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1. Urbanization, ethnicity and cardiovascular risk in a population in transition in Nakuru, Kenya: a population-based survey

Author

Foster Allen, Mathenge Wanjiku, and Kuper Hannah

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Cardiovascular disease (CVD) is the leading cause of death among older people in Africa. This study aimed to investigate the relationship of urbanization and ethnicity with CVD risk markers in Kenya. Methods A cross-sectional population-based survey was carried out in Nakuru Kenya in 2007-2008. 100 clusters of 50 people aged ≥50 years were selected by probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Participants were interviewed by nurses to collect socio-demographic and lifestyle information. Nurses measured blood pressure, height, weight and waist and hip circumference. A random finger-prick blood sample was taken to measure glucose and cholesterol levels. Hypertension was defined as systolic blood pressure (SBP) ≥140 mm Hg, or diastolic blood pressure (DBP) ≥90 mm Hg or current use of antihypertensive medication; Diabetes as reported current medication or diet control for diabetes or random blood glucose level ≥11.1 mmol/L; High cholesterol as random blood cholesterol level ≥5.2 mmol/L; and Obesity as Body Mass Index (BMI)≥30 kg/m2. Results 5010 eligible subjects were selected, of whom 4396 (88%) were examined. There was a high prevalence of hypertension (50.1%, 47.5-52.6%), obesity (13.0%, 11.7-14.5%), diabetes (6.6%, 5.6-7.7%) and high cholesterol (21.1%, 18.6-23.9). Hypertension, diabetes and obesity were more common in urban compared to rural groups and the elevated prevalence generally persisted after adjustment for socio-demographic, lifestyle, obesity and cardiovascular risk markers. There was also a higher prevalence of hypertension, obesity, diabetes and high cholesterol among Kikuyus compared to Kalenjins, even after multivariate adjustment. CVD risk markers were clustered both across the district and within individuals. Few people received treatment for hypertension (15%), while the majority of cases with diabetes received treatment (68%). Conclusions CVD risk markers are common in Kenya, particularly in urban areas. Exploring differences in CVD risk markers between ethnic groups may help to elucidate the epidemiology of these conditions.

Published
2010
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4. Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries

Author

Bron, Alain, Cheng, Ching-Yu, Fernandes, Arthur, Friedman, David, Gazzard, Andrew, Kahloun, Rim, Kempen, John, Khairallah, Moncef, Lansingh, Van C, Leasher, Janet, Leveziel, Nicolas, Limburg, Hans, Nowak, Michal, Pesudovs, Konrad, Peto, Tunde, Rossetti, Luca, Tahhan, Nina, Varma, Rohit, Alemayehu, Wondu, Arditi, Aries, Dana, Reza, Del Monte, Monte, Deva, jenny, Dreer, Laura, Ehrlich, Josh, Ellwein, Leon, Hammond, Billy, Hartnett, Mary E, Ingram, April, Khanna, Rohit, Kim, Judy, Lim, Jennifer, Morse, Alan, Musch, David, Parodi, Maurizio B, Ramulu, Pradeep, Robin, Alan, Serle, Janet, Shen, Tueng, Sitorus, Rita S, Stambolian, Dwight, Topouzis, Fotis, Tsilimbaris, Miltiadis, Virgili, Gianni, West, Sheila, Ababora, Jafer K, AlSawahli, Heba, Andriamanjato, Hery Harimanitra, Barrenechea, Rosario, Batlle, Juan F, Burnett, Anthea M, Finger, Robert P, Gallarreta, Marcelo, Gomez-Bastar, Pedro A, Gurung, Reeta, Jain, Elesh, Kabona, George E, Kalua, Khumbo, Kandeke, Levi, Karimurio, Jefitha, Kikira, Susan A, Kulkarni, Sucheta, Mathenge, Wanjiku, Mishra, Sailesh Kumar, Mohammadi, Seyed Farzad, Mörchen, Manfred, Muhammad, Nasiru, Mutati, Grace C, Nano, Maria Eugenia, Németh, János, Paduca, Ala, Páez, Alexander, Rabiu, M Mansur, Rif'ati, Lutfah, Salowi, Mohamad Aziz, Sapkota, Yuddha D, Sargent, Nicholas, Thoufeeq, Ubeydulla, Villalobos, Astrid V, Xiao, Biaxiang, Yee Melgar, Mariano, Zhang, Xiu Juan, Bourne, Rupert Richard Alexander, Cicinelli, Maria Vittoria, Sedighi, Tabassom, Tapply, Ian H, McCormick, Ian, Jonas, Jost B, Congdon, Nathan G, Ramke, Jacqueline, Naidoo, Kovin S, Fricke, Timothy R, Burton, Matthew J, Müller, Andreas, Bikbov, Mukharram M, Furtado, João M, Kyari, Fatima, He, Mingguang, Wang, Ya Xing, Vijaya, Lingam, Nangia, Vinay, Brian, Garry, Emamian, Mohammad Hassan, Fotouhi, Akbar, Hashemi, Hassan, Khandekar, Rajiv B, Marmamula, Srinivas, Salomão, Solange, George, Ronnie, Kazakbaeva, Gyulli, Braithwaite, Tasanee, Casson, Robert J, Iwase, Aiko, Gupta, Noopur, Abdianwall, Mohammad H, Wong, Tien Y, Wang, Ningli, Taylor, Hugh R, Flaxman, Seth R, Keel, Stuart, and Resnikoff, Serge

Published
2022
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5. Effective cataract surgical coverage in adults aged 50 years and older: estimates from population-based surveys in 55 countries

Author

Ababora, Jafer K, AlSawahli, Heba, Alvarado, Doris M, Andriamanjato, Hery Harimanitra, Ashraf Amalius, Ahmad, Barrenechea, Rosario, Batlle, Juan F, Brea, Ileana, Burnett, Anthea M, Chiriboga, Felipe A, Davaatseren, Uranchimeg, Duerksen, Rainald, Eusebio, Cristina I, Finger, Robert P, Gomez-Bastar, Pedro A, Gonzales, César, Gurung, Reeta, Hajar, Saad, Jadoon, Muhammad Zahid, Jain, Elesh, Kabona, George E, Kalua, Khumbo, Kandeke, Levi, Kandel, Ram P, Karimurio, Jefitha, Kulkarni, Sucheta, Lansingh, Van C, Lepcha, Nor T, Mathenge, Wanjiku, Mishra, Sailesh Kumar, Mohammadi, Seyed Farzad, Mörchen, Manfred, Muhammad, Nasiru, Musana, Paddy B, Mutati, Grace C, Nano, Maria Eugenia, Németh, János, Paduca, Ala, Páez, Alexander, Polack, Sarah, Rabiu, M Mansur, Rif'ati, Lutfah, Rodríguez Rodríguez, Beatriz Natividad, Salowi, Mohamad Aziz, Sapkota, Yuddha D, Sargent, Nicholas, Syumarti, Mansyur, Thoufeeq, Ubeydulla, Villalobos, Astrid V, Wachira, Joseph W, Wu, Min, Xiao, Biaxiang, Yee Melgar, Mariano, Zhang, Xiu Juan, McCormick, Ian, Butcher, Robert, Evans, Jennifer R, Mactaggart, Islay Z, Limburg, Hans, Jolley, Emma, Oye, Joseph Enyegue, Bastawrous, Andrew, Furtado, João M, Joshi, Anagha, Xiao, Baixiang, Ravilla, Thulasiraj D, Bourne, Rupert R A, Cieza, Alarcos, Keel, Stuart, Burton, Matthew J, and Ramke, Jacqueline

Published
2022
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6. Grand Challenges in global eye health: a global prioritisation process using Delphi method

Author

Aghaji, Ada, Adewole, Adeyemi T, Csutak, Adrienne, Salam, Ahmad Shah, Paduca, Ala, Bron, Alain M, Denniston, Alastair K, Lazo Legua, Alberto, Halim, Aldiana, Tefera, Alemayehu Woldeyes, Mwangi, Alice, Jenkins, Alicia J, Davis, Amanda, Meddeb-Ouertani, Amel, Wali, Amina H, Palis, Ana G, Bastos de Carvalho, Ana, Joshi, Anagha, Kreis, Andreas J, Mueller, Andreas, Bastawrous, Andrew, Cooper, Andrew, Smith, Andrew F, Grzybowski, Andrzej, Arvind, Anitha, Karanu, Anne M, Orlina, Anne O, Burnett, Anthea, Yashadhana, Aryati, Abeydeera, Asela P, Abdurakhmanova, Aselia, Mohamed, Ashik, Bacchav, Ashish, Bernhisel, Ashlie, Webson, Aubrey Walton, Azuara-Blanco, Augusto, Hossain, Ava, Ilhan, Bayazit, Assumpta Lucienne, Bella, Tousignant, Benoit, Shamanna, Bindiganavale R, Wiafe, Boateng, Mueller, Brigitte, Caglar, Cagatay, Mpyet, Caleb, Abraham, Carl H, Cheung, Carol Y, Thiel, Cassandra L, Jan, Catherine L, Emedike, Chike, Chuluunkhuu, Chimgee, Chinyere, Chinomso, Henein, Christin, Gilbert, Clare E, Bascaran, Covadonga, Nitulescu, Cristina Elena, Patel, Daksha, Bachani, Damodar, Kiage, Daniel, Etya'ale, Daniel, Dahdal, David, Woo Lawson, Dawn, Godin, Denise, Nkanga, Dennis G, Ondeyo, Dennis M, O'Brien, Donna, Mutie, Dorothy M, Alalawi, Ebtisam S K, Mayorga, Eduardo, Bin Hashim, Effendy, Ashrafi, Elham, Kishiki, Elizabeth Andrew, Kurian, Elizabeth, D'Esposito, Fabrizio, Masila, Faith, Pena, Fernando Yaacov, Büsch, Fortunat, Topouzis, Fotis, Bandello, Francesco, Oyediji, Funmilayo J, Thumann, Gabriele, Ezz Elarab, Gamal, Kitema, Gatera Fiston, Schlenther, Gerhard, Fefoame, Gertrude Oforiwa, Cochrane, Gillian M, Laganovska, Guna, Awan, Haroon R, Ansari, Harris M, Philippin, Heiko, Burn, Helen, Dimaras, Helen, Filipe, Helena P, Monye, Henrietta I, Kandel, Himal, Randrianarisoa, Hoby Lalaina, Jones, Iain, Murdoch, Ian E, Fabian, Ido Didi, Khan, Imran A, Sharma, Indra P, Elbeih, Islam, Mactaggart, Islay, Pastor, J Carlos, Keunen, Jan E E, Ohuma, Jane A, Pithuwa Nirwoth, Jason, Hammou, Jaouad, Vianna, Jayme R, Biao, Jean-eudes, Burr, Jennifer M, Keenan, Jeremy D, Blijkers, Jess, Black, Joanna M, Barbosa Breda, Joao, Furtado, Joao M, Buchan, John C, Lawrenson, John G, Kempen, John H, Ehrlich, Joshua R, Stern, Judith, Zhang, Justine H, Keskinbora, Kadircan H, Knoll, Karin M, Blanchet, Karl, Schmid, Katrina L, Ono, Koichi, Ogundimu, Kolawole, Balo, Komi, Somda, Kussome Paulin, Yeboah, Kwame, Amissah-Arthur, Kwesi N, Nasehi, Leone, Øverland, Lene, Vijaya, Lingam, Keay, Lisa, Hamm, Lisa M, Mowatt, Lizette, Harrison-Williams, Lloyd C M, Silva, Lucia, Bilotto, Luigi, Mörchen, Manfred, Rabiu, Mansur, Zondervan, Marcia, Chagunda, Margarida, Sandinha, Maria Teresa, Yee Melgar, Mariano, Salas Vargas, Marisela, Daniell, Mark D, Katibeh, Marzieh, Broom, Matt, Collins, Megan E, Alp, Mehmet Numan, Kwarteng, Michael A, Belkin, Michael, Gichangi, Michael, Sylvanowicz, Michelle, Wu, Min, Cano, Miriam R, Shalaby, Mohammad, Duggal, Mona, Khairallah, Moncef, Batur, Muhammed, Bikbov, Mukharram M, Ramappa, Muralidhar, Pamarathi, Nagaraju, Khachatryan, Naira, Muhammad, Nasiru, Kennedy, Neil, Murray, Neil, Beare, Nicholas A V, Astbury, Nick, Carnt, Nicole A, St Rose, Nigel A, Barker, Nigel H, Pehere, Niranjan K, Uche, Nkechinyere J, Lois, Noemi, Awe, Oluwaseun O, Mujica, Oscar J, Okolo, Oteri E, Rani, Padmaja Kumari, Ruamviboonsuk, Paisan, Ndiaye, Papa Amadou, Dhakhwa, Parami, Rozsival, Pavel, Mbulawa, Pearl K, Keane, Pearse A, Jones, Pete R, Holland, Peter, Nukella, Phanindra Babu, Burgess, Philip I, O'Dwyer, Pinar Aydin, Piyasena, Prabhath, Bastola, Pradeep, Morjaria, Priya, Nasimee, Qais, Rambacal, Raizza A T, Das, Rajdeep, Khandekar, Rajiv B, Azad, Rajvardhan, Bashshur, Ramona, Sousa, Raúl A R C, Oenga, Rebecca, Gurung, Reeta, Geneau, Robert, Jacobs, Robert J, Finger, Robert P, Guymer, Robyn H, Sevciuc, Rodica, Khanna, Rohit C, George, Ronnie, Graham, Ronnie, Kawasaki, Ryo, Ho, S May, Mishra, Sailesh Kumar, Buttan, Sandeep, Block, Sandra S, Talero, Sandra, Yoon, Sangchul, Joseph, Sanil, Safi, Sare, Dodson, Sarity, Munoz, Sergio R, Bakayoko, Seydou, Mohammadi, Seyed Farzad, Muez, Shabir Ahmad, Pardhan, Shahina, Hopkins, Shelley, Sheu, Shwu-Jiuan, Coulibaly, Sidi Mohamed, Schellini, Silvana A, Arunga, Simon, Bush, Simon R, Sivaprasad, Sobha, Salomao, Solange R, Marmamula, Srinivas, Onwubiko, Stella N, Misra, Stuti L, Kuyyadiyil, Subeesh, Kulkarni, Sucheta, khanal, Sudarshan, Yasmin, Sumrana, Pavljasevic, Suzana Nikolic, Gilbert, Suzanne S, Braithwaite, Tasanee, Ghidirimschi, Tatiana, Ravilla, Thulasiraj, Fricke, Timothy R, Cogliati, Tiziana, Kassa, Tsehaynesh, Peto, Tunde, Dibb, Ute, Lansingh, Van C, Hu, Victor H, Sheffield, Victoria M, Mathenge, Wanjiku, Dean, William H, Nolan, Winifred, Hiratsuka, Yoshimune, Mahsood, Yousaf Jamal, Sapkota, Yuddha, Ramke, Jacqueline, Evans, Jennifer R, Habtamu, Esmael, Mwangi, Nyawira, Silva, Juan Carlos, Swenor, Bonnielin K, Congdon, Nathan, Faal, Hannah B, Foster, Allen, Friedman, David S, Gichuhi, Stephen, Jonas, Jost B, Khaw, Peng T, Kyari, Fatima, Murthy, Gudlavalleti V S, Wang, Ningli, Wong, Tien Y, Wormald, Richard, Yusufu, Mayinuer, Taylor, Hugh, Resnikoff, Serge, West, Sheila K, and Burton, Matthew J

Published
2022
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7. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020

Author

Burton, Matthew J, Ramke, Jacqueline, Marques, Ana Patricia, Bourne, Rupert R A, Congdon, Nathan, Jones, Iain, Ah Tong, Brandon A M, Arunga, Simon, Bachani, Damodar, Bascaran, Covadonga, Bastawrous, Andrew, Blanchet, Karl, Braithwaite, Tasanee, Buchan, John C, Cairns, John, Cama, Anasaini, Chagunda, Margarida, Chuluunkhuu, Chimgee, Cooper, Andrew, Crofts-Lawrence, Jessica, Dean, William H, Denniston, Alastair K, Ehrlich, Joshua R, Emerson, Paul M, Evans, Jennifer R, Frick, Kevin D, Friedman, David S, Furtado, João M, Gichangi, Michael M, Gichuhi, Stephen, Gilbert, Suzanne S, Gurung, Reeta, Habtamu, Esmael, Holland, Peter, Jonas, Jost B, Keane, Pearse A, Keay, Lisa, Khanna, Rohit C, Khaw, Peng Tee, Kuper, Hannah, Kyari, Fatima, Lansingh, Van C, Mactaggart, Islay, Mafwiri, Milka M, Mathenge, Wanjiku, McCormick, Ian, Morjaria, Priya, Mowatt, Lizette, Muirhead, Debbie, Murthy, Gudlavalleti V S, Mwangi, Nyawira, Patel, Daksha B, Peto, Tunde, Qureshi, Babar M, Salomão, Solange R, Sarah, Virginia, Shilio, Bernadetha R, Solomon, Anthony W, Swenor, Bonnielin K, Taylor, Hugh R, Wang, Ningli, Webson, Aubrey, West, Sheila K, Wong, Tien Yin, Wormald, Richard, Yasmin, Sumrana, Yusufu, Mayinuer, Silva, Juan Carlos, Resnikoff, Serge, Ravilla, Thulasiraj, Gilbert, Clare E, Foster, Allen, and Faal, Hannah B

Published
2021
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9. Feasibility and acceptance of artificial intelligence-based diabetic retinopathy screening in Rwanda.

Author

Whitestone, Noelle, Nkurikiye, John, Patnaik, Jennifer L., Jaccard, Nicolas, Lanouette, Gabriella, Cherwek, David H., Congdon, Nathan, and Mathenge, Wanjiku

Abstract

Background Evidence on the practical application of artificial intelligence (AI)-based diabetic retinopathy (DR) screening is needed. Methods Consented participants were screened for DR using retinal imaging with AI interpretation from March 2021 to June 2021 at four diabetes clinics in Rwanda. Additionally, images were graded by a UK National Health System-certified retinal image grader. DR grades based on the International Classification of Diabetic Retinopathy with a grade of 2.0 or higher were considered referable. The AI system was designed to detect optic nerve and macular anomalies outside of DR. A vertical cup to disc ratio of 0.7 and higher and/or macular anomalies recognised at a cut-off of 60% and higher were also considered referable by AI. Results Among 827 participants (59.6% women (n=493)) screened by AI, 33.2% (n=275) were referred for follow-up. Satisfaction with AI screening was high (99.5%, n=823), and 63.7% of participants (n=527) preferred AI over human grading. Compared with human grading, the sensitivity of the AI for referable DR was 92% (95% CI 0.863%, 0.968%), with a specificity of 85% (95% CI 0.751%, 0.882%). Of the participants referred by AI: 88 (32.0%) were for DR only, 109 (39.6%) for DR and an anomaly, 65 (23.6%) for an anomaly only and 13 (4.73%) for other reasons. Adherence to referrals was highest for those referred for DR at 53.4%. Conclusion DR screening using AI led to accurate referrals from diabetes clinics in Rwanda and high rates of participant satisfaction, suggesting AI screening for DR is practical and acceptable. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Guidelines on Diabetic Eye Care: The International Council of Ophthalmology Recommendations for Screening, Follow-up, Referral, and Treatment Based on Resource Settings

Author

Wong, Tien Y., Sun, Jennifer, Kawasaki, Ryo, Ruamviboonsuk, Paisan, Gupta, Neeru, Lansingh, Van Charles, Maia, Mauricio, Mathenge, Wanjiku, Moreker, Sunil, Muqit, Mahi M.K., Resnikoff, Serge, Verdaguer, Juan, Zhao, Peiquan, Ferris, Frederick, Aiello, Lloyd P., and Taylor, Hugh R.

Published
2018
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14. Effective refractive error coverage in adults aged 50 years and older: estimates from population-based surveys in 61 countries

Author

Bourne, Rupert Richard Alexander, primary, Cicinelli, Maria Vittoria, additional, Sedighi, Tabassom, additional, Tapply, Ian H, additional, McCormick, Ian, additional, Jonas, Jost B, additional, Congdon, Nathan G, additional, Ramke, Jacqueline, additional, Naidoo, Kovin S, additional, Fricke, Timothy R, additional, Burton, Matthew J, additional, Müller, Andreas, additional, Bikbov, Mukharram M, additional, Furtado, João M, additional, Kyari, Fatima, additional, He, Mingguang, additional, Wang, Ya Xing, additional, Vijaya, Lingam, additional, Nangia, Vinay, additional, Brian, Garry, additional, Emamian, Mohammad Hassan, additional, Fotouhi, Akbar, additional, Hashemi, Hassan, additional, Khandekar, Rajiv B, additional, Marmamula, Srinivas, additional, Salomão, Solange, additional, George, Ronnie, additional, Kazakbaeva, Gyulli, additional, Braithwaite, Tasanee, additional, Casson, Robert J, additional, Iwase, Aiko, additional, Gupta, Noopur, additional, Abdianwall, Mohammad H, additional, Varma, Rohit, additional, Wong, Tien Y, additional, Wang, Ningli, additional, Taylor, Hugh R, additional, Flaxman, Seth R, additional, Keel, Stuart, additional, Resnikoff, Serge, additional, Bron, Alain, additional, Cheng, Ching-Yu, additional, Fernandes, Arthur, additional, Friedman, David, additional, Gazzard, Andrew, additional, Kahloun, Rim, additional, Kempen, John, additional, Khairallah, Moncef, additional, Lansingh, Van C, additional, Leasher, Janet, additional, Leveziel, Nicolas, additional, Limburg, Hans, additional, Nowak, Michal, additional, Pesudovs, Konrad, additional, Peto, Tunde, additional, Rossetti, Luca, additional, Tahhan, Nina, additional, Alemayehu, Wondu, additional, Arditi, Aries, additional, Dana, Reza, additional, Del Monte, Monte, additional, Deva, jenny, additional, Dreer, Laura, additional, Ehrlich, Josh, additional, Ellwein, Leon, additional, Hammond, Billy, additional, Hartnett, Mary E, additional, Ingram, April, additional, Khanna, Rohit, additional, Kim, Judy, additional, Lim, Jennifer, additional, Morse, Alan, additional, Musch, David, additional, Parodi, Maurizio B, additional, Ramulu, Pradeep, additional, Robin, Alan, additional, Serle, Janet, additional, Shen, Tueng, additional, Sitorus, Rita S, additional, Stambolian, Dwight, additional, Topouzis, Fotis, additional, Tsilimbaris, Miltiadis, additional, Virgili, Gianni, additional, West, Sheila, additional, Ababora, Jafer K, additional, AlSawahli, Heba, additional, Andriamanjato, Hery Harimanitra, additional, Barrenechea, Rosario, additional, Batlle, Juan F, additional, Burnett, Anthea M, additional, Finger, Robert P, additional, Gallarreta, Marcelo, additional, Gomez-Bastar, Pedro A, additional, Gurung, Reeta, additional, Jain, Elesh, additional, Kabona, George E, additional, Kalua, Khumbo, additional, Kandeke, Levi, additional, Karimurio, Jefitha, additional, Kikira, Susan A, additional, Kulkarni, Sucheta, additional, Mathenge, Wanjiku, additional, Mishra, Sailesh Kumar, additional, Mohammadi, Seyed Farzad, additional, Mörchen, Manfred, additional, Muhammad, Nasiru, additional, Mutati, Grace C, additional, Nano, Maria Eugenia, additional, Németh, János, additional, Paduca, Ala, additional, Páez, Alexander, additional, Rabiu, M Mansur, additional, Rif'ati, Lutfah, additional, Salowi, Mohamad Aziz, additional, Sapkota, Yuddha D, additional, Sargent, Nicholas, additional, Thoufeeq, Ubeydulla, additional, Villalobos, Astrid V, additional, Xiao, Biaxiang, additional, Yee Melgar, Mariano, additional, and Zhang, Xiu Juan, additional

Published
2022
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15. Effective cataract surgical coverage in adults aged 50 years and older: estimates from population-based surveys in 55 countries

Author

McCormick, Ian, primary, Butcher, Robert, additional, Evans, Jennifer R, additional, Mactaggart, Islay Z, additional, Limburg, Hans, additional, Jolley, Emma, additional, Sapkota, Yuddha D, additional, Oye, Joseph Enyegue, additional, Mishra, Sailesh Kumar, additional, Bastawrous, Andrew, additional, Furtado, João M, additional, Joshi, Anagha, additional, Xiao, Baixiang, additional, Ravilla, Thulasiraj D, additional, Bourne, Rupert R A, additional, Cieza, Alarcos, additional, Keel, Stuart, additional, Burton, Matthew J, additional, Ramke, Jacqueline, additional, Ababora, Jafer K, additional, AlSawahli, Heba, additional, Alvarado, Doris M, additional, Andriamanjato, Hery Harimanitra, additional, Ashraf Amalius, Ahmad, additional, Barrenechea, Rosario, additional, Batlle, Juan F, additional, Brea, Ileana, additional, Burnett, Anthea M, additional, Chiriboga, Felipe A, additional, Davaatseren, Uranchimeg, additional, Duerksen, Rainald, additional, Eusebio, Cristina I, additional, Finger, Robert P, additional, Gomez-Bastar, Pedro A, additional, Gonzales, César, additional, Gurung, Reeta, additional, Hajar, Saad, additional, Jadoon, Muhammad Zahid, additional, Jain, Elesh, additional, Kabona, George E, additional, Kalua, Khumbo, additional, Kandeke, Levi, additional, Kandel, Ram P, additional, Karimurio, Jefitha, additional, Kulkarni, Sucheta, additional, Lansingh, Van C, additional, Lepcha, Nor T, additional, Mathenge, Wanjiku, additional, Mohammadi, Seyed Farzad, additional, Mörchen, Manfred, additional, Muhammad, Nasiru, additional, Musana, Paddy B, additional, Mutati, Grace C, additional, Nano, Maria Eugenia, additional, Németh, János, additional, Paduca, Ala, additional, Páez, Alexander, additional, Polack, Sarah, additional, Rabiu, M Mansur, additional, Rif'ati, Lutfah, additional, Rodríguez Rodríguez, Beatriz Natividad, additional, Salowi, Mohamad Aziz, additional, Sargent, Nicholas, additional, Syumarti, Mansyur, additional, Thoufeeq, Ubeydulla, additional, Villalobos, Astrid V, additional, Wachira, Joseph W, additional, Wu, Min, additional, Xiao, Biaxiang, additional, Yee Melgar, Mariano, additional, and Zhang, Xiu Juan, additional

Published
2022
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16. Improving eye care in Rwanda

Author

Binagwaho, Agnes, Scott, Kirstin, Rosewall, Thomas, Mackenzie, Graeme, Rehnborg, Gweneth, Hannema, Sjoerd, Presente, Max, Mathenge, Wanjiku, Noe, Piet, Nkurikiye, John, Habiyaremye, Francois, and Dushime, Thophile

Subjects
Rwanda -- Health policy, Health
Abstract

Problem Visual Impairment affects nearly 285 million people worldwide. Although there has been much progress in combating the burden of visual impairment through initiatives such as VISION 2020, barriers to progress, especially in African countries, remain high. Approach The Rwandan Ministry of Health has formed partnerships with several nongovernmental organizations and has worked to integrate their efforts to prevent and treat visual impairment, including presbyopia. Local setting Rwanda, an eastern African country of approximately 11 million people. Relevant changes The Rwandan Ministry of Health developed a single national plan that allows key partners In vision care to coordinate more effectively in measuring eye disease, developing eye care infrastructure, building capacity, controlling disease, and delivering and evaluating services. Lessons learnt Collaboration between stakeholders under a single national plan has ensured that resources and efforts are complementary, optimizing the ability to provide eye care. Improved access to primary eye care and insurance coverage has increased demand for services at secondary and tertiary levels. A comprehensive strategy that includes prevention as well as a supply chain for glasses and lenses is needed. [TEXT NOT REPRODUCIBLE IN ASCII] [TEXT NOT REPRODUCIBLE IN ASCII] Probleme Pres de 285 millions de personnes dans le monde presentent des deficiences visuelles. Bien que les efforts pour reduire la charge qu'elles representent aient beaucoup progresse, grce a des initiatives telles que VISION 2020, les obstacles au progres, en particulier dans les pays d'Afrique, restent importants. Approche Le Ministere de la Sante rwandais a etabli des partenariats avec plusieurs organisations non gouvernementales en tchant d'integrer leurs efforts pour prevenir et traiter les deficiences visuelles, notamment la presbytie. Environnement local Le Rwanda, un pays d'Afrique de l'Est comptant environ 11 millions d'habitants. Changements significatifs Le Ministere de la Sante rwandais a mis en place un plan national qui permet une coordination plus efficace entre les partenaires cles de l'ophtalmologie, pour depister les maladies des yeux, developper des infrastructures de prise en charge des affections oculaires, renforcer les capacites, controler les maladies, fournir des services et evaluer ces derniers. Lecons tirees La collaboration entre les differents acteurs, dans le cadre d'un plan national unique,.a permis d'assurer la complementarite des ressources et des efforts et d'optimiser les capacites de prise en charge des affections oculaires. L'amelioration de l'acces aux soins oculaires de base ainsi qu'aux assurances a intensifie la demande de services aux niveaux secondaire et tertiaire. Une strategie globale de prevention et d'acquisition de lunettes ct de lentilles est maintenant necessaire. [TEXT NOT REPRODUCIBLE IN ASCII] Situacion La discapacidad visual afecta aproximadamente a 285 millones de personas en todo el mundo. Si bien se han hecho muchos avances en la lucha contra la carga de la discapacidad visual mediante iniciativas como el programa VISION 2020, las barreras hacia el progreso siguen siendo altas, especialmente en los paises de Africa. Enfoque El Ministerio de Salud de Rwanda ha establecido colaboraciones con varias organizaciones no gubernamentales y ha trabajado para integrar sus esfuerzos para prevenir y tratar la discapacidad visual, incluida la presbicia. Marco regional Rwanda, un pais del Africa oriental con aproximadamente 11 millones de habitantes. Cambios importantes El Ministerio de Salud de Rwanda desarrollo un unico plan nacional que permite a los colaboradores clave que trabajan en la atencion oftalmica coordinar de una manera mas efectiva la medicion de las enfermedades oculares, el desarrollo de una infraestructura para la atencion oftalmica, la generacion de capacidades, el control de las enfermedades y la prestacion y evaluacion de servicios. Lecciones aprendidas La colaboracion entre las partes interesadas bajo un unico plan nacional ha garantizado que los recursos y esfuerzos sean complementarios, optimizando la capacidad de proporcionar servicios de atencion oftalmica. La mejora del acceso a la atencion oftalmica primaria y la cobertura del seguro ha incrementado la demanda de servicios a nivel secundario y terciario. Se necesita una estrategia exhaustiva que incluya la prevencion y una cadena de suministro de gafas y lentes., Ameliorer les soins oculaires au Rwanda Mejorar la atencion oftalmica en Rwanda Introduction Visual impairment--both preventable and treatable--affects an estimated 285 million people globally. Most of the people affected (87%) [...]

Published
2015
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18. Grand Challenges in global eye health: a global prioritisation process using Delphi method

Author

Ramke, Jacqueline, primary, Evans, Jennifer R, additional, Habtamu, Esmael, additional, Mwangi, Nyawira, additional, Silva, Juan Carlos, additional, Swenor, Bonnielin K, additional, Congdon, Nathan, additional, Faal, Hannah B, additional, Foster, Allen, additional, Friedman, David S, additional, Gichuhi, Stephen, additional, Jonas, Jost B, additional, Khaw, Peng T, additional, Kyari, Fatima, additional, Murthy, Gudlavalleti V S, additional, Wang, Ningli, additional, Wong, Tien Y, additional, Wormald, Richard, additional, Yusufu, Mayinuer, additional, Taylor, Hugh, additional, Resnikoff, Serge, additional, West, Sheila K, additional, Burton, Matthew J, additional, Aghaji, Ada, additional, Adewole, Adeyemi T, additional, Csutak, Adrienne, additional, Salam, Ahmad Shah, additional, Paduca, Ala, additional, Bron, Alain M, additional, Denniston, Alastair K, additional, Lazo Legua, Alberto, additional, Halim, Aldiana, additional, Tefera, Alemayehu Woldeyes, additional, Mwangi, Alice, additional, Jenkins, Alicia J, additional, Davis, Amanda, additional, Meddeb-Ouertani, Amel, additional, Wali, Amina H, additional, Palis, Ana G, additional, Bastos de Carvalho, Ana, additional, Joshi, Anagha, additional, Kreis, Andreas J, additional, Mueller, Andreas, additional, Bastawrous, Andrew, additional, Cooper, Andrew, additional, Smith, Andrew F, additional, Grzybowski, Andrzej, additional, Arvind, Anitha, additional, Karanu, Anne M, additional, Orlina, Anne O, additional, Burnett, Anthea, additional, Yashadhana, Aryati, additional, Abeydeera, Asela P, additional, Abdurakhmanova, Aselia, additional, Mohamed, Ashik, additional, Bacchav, Ashish, additional, Bernhisel, Ashlie, additional, Webson, Aubrey Walton, additional, Azuara-Blanco, Augusto, additional, Hossain, Ava, additional, Ilhan, Bayazit, additional, Assumpta Lucienne, Bella, additional, Tousignant, Benoit, additional, Shamanna, Bindiganavale R, additional, Wiafe, Boateng, additional, Mueller, Brigitte, additional, Caglar, Cagatay, additional, Mpyet, Caleb, additional, Abraham, Carl H, additional, Cheung, Carol Y, additional, Thiel, Cassandra L, additional, Jan, Catherine L, additional, Emedike, Chike, additional, Chuluunkhuu, Chimgee, additional, Chinyere, Chinomso, additional, Henein, Christin, additional, Gilbert, Clare E, additional, Bascaran, Covadonga, additional, Nitulescu, Cristina Elena, additional, Patel, Daksha, additional, Bachani, Damodar, additional, Kiage, Daniel, additional, Etya'ale, Daniel, additional, Dahdal, David, additional, Woo Lawson, Dawn, additional, Godin, Denise, additional, Nkanga, Dennis G, additional, Ondeyo, Dennis M, additional, O'Brien, Donna, additional, Mutie, Dorothy M, additional, Alalawi, Ebtisam S K, additional, Mayorga, Eduardo, additional, Bin Hashim, Effendy, additional, Ashrafi, Elham, additional, Kishiki, Elizabeth Andrew, additional, Kurian, Elizabeth, additional, D'Esposito, Fabrizio, additional, Masila, Faith, additional, Pena, Fernando Yaacov, additional, Büsch, Fortunat, additional, Topouzis, Fotis, additional, Bandello, Francesco, additional, Oyediji, Funmilayo J, additional, Thumann, Gabriele, additional, Ezz Elarab, Gamal, additional, Kitema, Gatera Fiston, additional, Schlenther, Gerhard, additional, Fefoame, Gertrude Oforiwa, additional, Cochrane, Gillian M, additional, Laganovska, Guna, additional, Awan, Haroon R, additional, Ansari, Harris M, additional, Philippin, Heiko, additional, Burn, Helen, additional, Dimaras, Helen, additional, Filipe, Helena P, additional, Monye, Henrietta I, additional, Kandel, Himal, additional, Randrianarisoa, Hoby Lalaina, additional, Jones, Iain, additional, Murdoch, Ian E, additional, Fabian, Ido Didi, additional, Khan, Imran A, additional, Sharma, Indra P, additional, Elbeih, Islam, additional, Mactaggart, Islay, additional, Pastor, J Carlos, additional, Keunen, Jan E E, additional, Ohuma, Jane A, additional, Pithuwa Nirwoth, Jason, additional, Hammou, Jaouad, additional, Vianna, Jayme R, additional, Biao, Jean-eudes, additional, Burr, Jennifer M, additional, Keenan, Jeremy D, additional, Blijkers, Jess, additional, Black, Joanna M, additional, Barbosa Breda, Joao, additional, Furtado, Joao M, additional, Buchan, John C, additional, Lawrenson, John G, additional, Kempen, John H, additional, Ehrlich, Joshua R, additional, Stern, Judith, additional, Zhang, Justine H, additional, Keskinbora, Kadircan H, additional, Knoll, Karin M, additional, Blanchet, Karl, additional, Schmid, Katrina L, additional, Ono, Koichi, additional, Ogundimu, Kolawole, additional, Balo, Komi, additional, Somda, Kussome Paulin, additional, Yeboah, Kwame, additional, Amissah-Arthur, Kwesi N, additional, Nasehi, Leone, additional, Øverland, Lene, additional, Vijaya, Lingam, additional, Keay, Lisa, additional, Hamm, Lisa M, additional, Mowatt, Lizette, additional, Harrison-Williams, Lloyd C M, additional, Silva, Lucia, additional, Bilotto, Luigi, additional, Mörchen, Manfred, additional, Rabiu, Mansur, additional, Zondervan, Marcia, additional, Chagunda, Margarida, additional, Sandinha, Maria Teresa, additional, Yee Melgar, Mariano, additional, Salas Vargas, Marisela, additional, Daniell, Mark D, additional, Katibeh, Marzieh, additional, Broom, Matt, additional, Collins, Megan E, additional, Alp, Mehmet Numan, additional, Kwarteng, Michael A, additional, Belkin, Michael, additional, Gichangi, Michael, additional, Sylvanowicz, Michelle, additional, Wu, Min, additional, Cano, Miriam R, additional, Shalaby, Mohammad, additional, Duggal, Mona, additional, Khairallah, Moncef, additional, Batur, Muhammed, additional, Bikbov, Mukharram M, additional, Ramappa, Muralidhar, additional, Pamarathi, Nagaraju, additional, Khachatryan, Naira, additional, Muhammad, Nasiru, additional, Kennedy, Neil, additional, Murray, Neil, additional, Beare, Nicholas A V, additional, Astbury, Nick, additional, Carnt, Nicole A, additional, St Rose, Nigel A, additional, Barker, Nigel H, additional, Pehere, Niranjan K, additional, Uche, Nkechinyere J, additional, Lois, Noemi, additional, Awe, Oluwaseun O, additional, Mujica, Oscar J, additional, Okolo, Oteri E, additional, Rani, Padmaja Kumari, additional, Ruamviboonsuk, Paisan, additional, Ndiaye, Papa Amadou, additional, Dhakhwa, Parami, additional, Rozsival, Pavel, additional, Mbulawa, Pearl K, additional, Keane, Pearse A, additional, Jones, Pete R, additional, Holland, Peter, additional, Nukella, Phanindra Babu, additional, Burgess, Philip I, additional, O'Dwyer, Pinar Aydin, additional, Piyasena, Prabhath, additional, Bastola, Pradeep, additional, Morjaria, Priya, additional, Nasimee, Qais, additional, Rambacal, Raizza A T, additional, Das, Rajdeep, additional, Khandekar, Rajiv B, additional, Azad, Rajvardhan, additional, Bashshur, Ramona, additional, Sousa, Raúl A R C, additional, Oenga, Rebecca, additional, Gurung, Reeta, additional, Geneau, Robert, additional, Jacobs, Robert J, additional, Finger, Robert P, additional, Guymer, Robyn H, additional, Sevciuc, Rodica, additional, Khanna, Rohit C, additional, George, Ronnie, additional, Graham, Ronnie, additional, Kawasaki, Ryo, additional, Ho, S May, additional, Mishra, Sailesh Kumar, additional, Buttan, Sandeep, additional, Block, Sandra S, additional, Talero, Sandra, additional, Yoon, Sangchul, additional, Joseph, Sanil, additional, Safi, Sare, additional, Dodson, Sarity, additional, Munoz, Sergio R, additional, Bakayoko, Seydou, additional, Mohammadi, Seyed Farzad, additional, Muez, Shabir Ahmad, additional, Pardhan, Shahina, additional, Hopkins, Shelley, additional, Sheu, Shwu-Jiuan, additional, Coulibaly, Sidi Mohamed, additional, Schellini, Silvana A, additional, Arunga, Simon, additional, Bush, Simon R, additional, Sivaprasad, Sobha, additional, Salomao, Solange R, additional, Marmamula, Srinivas, additional, Onwubiko, Stella N, additional, Misra, Stuti L, additional, Kuyyadiyil, Subeesh, additional, Kulkarni, Sucheta, additional, khanal, Sudarshan, additional, Yasmin, Sumrana, additional, Pavljasevic, Suzana Nikolic, additional, Gilbert, Suzanne S, additional, Braithwaite, Tasanee, additional, Ghidirimschi, Tatiana, additional, Ravilla, Thulasiraj, additional, Fricke, Timothy R, additional, Cogliati, Tiziana, additional, Kassa, Tsehaynesh, additional, Peto, Tunde, additional, Dibb, Ute, additional, Lansingh, Van C, additional, Hu, Victor H, additional, Sheffield, Victoria M, additional, Mathenge, Wanjiku, additional, Dean, William H, additional, Nolan, Winifred, additional, Hiratsuka, Yoshimune, additional, Mahsood, Yousaf Jamal, additional, and Sapkota, Yuddha, additional

Published
2022
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19. Keeping an eye on eye care: monitoring progress towards effective coverage

Author

Keel, Stuart, Müller, Andreas, Block, Sandra, Bourne, Rupert R. A., Burton, Matthew J., Chatterji, Somnath, He, Mingguang, Lansingh, Van C., Mathenge, Wanjiku, Mariotti, Silvio, Muirhead, Debbie, Rabiu, M. Mansur, Ravilla, Thulasiraj D, Resnikoff, Serge, Silva, Juan C., Tapply, Ian, Vos, Theo, Wang, Ningli, and Cieza, Alarcos

Abstract

The eye care sector is well positioned to contribute to the advancement of universal health coverage within countries. Given the large unmet need for care associated with cataract and refractive error, coupled with the fact that highly cost-effective interventions exist, we propose that effective cataract surgery coverage (eCSC) and effective refractive error coverage (eREC) serve as ideal indicators to track progress in the uptake and quality of eye care services at the global level, and to monitor progress towards universal health coverage in general. Global targets for 2030 for these two indicators were endorsed by WHO Member States at the 74th World Health Assembly in May, 2021. To develop consensus on the data requirements and methods of calculating eCSC and eREC, WHO convened a series of expert consultations to make recommendations for standardising the definitions and measurement approaches for eCSC and eREC and to identify areas in which future work is required.

Published
2021

20. Toward Universal Eye Health Coverage-Key Outcomes of the World Health Organization Package of Eye Care Interventions: A Systematic Review.

Author

Keel, Stuart, Lingham, Gareth, Misra, Neha, Block, Sandra, Bourne, Rupert, Calonge, Margarita, Cheng, Ching-Yu, Friedman, David S., Furtado, João M., Khanna, Rohit, Mariotti, Silvio, Mathenge, Wanjiku, Matoto, Elenoa, Müeller, Andreas, Rabiu, Mansur, Rasengane, Tuwani, Resnikoff, Serge, Wormald, Richard, Yasmin, Sumrana, and Zhao, Jialiang

Published
2022
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24. A case-control study to assess the relationship between poverty and visual impairment from cataract in Kenya, the Philippines, and Bangladesh

Author

Kuper, Hannah, Polack, Sarah, Eusebio, Cristina, Mathenge, Wanjiku, Wadud, Zakia, and Foster, Allen

Subjects
Poverty -- Philippines -- Kenya -- Bangladesh -- Influence, Vision disorders -- Diagnosis -- Demographic aspects -- Care and treatment -- Surveys, Cataract -- Surgery, Biological sciences
Abstract

Background The link between poverty and health is central to the Millennium Development Goals (MDGs). Poverty can be both a cause and consequence of poor health, but there are few epidemiological studies exploring this complex relationship. The aim of this study was to examine the association between visual impairment from cataract and poverty in adults in Kenya, Bangladesh, and the Philippines. Methods and Findings A population-based case-control study was conducted in three countries during 2005-2006. Cases were persons aged 50 y or older and visually impaired due to cataract (visual acuity < 6/ 24 in the better eye). Controls were persons age- and sex-matched to the case participants with normal vision selected from the same cluster. Household expenditure was assessed through the collection of detailed consumption data, and asset ownership and self-rated wealth were also measured. In total, 596 cases and 535 controls were included in these analyses (Kenya 142 cases, 75 controls; Bangladesh 216 cases, 279 controls; Philippines 238 cases, 180 controls). Case participants were more likely to be in the lowest quartile of per capita expenditure (PCE) compared to controls in Kenya (odds ratio = 2.3, 95% confidence interval 0.9-5.5), Bangladesh (1.9, 1.1-3.2), and the Philippines (3.1, 1.7-5.7), and there was significant dose-response relationship across quartiles of PCE. These associations persisted after adjustment for self-rated health and social support indicators. A similar pattern was observed for the relationship between cataract visual impairment with asset ownership and self-rated wealth. There was no consistent pattern of association between PCE and level of visual impairment due to cataract, sex, or age among the three countries. Conclusions Our data show that people with visual impairment due to cataract were poorer than those with normal sight in all three low-income countries studied. The MDGs are committed to the eradication of extreme poverty and provision of health care to poor people, and this study highlights the need for increased provision of cataract surgery to poor people, as they are particularly vulnerable to visual impairment from cataract., Introduction Improvements in health are at the heart of the Millennium Development Goals, with the recognition that better health is central to the primary aim of reducing poverty as well [...]

Published
2008

25. Strengthening the integration of eye care into the health system: methodology for the development of the WHO package of eye care interventions

Author

Keel, Stuart, Evans, Jennifer R, Block, Sandra, Bourne, Rupert, Calonge, Margarita, Cheng, Ching-Yu, Friedman, David S, Furtado, João M, Khanna, Rohit C, Mathenge, Wanjiku, Mariotti, Silvio, Matoto, Elenoa, Müller, Andreas, Rabiu, M Mansur, Rasengane, Tuwani, Zhao, Jialang, Wormald, Richard, Cieza, Alarcos, Keel, Stuart [0000-0001-6756-348X], and Apollo - University of Cambridge Repository

Subjects
genetic structures, Original research, public health, eye diseases
Abstract

Objective:\ud To describe the rational for, and the methods that will be employed to develop, the WHO package of eye care interventions (PECI).\ud Methods and analysis:\ud The development of the package will be conducted in four steps: (1) selection of eye conditions (for which interventions will be included in the package) based on epidemiological data on the causes of vision impairment and blindness, prevalence estimates of eye conditions and health facility data; (2) identification of interventions and related evidence for the selected eye conditions from clinical practice guidelines and high-quality systematic reviews by a technical working group; (3) expert agreement on the inclusion of eye care interventions in the package and the description of resources required for the provision of the selected interventions; and (4) peer review. The project will be led by the WHO Vision Programme in collaboration with Cochrane Eyes and Vision. A Technical Advisory Group, comprised of public health and clinical experts in the field, will provide technical input throughout all stages of development.\ud Results:\ud After considering the feedback of Technical Advisory Group members and reviewing-related evidence, a final list of eye conditions for which interventions will be included in the package has been collated.\ud Conclusion:\ud The PECI will support Ministries of Health in prioritising, planning, budgeting and integrating eye care interventions into health systems. It is anticipated that the PECI will be available for use in 2021.

Published
2020
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27. Rapid assessment of avoidable blindness in Western Rwanda: blindness in a postconflict setting

Author

Mathenge, Wanjiku, Nkurikiye, John, Limburg, Hans, and Kuper, Hannah

Subjects
World Health Organization -- Reports, Blindness -- Statistics, Blindness -- Causes of, Blindness -- Demographic aspects
Abstract

Background The World Health Organization estimates that there were 37 million blind people in 2002 and that the prevalence of blindness was 9% among adults in Africa aged 50 years [...]

Published
2007

35. Incidence of Visually Impairing Cataracts Among Older Adults in Kenya

Author

Bastawrous, Andrew, Mathenge, Wanjiku, Nkurikiye, John, Wing, Kevin, Rono, Hillary, Gichangi, Michael, Weiss, Helen A, Macleod, David, Foster, Allen, Burton, Matthew, and Kuper, Hannah

Subjects
Aged, 80 and over, Male, genetic structures, Research, Incidence, Vision Disorders, Cataract Extraction, Middle Aged, Blindness, Kenya, eye diseases, Cataract, Online Only, Ophthalmology, Age Distribution, Risk Factors, Prevalence, Humans, Female, sense organs, Visually Impaired Persons, Original Investigation, Aged
Abstract

Key Points Question How many new people per year become visually impaired from cataract in Kenya? Findings In this secondary analysis of the Nakuru Eye Disease Cohort Study of 4364 participants at baseline and 2159 participants at follow-up, the 6-year cumulative incidence of visually significant cataract in either eye was 251.9 per 1000, with the incidence increasing with age among those aged 50 to 59 years and those 80 years or older. Meaning In Kenya, reducing the burden of sight loss from cataract is a national priority, given its high incidence among older adults; the cataract surgical rate needs to be at the level of the incident rate to prevent the prevalence of blindness and visual impairment from increasing., Importance Half of all the cases of blindness worldwide are associated with cataract. Cataract disproportionately affects people living in low- and middle-income countries and persons of African descent. Objective To estimate the 6-year cumulative incidence of visually impairing cataract in adult participants in the Nakuru Eye Disease Cohort Study in Kenya. Design, Setting, and Participants This secondary analysis of the Nakuru Eye Disease Cohort Study was conducted from February 2016 to April 2016. This cohort comprised citizens of Nakuru, Kenya, aged 50 years or older who consented to participate in the initial or baseline survey from January 2007 to November 2008, as well as the follow-up conducted from January 2013 to March 2014. All participants at baseline (n = 4364) and follow-up (n = 2159) underwent ophthalmic examination. Main Outcomes and Measures Six-year cumulative incidence of visually impairing cataract, risk factors of incidence, population estimates, and required cataract surgical rates to manage incident visually impairing cataract. Results In total, 4364 individuals (with a mean [SD] age of 63.4 [10.5] years and with 2275 women [52.1%]) had complete eye examinations at baseline, and 2159 participants (with a mean [SD] age of 62.5 [9.3] years and with 1140 men [52.8%]) were followed up 6 years later. The 6-year cumulative incidence of visually significant cataract in either eye was 251.9 per 1000 (95% CI, 228.5-276.8), with an increase with age from 128.9 (95% CI, 107.9-153.2) per 1000 for the group aged 50 to 59 years to 624.5 (95% CI, 493.1-739.9) per 1000 for the group aged 80 years or older. This equated to an annual incidence of visually significant cataract of 45.0 per 1000 people aged 50 years or older. Multivariable analysis showed alcohol consumption (risk ratio [RR], 1.4; 95% CI, 1.1-1.8), diabetes (RR, 1.7; 95% CI, 1.3-2.3), educational level, and increasing age (RR, 3.8; 95% CI, 2.6-5.5 for those aged ≥80 years) were associated with incident visually impairing cataract. Extrapolations to all people aged 50 years or older in Kenya indicated that 148 280 (95% CI, 134 510-162 950) individuals might develop new visually impairing cataract in either eye (visual acuity, This secondary analysis of the Nakura Eye Disease Cohort Study estimates the 6-year cumulative incidence of visually impairing cataracts among older adults in Kenya.

Published
2019
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37. Glaucoma Features in an East African Population: A 6-Year Cohort Study of Older Adults in Nakuru, Kenya

Author

Bastawrous, Andrew, Mathenge, Wanjiku, Buchan, John, Kyari, Fatima, Peto, Tunde, Rono, Hillary, Weiss, Helen A, Macleod, David, Foster, Allen, Burton, Matthew J, and Kuper, Hannah

Subjects
genetic structures, sense organs, eye diseases
Abstract

PURPOSE: Glaucoma is a leading cause of blindness in people of African descent. Minimal data is available from African population-based cohort studies. The primary aims of this study were to describe the normative distribution of glaucoma features to enable glaucoma classification and to assess risk factors for those with glaucoma at follow-up among people aged 50 years and above in Kenya. MATERIALS AND METHODS: Random cluster sampling with probability proportionate to size was used to select a representative cross-sectional sample of adults aged 50 years and above in 2007 to 2008 in Nakuru District, Kenya. A 6-year follow-up was undertaken in 2013 to 2014. Comprehensive ophthalmic examination included visual acuity, digital retinal photography, visual fields, intraocular pressure, optical coherence tomography, and independent grading of optic nerve images. We report glaucoma features, prevalence and predictors for glaucoma based on the International Society for Geographical & Epidemiological Ophthalmology (ISGEO) criteria. Measures were estimated using a Poisson regression model and including inverse-probability weighting for loss to follow-up. RESULTS: At baseline, 4414 participants aged 50 years and above underwent examination. Anterior chamber optical coherence tomography findings: mean anterior chamber angle of 36.6 degrees, mean central corneal thickness of 508.1 μm and a mean anterior chamber depth of 2.67 mm. A total of 2171 participants were examined at follow-up. The vertical cup to disc ratio distribution was 0.7 and 0.8 at the 97.5th and 99.5th percentiles, respectively. A total of 88 (4.3%, 95% confidence interval, 3.5%-5.9%) of participants at follow-up had glaucoma consistent with ISGEO criteria. A relative afferent pupillary defect and raised intraocular pressure were associated with the diagnosis. CONCLUSIONS: Glaucoma is a public health challenge in low-resource settings. Research into testing and treatment modalities in Africa is needed.

Published
2018

38. Cataract surgery in patients with complex conditions

Author

Mathenge, Wanjiku

Subjects
surgery, Editorial, genetic structures, lcsh:Ophthalmology, lcsh:RE1-994, fungi, food and beverages, eye diseases, Cataract
Abstract

Cataract surgery is not always straightforward, but with careful planning by the surgical team, patients with complex conditions can still have a successful outcome.

Published
2019

39. Mortality during 6 years of follow-up in relation to visual impairment and eye disease: results from a population-based cohort study of people aged 50 years and above in Nakuru, Kenya

Author

Kuper, Hannah, primary, Mathenge, Wanjiku, additional, Macleod, David, additional, Foster, Allen, additional, Gichangi, Michael, additional, Rono, Hillary, additional, Wing, Kevin, additional, Weiss, Helen Anne, additional, Bastawrous, Andrew, additional, and Burton, Matthew, additional

Published
2019
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41. Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study

Author

Bastawrous, Andrew, Mathenge, Wanjiku, Wing, Kevin, Rono, Hillary, Gichangi, Michael, Weiss, Helen A., Macleod, David, Foster, Allen, Burton, Matthew J., and Kuper, Hannah

Subjects
Adult, Male, Clinical and Epidemiologic Research, Incidence, Cohort, visual impairment, Vision, Low, cohort, Population-based, Visual impairment, Middle Aged, Blindness, Kenya, population-based, Cohort Studies, Age Distribution, Risk Factors, Africa, Humans, Female, Sex Distribution, Visually Impaired Persons, Aged
Abstract

PURPOSE. To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ≥50 years, enrolled in 2007–2008. Of these, 2170 (50%) were reexamined in 2013–2014. METHODS. The World Health Organization (WHO) and US definitions were used to calculate presenting visual acuity classifications based on logMAR visual acuity tests at baseline and follow-up. Detailed ophthalmic and anthropometric examinations as well as a questionnaire, which included past medical and ophthalmic history, were used to assess risk factors for study participation and vision loss. Cumulative incidence of VI and blindness, and factors associated with these outcomes, were estimated. Inverse probability weighting was used to adjust for nonparticipation. RESULTS. Visual acuity measurements were available for 2164 (99.7%) participants. Using WHO definitions, the 6-year cumulative incidence of VI was 11.9% (95%CI [confidence interval]: 10.3–13.8%) and blindness was 1.51% (95%CI: 1.0–2.2%); using the US classification, the cumulative incidence of blindness was 2.70% (95%CI: 1.8–3.2%). Incidence of VI increased strongly with older age, and independently with being diabetic. There are an estimated 21 new cases of VI per year in people aged ≥50 years per 1000 people, of whom 3 are blind. Therefore in Kenya we estimate that there are 92,000 new cases of VI in people aged ≥50 years per year, of whom 11,600 are blind, out of a total population of approximately 4.3 million people aged 50 and above. CONCLUSIONS. The incidence of VI and blindness in this older Kenyan population was considerably higher than in comparable studies worldwide. A continued effort to strengthen the eye health system is necessary to support the growing unmet need in an aging and growing population.

Published
2016
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42. Prevalence of age-related macular degeneration in Nakuru, Kenya: a cross-sectional population-based study

Author

Mathenge, Wanjiku, Bastawrous, Andrew, Peto, Tunde, Leung, Irene, Foster, Allen, and Kuper, Hannah

Subjects
Population biology -- Research, Prevalence studies (Epidemiology) -- Research, Macular degeneration -- Physiological aspects, Social medicine -- Research, Biological sciences
Abstract

Background: Diseases of the posterior segment of the eye, including age-related macular degeneration (AMD), have recently been recognised as the leading or second leading cause of blindness in several African countries. However, prevalence of AMD alone has not been assessed. We hypothesized that AMD is an important cause of visual impairment among elderly people in Nakuru, Kenya, and therefore sought to assess the prevalence and predictors of AMD in a diverse adult Kenyan population. Methods and Findings: In a population-based cross-sectional survey in the Nakuru District of Kenya, 100 clusters of 50 people 50 y of age or older were selected by probability-proportional-to-size sampling between 26 January 2007 and 11 November 2008. Households within clusters were selected through compact segment sampling. All participants underwent a standardised interview and comprehensive eye examination, including dilated slit lamp examination by an ophthalmologist and digital retinal photography. Images were graded for the presence and severity of AMD lesions following a modified version of the International Classification and Grading System for Age-Related Maculopathy. Comparison was made between slit lamp biomicroscopy (SLB) and photographic grading. Of 4,381 participants, fundus photographs were gradable for 3,304 persons (75.4%), and SLB was completed for 4,312 (98%). Early and late AMD prevalence were 11.2% and 1.2%, respectively, among participants graded on images. Prevalence of AMD by SLB was 6.7% and 0.7% for early and late AMD, respectively. SLB underdiagnosed AMD relative to photographic grading by a factor of 1.7. After controlling forage, women had a higher prevalence of early AMD than men (odds ratio 1.5;95% CI, 1.2-1.9). Overall prevalence rose significantly with each decade of age. We estimate that,inKenya,283,900 to 362,800 people 50 y and older have early AMD and 25,200 to 50,500 have late AMD, based on population estimates in 2007. Conclusions: AMD is an important cause of visual impairment and blindness in Kenya. Greater availability of low vision services and ophthalmologist training in diagnosis and treatment of AMD would be appropriate next steps., Introduction In the latest estimates of global blindness and visual impairment undertaken by the World Health Organization, in 2010, age-related macular degeneration (AMD) is the third most common cause of [...]

Published
2013
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44. Emergency management: exposure keratopathy

Author

Mathenge, Wanjiku

Subjects
Cornea, keratopathy, Eye Emergencies, lcsh:Ophthalmology, lcsh:RE1-994, fungi, food and beverages, sense organs, eye diseases
Abstract

Exposure keratopathy can result in destruction of the cornea and blindness if not treated urgently.

Published
2018

47. The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people age 50 years and over in Nakuru, Kenya

Author

Bastawrous, Andrew, primary, Mathenge, Wanjiku, additional, Wing, Kevin, additional, Bastawrous, Madeleine, additional, Rono, Hillary, additional, Weiss, Helen A., additional, Macleod, David, additional, Foster, Allen, additional, Peto, Tunde, additional, Blows, Peter, additional, Burton, Matthew, additional, and Kuper, Hannah, additional

Published
2017
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48. Keeping my professional development continuous

Author

Mathenge, Wanjiku

Subjects
ophthalmology, Case Study, lcsh:Ophthalmology, lcsh:RE1-994, cpd
Abstract

Keeping up professionally means knowing what is current and then selecting what is applicable to your work. This requires a personal commitment to recognise the need, find the time and seek resources. The process is lifelong and can become part of your routine.

Published
2017

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