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Ngozika Ezinne,1 Haile W Alemu,2 Tarekegn Cheklie,2 Kingsley Ekemiri,1 Ryan Mohammed,1 Sakeem James1 1Optometry Unit, Department of Clinical Surgical Sciences, University of the West Indies, Saint Augustine Campus, Trinidad and Tobago, West Indies; 2Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Tarekegn Cheklie, Email tarekegncheklie2691@gmail.comBackground: The Covid-19 pandemic lockdown obligated higher education students to attend online courses, leading to prolonged exposure to digital displays. Excessive time on digital devices could be a risk factor for ocular problems, including symptomatic dry eye. There are limited evidences to show the magnitude of symptomatic dry eye disease and its associated factors during COVID-19 pandemic. This study aimed to fill this gap, among university students in Trinidad and Tobago.Methods: An institutional-based cross-sectional study was conducted among undergraduate students attending the University of West Indies, Saint Augustine Campus from October 2020 to April 2021. The standardized ocular surface disease index questionnaire, descriptive statics and binary logistic regression were used to assess the prevalence and associated factors of dry eye diseases. Variables with a p-value of less than 0.05 were considered to be statistically significant.Results: Four hundred (96.3%) participants completed the questionnaire. Among all, 64.8% were female and 50.5% were east Indians. About 48% were using visual display units for average of 10– 15 hours/day. The prevalence of symptomatic dry eye disease was 84.3% (95% CI = 80.8– 87.5%) with OSDI score ≥ 13. Lack of education about dry eye 2.69 (95% CI: 1.41– 5.13), use of the reading mode of computer 3.92 (95% CI: 1.57– 9.80), refractive error 3.20 (95% CI: 1.66– 6.20), previous systemic medications 2.80 (95% CI: 1.15– 6.81), and average hours of visual display unit use/day (p< 0.001) were significantly associated with symptomatic dry eye disease.Conclusion: Symptomatic dry eye disease was a prominent problem among students at the University of West Indies. Average of > 4 hours of visual display unit use/day, refractive error, positive history of systemic medication, lack of education about dry eye, and using computers in reading mode were associated factors.Keywords: symptomatic dry eye disease, prevalence, associated factors, West Indies, Caribbean

Tambuzai Liyo,1 Grace Obumneke Ogbonna,1 Thokozani Mzumara,1,2 Ngozika Esther Ezinne3 1Department of Optometry, Mzuzu University, Mzuzu, Malawi; 2Department of Ophthalmology, Mzimba North District Hospital, Mzimba, Malawi; 3Optometry Unit, Department of Clinical Surgical Sciences, University of the West Indies, Saint Augustine Campus, Saint Augustine, Trinidad and TobagoCorrespondence: Grace Obumneke Ogbonna, Department of Optometry, Mzuzu University, P/Bag 201, Mzuzu, Malawi, Email Ogbonnagrace19@gmail.comPurpose: To assess the prevalence of ocular morbidities and associated factors among hearing-impaired (HI) students at the Embangweni School for the Deaf in Mzimba, Malawi.Methods: This was an institutional cross-sectional study of HI students at Embangweni School for the Deaf. A series of optometric and audiometric tests was performed, and the results were exported to the Statistical Package for Social Science for statistical analysis (SPSS) version 25. Pearson’s chi-square test was used to assess correlations and associations between variables. A P-value less significance was set at p < 0.05.Results: A total of 147 children comprising of 76 (51.7%) males and 71 (48.3%) females participated in this study. The prevalence of ocular conditions and visual impairment was 39 (26.5%) and 2 (1.4%), respectively. The Prevalence of eye disease was significantly associated with male sex (p=0.02) and type of HI (p=0.031). Allergic conjunctivitis 36 (24.5%) was the most common ocular condition, followed by refractive error 28 (19%).Conclusion: The prevalence of ocular conditions among HI students was significant and associated with sex. Regular school vision screening of students with HI is highly advised to reduce the burden of visual impairment.Plain Language Summary: Hearing impairment places a great burden on the sufferers. Ocular conditions among this population further disadvantages them in terms of education and personal development. The current study evaluated the prevalence of ocular conditions among school children at the Embangweni School of the Deaf. We observed that there is high prevalence of eye conditions among this population which was more prevalent among the males. Conjunctivitis was the most prevalent ocular condition. There is a great need for regular vision screening for this population for early detection and management of ocular conditions among them.Keywords: child health, hearing impairment, ocular morbidity, special education, vision screening, visual impairment

Abstract Background Undocumented immigrants are expected to face increased risks related to COVID-19 due to marginalizing restrictive immigration policies. However, few studies have assessed the prevalence of direct encounters with the immigration enforcement system among the undocumented and its impacts on their COVID-related health behaviors and outcomes. In this study, we quantify undocumented immigrants' lifetime exposure to various immigration enforcement tactics and their association with delays in COVID-19 testing and healthcare behaviors. Methods This cross-sectional study included a non-random sample of 326 Asian and Latinx undocumented immigrants in California from September 2020 to February 2021. The primary exposure was immigration enforcement encounter scores ranging from 0–9, assessed through self-reports of direct experiences with the immigration system, immigration officials, and law enforcement. The main outcomes were positive test for COVID-19, had or suspected having COVID-19, and delayed or avoided testing and/or treatment for COVID-19 due to immigration status. We used multivariable logistic regression models to examine the association between the primary exposure and outcomes of interest. Results Among 326 participants, 7% had received a positive COVID-19 test result, while 43% reported having or suspected having COVID-19. Almost 13% delayed or avoided COVID-19 testing and/or treatment because of their immigration status. Overall, an increase in immigration enforcement encounters was associated with higher odds of suspecting having had COVID-19 (aOR = 1.13; 95% CI: 1.01,1.26). Reporting an additional enforcement encounter was associated with higher odds of delaying or avoiding testing and/or treatment because of immigration status (aOR = 1.53, 95% CI: 1.26,1.86). Compared to their Latino counterparts, Asian respondents were more likely to report higher odds of delaying or avoiding testing and/or treatment (aOR = 3.13, 95% CI: 1.17,8.42). There were no significant associations between the enforcement score and testing positive for COVID-19. Additionally, while Latinxs were more likely to report immigration enforcement encounters than Asians, there were no differences in the effects of race on COVID-19 testing and healthcare behaviors in models with race as an interaction term (p

Coccidiosis, Salmonella, and Newcastle are the common poultry diseases that curtail poultry production if they are not detected early. In Tanzania, these diseases are not detected early due to limited access to agricultural support services by poultry farmers. Deep learning techniques have the potential for early diagnosis of these poultry diseases. In this study, a deep Convolutional Neural Network (CNN) model was developed to diagnose poultry diseases by classifying healthy and unhealthy fecal images. Unhealthy fecal images may be symptomatic of Coccidiosis, Salmonella, and Newcastle diseases. We collected 1,255 laboratory-labeled fecal images and fecal samples used in Polymerase Chain Reaction diagnostics to annotate the laboratory-labeled fecal images. We took 6,812 poultry fecal photos using an Open Data Kit. Agricultural support experts annotated the farm-labeled fecal images. Then we used a baseline CNN model, VGG16, InceptionV3, MobileNetV2, and Xception models. We trained models using farm and laboratory-labeled fecal images and then fine-tuned them. The test set used farm-labeled images. The test accuracies results without fine-tuning were 83.06% for the baseline CNN, 85.85% for VGG16, 94.79% for InceptionV3, 87.46% for MobileNetV2, and 88.27% for Xception. Finetuning while freezing the batch normalization layer improved model accuracies, resulting in 95.01% for VGG16, 95.45% for InceptionV3, 98.02% for MobileNetV2, and 98.24% for Xception, with F1 scores for all classifiers above 75% in all four classes. Given the lighter weight of the trained MobileNetV2 and its better ability to generalize, we recommend deploying this model for the early detection of poultry diseases at the farm level.

COVID-19 vaccines are effective in preventing COVID-19 infection, disease, and death. However, there is no data about vaccine intentions among the 10.7 million undocumented immigrants in the US. This study examined the associations between immigration enforcement exposure and vaccine intentions among undocumented immigrants in California. This community-engaged study partnered with immigrant organizations across California during the COVID-19 pandemic to recruit 366 study participants to an online survey regarding their attitudes about the COVID-19 vaccine and past exposure with the immigration enforcement system. Data collection occurred from September 2020 – February 2021 before the vaccine became available. Overall, 65% of study participants indicated that they would definitely get the vaccine were it to become available. In multivariable logistic regressions, an increase in immigration enforcement scores were associated with a 12% decrease in vaccine acceptance (aOR = 0.88, CI: 0.78–0.99). Additionally, undocumented women were 3.09 times more likely to report vaccine acceptance compared to undocumented men (CI: 1.79–5.35) and undocumented Asians were 57% less likely to report vaccine acceptance compared to undocumented Latinx immigrants (aOR = 0.43, CI: 0.21–0.88). Exposure to the immigration enforcement system may undermine public health efforts to prevent further transmission of COVID-19 by reducing acceptability of vaccines among immigrant populations.

Background: Modern workplace requirements in the banking sector require bankers to work on screens for more than 6 h a day, putting much stress and strain on their eyes, which leads to computer vision syndrome. Therefore, this study aimed to assess the prevalence of computer vision syndrome and associated factors among urban and rural bankers in Trinidad and Tobago., Methods and Materials: A cross-sectional design was applied to collect data from 399 bankers between April and June 2023. The collected data was entered into Excel worksheets and later uploaded to SPSS for further analysis. A variable with a P -value of 0.25 in binary logistic regression is a candidate for multi-variable logistic regression analysis. Finally, a variable with a P -value of 0.05 was used to declare statistical significance., Results: A total of 371 participants were enrolled in this study, leading to a response rate of 92.9%. Of the total participants, 277 (74.7%) had computer vision syndrome. Working in rural areas (AOR = 2.69; 95% CI [1.41-5.13]) and using eyesight glasses (AOR = 0.57; 95% CI [0.33-0.97]) was associated with computer vision syndrome., Conclusion: Despite being easily preventable, computer vision syndrome is substantially prevalent among bankers in Trinidad. The use of eye-sight glasses and the working area are significantly associated with computer vision syndrome. Therefore, it is necessary to improve workplace practices by encouraging the use of anti-glare screens and glasses for employees who work long hours on the computer., Competing Interests: The authors declare that they have no competing interests., (© 2024 Ekemiri et al.)

Introduction: Low vision has a significant global health problem that impacts the personal, economical, psychological, and social life of an individual. Each year around 684 000 individuals die from falls, 80% of these deaths occur are in low- and middle-income countries. The risk of falling significantly increases with visual impairment. This review aimed to determine the global pooled prevalence of fall and associated factors among individuals with low vision., Methods and Materials: Systematic search of published studies done on PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science CINAHL and, Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to report the findings. Quality of studies was assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using a random-effects method using the STATA™ Version 14 software., Result: Thirty-five (35) studies from different regions involving 175,297 participants included in this meta-analysis. The overall pooled global prevalence fall among individual with low vision was17.7% (95% CI: 16.4-18.9) whereas the highest prevalence was 35.5%; (95% CI: 28.4-42.5) in Australia and the lowest was 19.7%; (95% CI: 7.6-31.8) seen in South America. Fear of falling (OR: 0.16(95%CI 0.09-0.30), and severity of visual impairment (OR: 0.27(95%CI (0.18-0.39) increases the odds of falling., Conclusion: As one cause of accidental death, the prevalence of falls among individuals with low vision is high. Fear of falling and severity of falling increases the odds of falling. Different stakeholders should give due attention and plan effective strategies to reduce the fall among this population., Competing Interests: NO authors have competing interests The authors have declared that no competing interests exist., (Copyright: © 2024 Ekemiri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The increase in online learning during the pandemic has been linked to various ocular complaints. This study determined the prevalence and factors associated with ocular complaints among schoolchildren aged 12-19 years during the COVID-19 lockdown in Trinidad and Tobago (T&T)., Methods: A cross-sectional study was conducted between January and May 2021, during the COVID-19 lockdown in T&T among secondary school students studying remotely. A two-stage cluster sampling method was employed. A modified web-based Computer Vision Syndrome questionnaire was administered to students. Data on demography, duration of digital device use, and ocular complaints were collected, and multilevel logistic regression was used to determine factors associated with ocular complaints among school children, 12-19 years of age in T&T., Results: A total of 435 schoolchildren (mean age, standard deviation, 15.2 ± 1.9 years range 12-19 years) responded to the questionnaire. The prevalence of self-reported symptoms of headache, blurred vision, dry eyes, itchy eyes, and double vision were 75.0%, 65.1%; 56.8%; 46.4%; and 33.5%, respectively. Schoolchildren aged 18-19 years, those that used spectacles for correction of their refractive errors, and spent more than 6 h on average on digital devices, reported a high prevalence of any ocular complaints. Analysis also revealed that age (14-15 years) was associated with dry eyes, blurred vision, and headaches, while gender (more prevalently females) was associated with blurred vision and headache. Those that had an eye examination in the last year and schoolchildren that took action to resolve ocular complaints were more likely to experience nearly all ocular complaints., Conclusions: During the COVID-19 lockdown, over three in four students in T&T reported ocular complaints from digital devices for online learning. Tailored interventional messages to reduce all forms of ocular complaints should target older students, particularly females, those who laid down when learning online via their devices and people who regularly examine their eyes., Competing Interests: The authors declare that they have no competing interests., (© 2022 Ekemiri et al.)

Purpose: To evaluate the 5-item dry eye questionnaire (DEQ-5) for measurement precision and unidimensionality, and assess the ability of Ocular Surface Disease Index (OSDI), McMonnies Dry Eye Questionnaire (MQ), Ocular Comfort Index questionnaires (OCI), and DEQ to predict clinical measures of DED in an African population., Method: Participants (n = 113; mean age 24.7 ± 5.4 years) completed all four questionnaires administered in a randomized order. Internal consistency and test-retest reliability of the instruments were assessed. A masked examiner performed clinical dry eye tests in both eyes of participants and the results used to classify into either "dry" or "non-dry" groups. The diagnostic criteria for dry eye disease were tear break up time (TBUT) < 10 s plus at least one of Schirmer <15 mm in 5 min., > 5 corneal staining spot, or > 9 conjunctival staining spots. Rasch analysis was performed to assess the DEQ for unidimensionality and measurement precision, and receiver operating characteristic curve (AUC) analysis was used to assess the ability of the four questionnaires to predict clinical measures of DED., Results: The responses from the DEQ-5 met the Rasch analysis criterion of unidimensionality with infit and outfit values of between 0.74-1.43 mean-square and 0.69-1.49 mean-square, respectively, and measurement precision of 2.33. Internal consistency and test-retest reliability of each test was high, with Cronbach alpha >0.70 for the questionnaire and their respective subscales but internal consistency reliability of the MQ was poor (Cronbach's alpha = 0 .29-0 0.52). Each test segregated the "dry" and "non-dry" groups with moderate (all AUC 0.70-0.80) and similar accuracy (P > .05)., Conclusion: The DEQ -5 demonstrated adequate measurement precision and unidimensionality. Each of the four questionnaires showed psychometric validity for clinical use in the African population, and modest and similar accuracy when screening for dry eye signs but the performance of the McMonnies questionnaire was limited in terms of internal consistency reliability., (Copyright © 2021 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.)