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PurposeTo determine the prevalence and causes of blindness and visual impairment among adults in Kogi, Nigeria.MethodsA Rapid assessment of avoidable blindness (RAAB) protocol was used with additional tools measuring disability and household wealth to measure the prevalence of blindness and visual impairment (VI) and associations with sex, disability, wealth, cataract surgical coverage and its effectiveness.ResultsAge- and sex-adjusted all-cause prevalence of bilateral blindness was 3.6% (95%CI 3.0-4.2%), prevalence of blindness among people living with additional, non-visual disabilities was 38.3% (95% CI 29.0-48.6%) compared to 1.6% (95%CI 1.2-2.1%; [Formula: see text] = 771.9, p6/18) was seen in 61 eyes (52.6%) increasing to 71 (61.2%) eyes with best correction. Cost was identified as the main barrier to surgery.ConclusionFindings suggest there exists inequalities in eye care with women, poorer people and people with disabilities having a lower Cataract Surgical Coverage, thereby, underscoring the importance of eye care programs to address these inequalities.

Objective: To evaluate the output of a child eye health programme in terms of identification, referral, and volume of paediatric cataract surgeries in Kaduna State, Nigeria., Materials and Methods: This was a retrospective review of the North-West Nigeria Child Eye Health Initiative programme referral registers at primary, secondary and tertiary hospitals in Kaduna State. Theatre registers of children 0-16 years who had cataract surgery at National Eye Centre Kaduna between 2016 and 2019 were also reviewed. Information on numbers of children, age, sex, laterality of cataract and programme status were summarised as frequencies, percentages and mean ± standard deviation. The initial 2 years of the programme (2018-2019) were compared with the 2 years (2016-2017) preceding them., Results: Between January 2018 and December 2019; primary health workers screened 41,552 children and referred 2,316 (5.6%). Of those referred 1772 (76.5%) presented at one of three zonal secondary hospitals where nurses identified 492 (27.8%) with leukocoria using torchlights and referred them to the tertiary hospital. At the tertiary hospital, 364 (74.0% of 492) attended and 262 (72.0% of 364) were confirmed to have operable cataracts after dilated slit lamp examination by ophthalmologists. Between 2016 and 2017 (pre-programme years), 201 children had cataract surgery compared to 352 in 2018 and 2019 (programme years) of whom 239 (67.9% of 352) were beneficiaries of the programme. The proportion of girls who had cataract surgery declined from 39.8% to 35.0%, while mean age increased from 5.7 ± 4.2 years to 7.5 ± 4.1 over 4 years. More children with unilateral cataracts (214 [60.8%]) presented during the programme years (Fishers exact test, P = 0.004), whereas unilateral cataract (207 [60.2%]) was significantly more common in males than females (Fisher's exact P = 0.017)., Conclusion: The programme has resulted in improved case detection of childhood leukocoria at primary eye care level. additionally, the eye health referral system in Kaduna State has been strengthened with increasing numbers of children accessing services: majority boys, older children, and unilateral cataracts., Competing Interests: There are no conflicts of interest., (© 2024 Journal of The West African College of Surgeons.)

Background: The Global Programme to Eliminate Lymphatic Filariasis (GPELF), launched in 2000, has the target of eliminating the disease as a public health problem by the year 2020. The strategy adopted is mass drug administration (MDA) to all eligible individuals in endemic communities and the implementation of measures to reduce the morbidity of those suffering from chronic disease. Success has been recorded in many rural endemic communities in which elimination efforts have centered. However, implementation has been challenging in several urban African cities. The large cities of West Africa, exemplified in Nigeria in Kano are challenging for LF elimination program because reaching 65% therapeutic coverage during MDA is difficult. There is therefore a need to define a strategy which could complement MDA. Thus, in Kano State, Nigeria, while LF MDA had reached 33 of the 44 Local Government Areas (LGAs) there remained eleven 'urban' LGAs which had not been covered by MDA. Given the challenges of achieving at least 65% coverage during MDA implementation over several years in order to achieve elimination, it may be challenging to eliminate LF in such settings. In order to plan the LF control activities, this study was undertaken to confirm the LF infection prevalence in the human and mosquito populations in three urban LGAs., Methods: The prevalence of circulating filarial antigen (CFA) of Wuchereria bancrofti was assessed by an immuno-chromatography test (ICT) in 981 people in three urban LGAs of Kano state, Nigeria. Mosquitoes were collected over a period of 4 months from May to August 2015 using exit traps, gravid traps and pyrethrum knock-down spray sheet collections (PSC) in different households. A proportion of mosquitoes were analyzed for W. bancrofti, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR)., Results: The results showed that none of the 981 subjects (constituted of <21% of children 5-10 years old) tested had detectable levels of CFA in their blood. Entomological results showed that An. gambiae s.l. had W. bancrofti DNA detectable in pools in Kano; W. bancrofti DNA was detected in between 0.96% and 6.78% and to a lesser extent in Culex mosquitoes where DNA was detected at rates of between 0.19% and 0.64%. DNA analysis showed that An. coluzzii constituted 9.9% of the collected mosquitoes and the remaining 90.1% of the mosquitoes were Culex mosquitoes., Conclusion: Despite detection of W. bancrofti DNA within mosquito specimens collected in three Kano urban LGAs, we were not able to find a subject with detectable level of CFA. Together with other evidence suggesting that LF transmission in urban areas in West Africa may not be of significant importance, the Federal Ministry of Health advised that two rounds of MDA be undertaken in the urban areas of Kano. It is recommended that the prevalence of W. bancrofti infection in the human and mosquito populations be re-assessed after a couple of years.