportunities for informed choices regarding their delivery options.
Caesarean Section, Pregnancy, Socioeconomic Factors, Medical Factors
Jennifer C. Emeziri, Augustine U. Akujobi, Priscilla O. Chinedu-Eleonu, Chidera A. Akujobi
Comparison of Manual and Automated Keratometric Measurements of the Anterior Corneal Curvature (ACC) and Refractive Power
The study compared the measurement of the Anterior Corneal Curvature (ACC) and refractive power using manual (Bausch and Lomb) and automated (GRK 2100) keratometers among healthy participants. The ACCs of 100 eyes of 50 healthy participants, aged 16 33 years, were measured using the manual (Bausch and Lomb) and automated (GRK 2100) keratometers. Data were analyzed using MathWorks MATLAB version R2024a (MathWorks, Inc., MA, USA). The 95% limits of agreement were evaluated with the Bland Altman plot The curvature plots of horizontal and vertical measurements showed tight clustering of data points around the zero bias line (red dashed line), with 95% limits of agreement (green dashed lines) confined within ±0.10 to ±0.15 mm. The narrow range indicates strong consistency between the two techniques. The horizontal and vertical power plots showed a broader spread of differences, with limits of agreement extending to approximately ±1.0 D and one data point in each plot exceeding ±2.0 D. Despite the wide range, the majority of the points remained within the limits, and the mean difference remained centered close to zero. Overall, automated and manual keratometry showed stronger agreement for curvature plots than power plots.
Automated Keratometry, Manual Keratometry, Anterior Corneal Curvature, Refractive Power
Munachi A. Ogbonna, Augustine U. Akujobi, Chidera A. Akujobi
Maternal Mortality and Morbidity Rates among Pregnant Mothers Attending Antenatal Care at Imo State Tertiary Health Institutions
Background: The study examined maternal mortality and morbidity rates among pregnant mothers that received antenatal care at tertiary health institutions in Imo State. Methods: The study adopted the retrospective and descriptive survey research designs. 9,651 pregnant women who attended antenatal care at Federal Medical Centre Owerri, Imo State University Teaching Hospital Orlu and Imo State Specialist Hospital Umuguma all in Imo State, Nigeria constituted the population of the study. Sample sizes of 384 and 528 pregnant women for the descriptive and retrospective studies were used. Data Abstraction Instrument on Determined Factor Effect and Preventive Measure Questionnaire (DFEPMQ) were used for data collection. The instruments were validated by experts in data extraction and Measurement and Evaluation. The reliability of the 2nd instrument was ascertained using the Cronbach’s Alpha reliability method and 0.81 was the reliability index obtained. A standard hospital profoma was used for relevant information abstraction from the health institutions while the investigator employed direct methods to collect responses using the questionnaires. The SPSS version 29.0.1while and t-test were used to analyze the results. Results: The study showed high maternal mortality and morbidity in health institutions in Imo State, Nigeria and the rates were higher in rural than urban areas among others. Conclusions: A functional Health Insurance Scheme at the community level can increase substantial resources to provide health care to women, the government should employ qualified health professionals and provide medical subsidy among others.
Mortality, Morbidity, Pregnant women, Ant-natal care, Health Institutions
Georginia C. Njoku; Adanma S. Nwagwu; Chinelo C. Vincent; Julia E. Ibebuike
Knowledge, Implications and Challenges of Continuous Assessment (CA) in Nursing Education: A Pilot Study
Background: Continuous Assessment (CA) has become a compulsory pedagogical technique in tertiary institutions across Nigeria. The knowledge, implications and challenges of CA in nursing education was investigated using a pilot study conducted at the Department of Nursing Science, Imo State University Orlu, Nigeria. Methods: A descriptive survey design was adopted for the study. Seven (7) lecturers in the Department of Nursing Science were sampled. Structured questionnaires were directly dispensed by the lead investigator to the lecturers and retrieved upon completion. The responses were collated, categorized and presented in tables. The statistical analyses were done using the Statistical Package for the Social Sciences (SPSS) version 22. Results: Lecturers’ knowledge about CA showed a grand mean of 3.93 which exceeded the criterion mean of 2.50. This implied that teachers showed good knowledge of CA, although the level of utilization was poor due mainly to teacher-related challenges. The respondents accepted all the items as their opinion on the implications of CA, with a grand mean of 4.00 which was greater than the criterion mean of 2.50. The challenges lecturers encountered in CA included insufficient time for teaching and assessment, over-populated classes, excess workload, lack of storage facilities for CA materials and lack of interest on the part of students. Conclusions: The need for teachers to continuously assess students’ academic progress during teaching and learning cannot be over-emphasized. In addition, regular trainings and workshops for lecturers will go a long way in improving their delivery of up-to-date techniques in continuous assessment.
Knowledge, Implications, Challenges, Nursing Education, Pilot study
Chioma Ibe; Scholarstica C. Alagwu; Christiana O. Mbama; Chidinma O. Osuagwu;, Obiageli G. Anoka; Madonna E. Ayozie; Uju P. Ogbu; Julia E. Ibebuike; Chinelo C. Vincent
Awareness and Treatment Methods of Ocular Onchocerciasis among Rural Dwellers in Amuro Community, Imo State, Nigeria
Background: Despite treatment and preventive interventions by international organisations and governments, ocular onchocerciasis still persists in endemic communities in Nigeria. This may be as a result of low awareness of the disease that leads to misconceptions held by large proportion of people about ocular onchocerciasis causation, transmission, treatment and prevention. This study therefore investigated ocular onchocerciasis awareness and treatment methods among rural dwellers in Amuro community. Methods: Survey research design was adopted for this study. Questionnaires and in-depth interviews were the data collection instruments. Using Kish formula for a single proportion, 321 respondents were derived as the study sample size. For the qualitative data of the study, a total of six (6) in-depth interviews were conducted. Purposive and convenience sampling techniques were used to identify and select the actual study respondents. The study quantitative data were analysed using descriptive and inferential statistics. Thematic analysis method was used to analyse the qualitative data. Ethical clearance was gotten from Imo State Ministry of Health. Furthermore, informed consent was obtained from individuals at their place of residence. Results: It was found among others that while the use of traditional medicine/herbs is high in Amuro community, the higher the peoples’ level of education, the more they are likely to use ivermectin to prevent the disease. Conclusions: Since educational level affect awareness of ocular onchocerciasis among rural dwellers, government and well-meaning individuals should encourage rural dwellers to acquire education by building more schools in Amuro community and making education free and compulsory.
Ocular Onchocerciasis, Treatment, Awareness, Amuro
Oluchi J. Okechukwu-Ajaegbu; Godwin C. Agu; Augustine U. Akujobi
Correlation of Ocular Onchocerciasis with the Refractive Status of the Eye among Selected Endemic Communities in Imo State, Nigeria
Background: The study was aimed at investigating the correlation between ocular onchocerciasis and refractive status of the eye among selected endemic communities in Imo State, Nigeria. Methods: A total of 462 participants aged 5-84 (44.9 ±12.1) years and comprised of 238 (51.5%) males and 224 (48.5%) females were sampled. Blood-free skin snips were collected using the skin snip biopsy technique. Bloodless skin snips were extirpated from the iliac crest region using a sclera-corneal punch which resulted in the removal of around 2 mg of tissue. To allow the microfilariae emerge, the tissue removed was incubated in normal saline at room temperature for 24 hours. The emerging microfilariae were then identified under a high powered 40X microscope. Out of the 462 participants, 221 (47.8%) tested positive to O. volvulus. Of the 221 that tested positive, 104 (47.1%) (male, 69 and female, 35) had ocular manifestations. Ocular examination was performed on positive individuals using the slit lamp biomicroscope under retro illumination. Results: Using the chi square statistical analysis, this study showed a statistically significant difference (P<0.05) between onchocerciasis and the refractive state of the eye in Amuro, Umulolo, Amano and Umuokpara community and odds ratio showed that onchocerciasis was more likely to cause these errors. There was no statistical significant difference (P>0.05) in the refractive state of the eye in Ihube. Conclusions: The result suggested that presbyopia had a higher manifestation while hyperopia and astigmatism had the least manifestation than other refractive errors. The result from the study showed a decline in the 5 studied communities but the presence of positive diagnosis suggests of a continuous disease transmission and onchocerciasis is not yet fully eliminated in Okigwe. With sustained high coverage of ivermectin mass drug administration by African Programme for Onchocerciasis Control (APOC), onchocerciasis prevalence would be eliminated.
Ocular onchocerciasis, Refractive status, Eye, Endemic communities
Chioma L. Vincent; Augustine U. Akujobi; Godwin C. Agu
Impact of Volunteer Optometric Services to Humanity (VOSH)/International in a Nigerian Rural Community
Background: The elimination of avoidable blindness and visual impairment requires enormous human and material resources supported by an enabling policy environment. The provision of a qualified workforce and funds for effective humanitarian clinics will address inherent gaps in the dispensation of primary eye-care services to rural and low income populations. This report highlights the oculo-visual anomalies observed in a Nigerian rural community during a humanitarian clinic. Methods: Temperature check, registration, blood pressure check, case history, visual acuity check, external examination, direct ophthalmoscopy, refraction, tonometry and dispensing of drugs and spectacles were conducted by clinicians. Results: Of the 186 patients examined, 42 (22.6 %) had pterygium, 35 (18.82%) had pinguecula, 20 (10.75 %) had conjunctivitis, 10 (5.38%) had glaucoma, 4 (2.15 %) had hypertensive retinopathy and 4 (2.15%) had dry eye. Ten (5.4%) patients had cataract in the right eye, 11 (5.9%) in the left eye and 78 (41.9%) in both eyes. There were 8 (4.30%) diagnosed of myopia, 18 (9.68%) with hyperopia, and 79 (42.47%) with presbyopia. Twenty-four (18.28%) required a distance correction, while 80 (43%) required a near correction. Thirty-four (8.28%) were referred for further eye-care, including those with high amounts of astigmatism or clinically significant anisometropia. Sixty (32.26%) were referred for high blood pressure management. Conclusions: This report re-emphasizes the need for effective collaboration between optometry schools and volunteer optometric organizations in the provision of primary eye-care services for rural and low income populations in order to curb the enormous burden of oculo-visual anomalies and avoidable blindness.
VOSH/International, Nigeria, Rural Community, Humanitarian Clinic
A. U. Akujobi; M. Arce-Moreira; J. L. Weaver; W. H. McAlister; J. C. Ekenze ; I. E. Obijuru; C. L. Vincent;, W. N. Okere ; P. C. Aliba; F. I. Duru ; B. C. Igwe ; F. O. Onyesom ; W. O. Emerenwa
Low Vision Assessment and Management of a Leukemia Patient Undergoing Chemotherapy: Everybody Deserves Good Functional Vision
Background: Acute myeloid leukemia (AML) is a malignant disorder of the hematopoietic stem cells characterized by abnormal proliferation of myeloid blast cells in the bone marrow and blood, preventing them from further differentiating into the specialized cells of the bone marrow and thus causing pancytopenia. Consequently, AML can affect various tissues and organs (liver, skin, central nervous system), including the eye and orbit. Ophthalmic manifestations of leukemia are more frequent with acute than chronic leukemia. It can affect all intraocular structures. Methods: We present a 17 year old male student with AML, who developed severe painless progressive reduction of vision. Visual acuity (VA) was found to be Hand Movement (HM) in both eyes. Patient’s ocular B-scan showed every other ocular structure to be normal except the retina and vitreous. They showed some areas of tumor deposit and some atrophic areas. Patient was counseled on reason for reduction in vision and referred to the optometry clinic for expert management. Patient was referred to Low Vision unit for low vision assessment as there was no improvement after refraction. Results: There was a great improvement from HM to 6/5 after assessment, training and prescription of low vision aids. Conclusions: Hope was restored when low vision aids were prescribed. Everybody deserves functional vision notwithstanding life expectancy as long there’s life.
Leukemia, low vision, functional vision, visual aids
Eme Okpo; Saddiqa Y. Nura; Ikechukwu P. Nwakuche
Comparing the Parasite Clearance Rates of Chloroquine and Doxycycline in Malaria infection
Background: The emergence of artemisinin-resistant malaria parasites has generated great concerns. In order to explore other treatment options, the clearance rates of chloroquine (CQ) and doxycycline (DX) on malaria parasitemia were compared. Methods: Participants were recruited at the central village square on consecutive basis. Thick peripheral capillary blood were obtained using finger pricking technique. Thick blood smears were prepared on laboratory slides using standard technique and visualized under 100X objective microscope per 100 high power fields (hpf). Of the 603 participants examined, 104 (17.2%) aged 10-≥60 years tested positive to malaria parasite and were randomly allotted into treatment Groups A (n=35) and B (n=35). The direct observed treatment method was adopted for the study. Group A was treated with the standard dose of chloroquine (CQ), while Group B was treated with 200mg daily dose of doxycycline (DX) for 7 days. Both groups were re-examined for parasite loads after treatment on day 8. Groups A and B were controlled with 17 participants per group who were treated with standard doses of multivitamin tablets for 7 days and re-evaluated for parasite load on day 8. Results: The ≥60 age group recorded the highest (4.7mp/100hpf) Mean Parasite Density (MPD) in Groups A and B. The clearance rate of CQ (43.42%) was not significant (p>0.05), while DX recorded a significant (p˂0.05) clearance rate of 100%. Conclusions: The outcome of this trial highlights the viability of doxycycline as a potential partner drug to ACT in the treatment of malaria.
Parasite; Clearance rate; Chloroquine; Doxycycline; Malaria
Microfilaricidal Actions of Chloroquine and Doxycycline on Onchocerca volvulus in vivo
Background: The study examined the microfilaricidal effects of oral administration of chloroquine and doxycycline on Onchocerca volvulus parasites. Methods: One (1) mg of bloodless skin snip was extirpated from the sterilized posterior iliac crest region of each parasitized participant using a corneo-scleral punch. The skin snip biopsy was immersed in a micro titre plate containing 0.2 ml of normal saline, vigorously agitated and left at the ambient room temperature for 24 hours. The aliquots were observed for emerging microfilariae (mf) which were visualized and counted under a 10X objective microscope prior to drug administration. One hundred (100) participants who tested positive to O. volvulus were recruited into the study on consecutive basis and stratified into 2 treatment and 2 placebo clusters. Group A (n=25) was treated with the standard dose of chloroquine and re-quantitated for parasitemia on day 7, while Group B (n=25) was treated with 200mg daily dose of doxycycline for 6 weeks and re-evaluated for parasite load on weekly basis for six weeks. Placebo participants (Control A n=25; Control B n=25) were treated with standard doses of multivitamin for 1 week and 6 weeks respectively. Results: Chloroquine and doxycycline exhibited clearance rates of 100% on day 7 and week 5-6 respectively. In Groups A and B, the post-treatment Mean Parasite Densities (MPDs) were significantly lower (p˂0.05) than the pre-treatment levels. Conclusions: The findings of the present study affirm those of previous studies which suggest that doxycycline could provide a suitable alternative to ivermectin in the treatment of onchocerciasis in Loasis co-endemic areas.
Microfilaricide; Chloroquine; Doxycycline; Onchocerca volvulus; in vivo
Socio-demographic Determinants of Childhood Immunization Coverage among Mothers in Ogbaku Community, Imo State, Nigeria
Background: Immunization reduces the number of vaccine-preventable diseases by attaining high levels of immunity using potent vaccines given at the right ages for children. This study examined the socio-demographic determinants of childhood immunization coverage among mothers in Ogbaku community in Mbaitoli Local Government Area, Imo State, Nigeria. Methodology: A cross sectional study was adopted. 151 mothers of children aged 1-2 years were sampled. The sampling was done in multi stages involving cluster, purposive, and census sampling techniques. Data were collected from the respondents using close ended structured questionnaires. Results: The study showed that 39.07% of the mothers use immunisation services fully, 38.41% use immunisation services partially, while 22.52% of the respondents do not utilise the immunisation services. The major constraints to utilisation of immunisation services in the community were inadequate information on immunisation (77.55%); myths that immunisation is unhealthy for the baby (51.02%); mothers’ occupation (47.96%); inadequate supply of vaccines (58.08%) and attitude of health workers (48.98%); there was no significant (p>0.05) relationship between age, marital status and mothers’ utilisation of immunisation services. However, there was a significant (p˂0.05) relationship between mothers’ educational qualification and their use of immunisation services for under-fives. Conclusion: Vigorous campaigns to forestall the barriers to childhood immunization and proper education of the mothers will go a long way in providing solutions to the challenges of immunization.
Socio-demographic, Determinants, Childhood, Immunization, Coverage
G. C. Njoku; I. N. Anukam;O. B. Nwokoma F. N. Ugwuegbu; C. E. Ezekwe; J. E. Ibebuike; C. C. Vincent; A. S. Nwagwu
Diagnosing Solar Retinopathy Using Optical Coherence Tomography (OCT)
OCT is the most sensitive diagnostic tool for detecting changes due to solar retinopathy. A 40-year-old African American female presented with a complaint of seeing an irregularly shaped structure when looking at distant surface. Other complaints include photophobia, headaches, and blurry vision at distance and at night. The patient confessed that she had stared at the sun and at red traffic lights on a regular basis for over 1 month thinking that she was getting some vitamins from this activity. Her medical history was unremarkable for any systemic condition.
Knowledge, Attitude and Practice of HIV Post-exposure Prophylaxis (PEP) among Primary Health Care Workers in Aba South Local Government Area, Abia State, Nigeria
Health-care workers are predisposed to post-exposure transmission of the Human Immunodeficiency Virus (HIV) infection. Remarkable knowledge, attitude and practice of post-exposure prophylaxis (PEP) are needful in mitigating the occupation-related transmission of HIV among health-care practitioners. Consequently, the Knowledge, Attitude and Practice of HIV Post Exposure Prophylaxis (PEP) among Healthcare Workers in Aba South Local Government Area, Abia State, Nigeria were investigated. Two hundred and two (202) health workers; including nurses, doctors, laboratory scientists and community health workers were sampled in a cross sectional survey study. Structured questionnaires were tested for internal consistency using the Cronbach’s Alpha, authenticated for face and content validity by institutional Body of Validators and administered on the respondents. Data were analysed, using the Statistical Package for Social Sciences (SPSS) Version 20 Software, with both descriptive and inferential statistics of Chi-square (X2) and One-way Analysis of Variance (ANOVA). 86.6% of respondents had knowledge of HIV PEP, 95.5% and 4.5% had positive and negative attitudes to PEP respectively, 83.2% had poor practice, while 16.8% had good practice. Knowledge of HIV PEP did not co-relate significantly (P>0.05) with PEP practice, but co-related significantly (p˂0.05) with attitude towards HIV PEP. Knowledge of HIV PEP across workers differed significantly (P<0.05), attitudes towards HIV PEP across professions did not differ significantly (P>0.05), while practice of HIV PEP across workers differed significantly (P < 0.05). Strategic health education and advocacy on HIV post-exposure prophylaxis among health-care practitioners should be intensified to enhance timely post-exposure prophylactic interventions.
Knowledge; Attitude; Practice; Post-exposure; Prophylaxis; HIV
Kate I. Okorie, Augustine U. Akujobi, John C. Ekenze
Prevalence of Near Esophoria among Young Adults in Imo State University Owerri, Nigeria
Vergence anomalies describe the anomalous disjunctive movement of the eyes in which there is a resultant convergent or divergent movement of the eyes, causing the eyes to inaccurately fixate and stabilize an image on the retina. Basic heterophoria is a common vergence anomaly, with esophoria as a form of heterophoria characterized by the inward deviation of the eye towards the nose upon dissociation of binocular fusion. Esophoria may be expressed at far (6m) or at near (40cm) and is associated with various symptoms as diplopia, headaches, blurred vision, poor concentration, and eye strain. This cross sectional study assessed the prevalence of esophoria at near among young adults in the Imo State University community, with the objective to determine the influence of age and gender on near esophoria among the study population. This was done by conducting the Von Graefe phoria test at near on eligible consenting subjects, 400 students aged 18 – 30 years old, in the Optometry clinic of the Imo State University, Owerri. The study findings revealed a high prevalence of esophoria at near, confirmed in 47% of the study population. Analysis of the findings with the ANOVA statistical tool, revealed that esophoria at near showed no significant relationship with age or gender in this study. The findings of this study reveal that the presence of esophoria at near in the young adult may be more commonly present, thus the near phoria status in young adults especially engaged in near work ought to be carefully evaluated routinely by clinicians.
Binocular vision; Phoria; Esophoria; Symptoms; Young adults
Jacqueline E. Obioma-Elemba, Augustine U. Akujobi, Ikenna E. Obijuru, Obianuju V. Igwe, Nnenne U. Onu, Chidinma L. Amuneke
Effect of Computer Use on Tear Film Production Among Commercial Computer Operators
The study was aimed at investigating the effect of computer use on tear film production among commercial computer operators in Owerri Municipal Council, Imo State, Nigeria. The study was an experimental study that adopted a purposive sampling technique to collect relevant data from 50 randomly-selected commercial computer operators in Owerri Municipal Council, Imo state, Nigeria. The Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaires were administered to 50 participants aged 18-50 to elicit relevant information; whereas the Schirmer 1 test was administered to determine the level of tear production. Findings revealed a significant decline in tear production after 2 hours of uninterrupted computer use showing that increase in age results in a greater decline in the mean tear production as shown among ages 41-50. Results across gender lines shows that the mean tear volume of females at all testing times was greater than in their male counterparts. Mean tear production at baseline and after 2 hours in female subjects were 38.92mm and 33.40mm respectively in contrast to the mean baseline tear production of their male counterparts at 31.66mm and 30.20mm after 2 hours. Tearing, blurry vision and irritation were the major symptoms cited by computer users over time. The use of the computer results in prolonged visual concentration and this was shown to affect the rate of tear production over time. The study under consideration has shown that apart from long-term computer use, factors like age and gender contribute significantly to decline in tear production. These have proved to be major contributors to symptoms of dry eye disease. This demonstrates the need to observe eye health precautions while using the computer over a long-term duration.
Tear production, dry eye, computer operators, ICT, Owerri Municipal Council
Ikenna E. Obijuru, Jacqueline E. Obioma-Elemba, Augustine U. Akujobi
Prevalence and Distribution of Anterior Segment Ocular Diseases among Commercial Biomass Fuel Users in Isuikwuato Local Government Area, Abia State, Nigeria
Food vendors who use biomass fuel are exposed to the toxic free radicals released from the combustion of wood, gaseous aromatic hydrocarbons, gaseous chemicals and the particulate solid irritants that are airborne. Therefore, the prevalence and distribution of anterior segment ocular diseases among commercial biomass fuel users in Isuikwuato Local Government Area, Abia State, Nigeria was investigated. One hundred (100) consenting participants were interviewed and subsequently subjected to clinical examinations which included external examinations with pen torch, Rose Bengal staining and ophthalmoscopy. Statistical analyses were performed using the chi-squared statistical method at 0.05 level of significance. It was observed that conjunctivitis was the most prevalent anterior segment disease in biomass fuel users occurring in 39 persons (29.32%), followed by cataract 33 (24.81%), dry eye disease 30 (22.56%), pterygium 21 (15.79%), and pinguecula 10 (7.52%). It was also observed that age and duration in business did not significantly affect the incidence of these diseases (p>0.05). While further studies on the relationship between biomass and ocular morbidities are encouraged, calls to make liquefied petroleum gas (LPG) more affordable for domestic cooking might be helpful especially for the protection of women and children who are primarily exposed.
Prevalence; Distribution; Biomass; Ocular Diseases; Anterior Segment
Samuel O. Ndukuba, Augustine U. Akujobi, James Nweke, Nnenne U. Onu, Amarachi Ezeigbo
Tear Film Production and Stabilizing Potentials of Dennettia tripetala
Dennettia tripetala (DT) is an ethno-medicinal plant whose seeds are consumed for nutritional and medicinal purposes. Based on this, the tear film production and stabilizing potentials of Dennettia tripetala were investigated. A single dose of 750mg/kg body weight of the seed extract was orally administered on 50 healthy adults aged 18-35 years (26.4±1.98). Schirmer I test (SIt) and Tear-break-up time (TBUT) scores were recorded at 30 minutes, 60 minutes and 90 minutes post-ingestion using calibrated Whatman No. 41 Schirmer strips and cobalt blue filters of the slit lamp biomicroscope respectively. Data were analyzed with Z-statistics at 95% confidence interval using the Decision Analyst STATSTM version 2.0 Software. Across the age groups, the mean of means baseline SIt score was 15.4±1.34mm. At 30 minutes and 60 minutes post-ingestion, the mean of means SIt scores significantly (pË‚0.05) increased to 19.2±1.68mm and 25.8±3.97mm respectively compared with the baseline score, while at 90 minutes post-ingestion the mean SIt score significantly (pË‚0.05) increased to 16.0±0.88mm when compared with the baseline score. The age distribution of mean TBUT scores indicates a baseline mean TBUT score of 15.0±2.31 seconds across the age groups. At 30 minutes and 60 minutes post-ingestion, the mean TBUT scores significantly (pË‚0.05) increased to 19.7±2.12 seconds and 24.3±2.58 seconds respectively compared with the baseline score. At 90 minutes post-ingestion, there was a reduction of the mean TBUT score to 19.2±1.71seconds, although it was significantly higher (pË‚0.05) than the baseline mean TBUT score. Males recorded significantly (pË‚0.05) lower mean SIt and TBUT scores than females. On the overall, the seed extracts of Dennettia tripetala proved effective in potentiating tear film production and stability; hence, can provide a natural remedy to keratoconjunctivitis sicca (dry eye syndrome).
Tear film; Production; Stability; Potential; Dennettia tripetala
Augustine U. Akujobi, ThankGod C. Awuzie