Publications


2009

KAHAKI, DRKIMANI, MARTIN DRKOLLMANNKH.  2009.  Listo BN, Kollmann KHM, Kimani K, Owino C.Ocular manifestations of HIV/AIDS at Moi Teaching and Referral Hospital (AMPATH Clinic). East Afr. j. ophthalmol. 2009 Jul; 15(1): 27-34.. African Journal of Midwifery and Womens. : Prof. Anna karani, Prof. Simon Kangethe & Johannes Njagi Njoka Abstract

<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> 

Objective: To determine the prevalence and pattern of ocular conditions in HIV/AIDS patients attending HIV/AIDS care clinic (AMPATH).

Design: Hospital-based cross sectional study.

Setting: Moi Teaching and Referral Hospital (AMPATH CLINIC) ,Eldoret, Kenya.

Subjects: HIV/AIDS patients seen at AMPATH, clinic.

Results: Two hundred patients with HIV/AIDS were examined. The overall prevalence of ocular findings was 154 patients (77%). One hundred and eighteen patients (59%) were on ARV therapy. The main findings were posterior segment lesions (53%), anterior segment disorders (26.5%). Posterior segment findings included; Retinal microvasculopathy (75 patients ,37.5%), chorioretinitis (9 patients, 4.5%), vitreous opacities (8 patients, 4%), macula edema (8 patients, 4%) and CMV retinitis (5 patients , 2.5%). Fibrous membrane attached to the iris mostly near the pupillary margin (37 patients, 18.5%) and iridocyclitis (11 patients, 5.5%) were the main anterior segment findings. Conjunctival growths (13 patients, 6,5%) and Kaposi (10 patients, 5%), conjunctival microvasculopathy (8 patients, 4%) and molluscum contagiosum (5 patients, 2.5%) were the main ocular adnexal findings. Tuberculosis was the main systemic findings (53%). This study found that ocular findings are directly related to the severity of clinical disease staging (e.g. WHO stages III and IV) and severity of immune suppression (CD4+ count).

Conclusion: The results of this study suggest a high prevalence of ocular findings in adolescents and adults with HIV/AIDS. Retinal microvasculopathy was the commonest posterior segment finding observed. Further studies are needed to investigate the unusual findings of the fibrous membrane attached to the iris observed in this study.

2008

STEPHEN, DRGICHUHI, MARCO DRSHEILAAKINYI, JEFITHA DRKARIMURIO, KAHAKI DRKIMANI, R. DRILAKODUNERA.  2008.  Barriers to utilization of eye care services in Kibera and Dagoreti Divisions of Nairobi, Kenya. E Afr J Ophthalmol. 2008 Nov; 14(2): 55-61. 2. Kimani K, Karimurio J, Gichuhi S, Marco S, Nyaga G, Wachira J, Ilako D.. East African Journal of Ophthalmology Nov; 14(2): 49-54.. : Prof. Anna karani, Prof. Simon Kangethe & Johannes Njagi Njoka Abstract

OBJECTIVE: To determine the barriers to uptake of eye care services and to establish the pattern of utilization of eye care services in the Nairobi Comprehensive Eye Care Services (NCES) Project; the catchment area of the Mbagathi District Eye Unit of Nairobi. DESIGN: Community based survey conducted from 15th to 31st October 2007. Setting: Kibera and Dagoreti divisions of Nairobi City. SUBJECTS: Of the 4,200 people of all ages who were randomly selected; 4,056 were examined giving a response rate of 96.6%. Of those not examined, 126 (3.0%) were not available and 15 (0.4%) refused to be examined. Mean age of the study population was 22 years. RESULTS: A total of 294 subjects (7.2%) despite having some ocular disorder, had not visited any health facility to seek treatment. The majority, 144 (49%) gave the reason as no perceived need to seek treatment as the problem did not bother them; especially those with refractive error. A third, 97 (33%), gave the reason as lack of money, 22 (7.5%) said that they did not know where to seek eye care and 20 (6.8%) said they had no time to seek eye care. Only 3 said that the health facility where to go for eye care was too far. The population in the survey area has vast number of nearby secondary and tertiary eye care facilities to choose from. The majority of subjects indicated Mbagathi District Hospital (20.9%), Kikuyu Eye Unit (18.5%), Kenyatta National Hospital (12.1%) and private clinics (10.9%) as their health facilities of choice for eye care. The rest preferred Lions Sight First Eye Hospital, St Mary's Hospital, City Council Health Centers and optical shops. 7.7% of the subjects would visit a health centre or dispensary if they had an eye problem. A signifi cant proportion of respondents (7.5%) had no idea where they could seek treatment for eye disorders; most of them knew Mbagathi District Hospital and Kenyatta National Hospital but were not aware that eye care services were available at these facilities. CONCLUSION: Despite the large number of eye care facilities surrounding the NCES, community members are not able to access their services mainly because of lack of felt need (ignorance) and lack of money (poverty). RECOMMENDATIONS: There is need for eye health education and review of cost of services to the very poor communities within the NCES. It is important to strengthen the community eye care structures and referral network now that the project area has excess secondary and tertiary health facilities offering eye care services.

JEFITHA, DRKARIMURIO, KAHAKI DRKIMANI, STEPHEN DRGICHUHI, MARCO DRSHEILAAKINYI, R. DRILAKODUNERA.  2008.  Karimurio J, Kimani K, Gichuhi S, Marco S, Nyaga G, Wachira J, Ilako D. Eye disease and visual impairment in Kibera and Dagoreti Divisions of Nairobi, Kenya. East Afr. j. ophthalmol. 2008 May; 14(1): 42-50.. East African Journal of Ophthalmology Nov; 14(2): 49-54.. : Prof. Anna karani, Prof. Simon Kangethe & Johannes Njagi Njoka Abstract

Objective: To determine the prevalence and pattern of eye diseases and visual<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

impairment in the Nairobi Comprehensive Eye Care Services (NCES) Project; the

catchment area of the Mbagathi District Eye Unit of Nairobi.

Design: Community based survey conducted from October 15th to 31st 2007

Setting: Kibera and Dagoreti divisions of Nairobi City

Subjects: 4200 people of all ages were randomly selected; 4056 were examined

(96.6% response rate). 122 (2.9%) were not available and 15 (0.4%) declined

to be examined.

Results: Females: 54.2%, Males: 45.8%. Mean age; 22.4 years, SD; 16.5. Only

241(5.9%) aged >50years old. The leading eye disorders in Kibera and Dagoretti

divisions are conjunctival disorders including allergic conjunctivitis and conjunctival

growths. This was found to affect 7.6% of the subjects. This was followed by

refractive errors found in 5.3% of the subjects. Cataract was found in 30 subjects

(0.7%). Disorders of the retina and the optic nerve were found in 1.1% of the

subjects and corneal disorders in 0.5%. The prevalence of visual impairment was

0.6%, severe visual impairment was 0.05% and blindness was 0.1%. This indicates

that most of the ocular disorders encountered were not visually threatening. The

main cause of visual impairment is refractive errors and the causes of severe visual

impairment and blindness are cataract, corneal opacity and glaucoma.

Conclusion: The population of the NCES is relatively young and the prevalence of

blindness and visual impairment is low. The main cause of visual impairment was

refractive errors and the causes of severe visual impairment and blindness were

cataract, corneal opacity and glaucoma.

Recommendations: The level of blindness in NCES is low and the project should

focus more on rendering eye care and not treatment of blindness. There is need to

address the issue of refractive errors as this was one of the main ocular problems

encountered. In this survey, it was not possible to perform detailed refraction and

hence it was recommend that a refractive error survey be conducted; especially

in school going children.

STEPHEN, DRGICHUHI, MARTIN DRKOLLMANNKH, JEFITHA DRKARIMURIO, KAHAKI DRKIMANI.  2008.  Baseline trachoma survey in ELCK-Arsim integrated development project area of Samburu North, Kenya.E Afr J Ophthalmol. 2008 Nov; 14(2): 49-54. 3. Karimurio J, Kimani K, Gichuhi S, Kollmann KHM.. East African Journal of Ophthalmology Nov; 14(2): 49-54.. : Prof. Anna karani, Prof. Simon Kangethe & Johannes Njagi Njoka

UoN Websites Search