Publications


2013

Karimurio, J;, Gichuhi S.  2013.  It is time for evidence based community interventions in prevention of blindness. Abstract

For a long time, it has been generally assumed that the level of blindness and need for prevention of blindness services in Africa is too high and there is no justifi cation for committing the little available resources in conducting community based surveys. Blindness surveys are relatively expensive in the short term but cost-effective in the long term. Exaggeration on the burden of blindness and visual impairment when planning may lead to wastage of scarce resources while underestimation may deny essential services to needy communities. Evidence from resent district surveys conducted in Kenya indicate that this general assumption may no longer be applicable and hence the need for more accurate baseline data before implementation of community interventions in the country; and probably in Africa. The global estimates we have been using may no longer be accurate. The only national blindness survey data we have since the inception the of the Kenya Ophthalmic Programme (KOP) in 1956 was collected in the 1980s.1 Results of two resent rapid assessments of avoidable blindness (RAAB) conducted in Nakuru2 and Kerich- Bomet-Bureti comprehensive eye services (CES) project and one rapid assessment cataract surgical services (RACSS) conducted in Embu and published in this journal (East Afr. Ophthalmol. J 2006; 13(3)estimated the prevalence of blindness in people aged >50 years at 2% in all the surveyed districts. This is much lower than the planning estimate of between 5% and 9% previously assumed. Blindness due to age related cataract was found to be lower than previously thought but the proportion of patients with good surgical outcome was low. Cataract surgical coverage (CSC) for cataract bilaterally blind people was also found to be high which implies that we should now give more emphasis to improvement of our cataract surgical outcomes as we increase our cataract surgical rates (CSR). Inadequate continuing skills update training, lack of biometry equipment (majority of eye clinics still implant standard intraocular power) and vitrectomy machines (poor vitreous loss management) are among the short term handicaps which need to be addressed. A survey conducted in Kibera slums in 2002 indicated that even the overall prevalence of blindness (0.6%) may be lower than the national average (0.7%) and the VISION 2020 estimate (1%) the KOP has been using for strategic planning. The authors of this article and others have just fi nalized an eye disease and blindness survey in Kibera and Dagoretti Divisions of Nairobi which form the Sight Savers supported Nairobi CES project area. The preliminary report estimates the prevalence of blindness at 0.1%. We hope that ongoing surveys in Nairobi City and several rural districts plus regular schools and schools for the blind will provide valuable additional information. The fi ndings of phase I and the ongoing phase II Kenya national trachoma survey (and in other endemic countries of Africa) indicate that this forgotten tropical disease which is “a manifestation of poverty through the eyes” is still a public health problem4. In some districts of Kenya, the prevalence is higher than previously assumed while in some previously assumed endemic districts (like Meru North and greater Laikipia); the prevalence has been found not to be a public health problem. The WHO forecasts a downward trend of blindness due to infectious causes like trachoma. The recent evidence makes us conclude that the trend may be different in Kenya and probably in Africa.6 Information from colleagues from other parts of Africa including Tanzania, Ethiopia, Niger, Nigeria and Eritrea among others carry the same message: Trachoma is a public health problem among very poor communities of Africa. The recommended treatment for districts where active trachoma is endemic is mass azithromycin distribution in the whole population excluding children below one year and pregnant mothers. Evidence from the National survey conducted in Tanzania and published in this journal (East Afr. Ophthalmol. J 2006; 13(3), indicates that this practice of excluding children below one year during azithromycin mass distribution may leave a signifi cant source of active infection in the treated communities. There are many barriers to utilization of eye care services but top on the list is the community member’s inability to pay for services. Economical use of little available resources is important so that one can serve more people within a fi xed budget. To be able to do this, we need accurate facts during planning for prevention of blindness.2,7,8 It is our humble submission that we need accurate scientifi c data and not “common knowledge” in eye care project planning in Kenya to avoid wastage of resources and denying funding to the very poor communities.

2010

R., DRILAKODUNERA, JEFITHA DRKARIMURIO.  2010.  Briesen S, Roberts H, Ilako D, Karimurio J, Courtright P. Are blind people more likely to accept free cataract surgery? A study of vision-related quality of life and visual acuity in Kenya.Ophthalmic Epidemiol. 2010 Jan-Feb;17(1):41-9. PMID: 20100099 [PubMed - indexed for MEDLINE]. : Korean Society of Crop Science and Springer Abstract

PURPOSE: To determine possible differences in visual acuity, socio-demographic factors and vision-related Quality of Life (QoL) between people accepting and people refusing sponsored cataract surgery.

METHODS: Three hundred and fifty seven local residents with visually impairing cataract, presenting at screening sites in Kwale District, Kenya were clinically assessed and interviewed. The World Health Organization (WHO) QoL-questionnaire WHO/Prevention of Blindness and Deafness Visual Functioning Questionnaire 20 (PBD-VFQ20) was used to determine the vision-related QoL. A standardized questionnaire asked for socio-demographic data and prior cataract surgery in one eye. After interview, patients were offered free surgery. Primary outcome was the mean QoL-score between acceptors and non-acceptors. Secondary outcomes were visual acuity and socio-demographic factors and their contribution to QoL-scores and the decision on acceptance or refusal.

RESULTS: Fifty nine people (16.5%) refused and 298 accepted cataract surgery. Vision-related QoL was poorer in people accepting than in those refusing (mean score 51.54 and 43.12 respectively). People with poor visual acuity were only slightly more likely to accept surgery than people with better vision; the strongest predictors of acceptance were the QoL-score and gender. Men were twice as likely to accept compared to women. Of people who accepted surgery, 73.8% had best eye vision of 20/200 or better.

CONCLUSION: In this population, visual acuity was of limited use to predict a person's decision to accept or refuse cataract surgery. QoL-scores provide further insight into which individuals will agree to surgery and it might be useful to adapt the QoL-questions for field use. Gender inequities remain a matter of concern with men being more likely to get sight-restoring surgery.

2009

JEFITHA, DRKARIMURIO, STEPHEN DRGICHUHI.  2009.  Mingaine M, Karimurio J, Gichuhi S, Githeko K. Intraocular pressure changes in eyes receiving intravitreal acetonide in Kikuyu Eye Unit. East Afr. j. ophthalmol. 2009 Dec; 15(2): 46-52.. East African Journal of Ophthalmology. : Korean Society of Crop Science and Springer Abstract
Objective: To determine the magnitude and pattern of intraocular pressure (IOP) changes in eyes that received intravitreal triamcinolone acetonide (IVTA) in Kikuyu Eye Unit. Study Design: Retrospective interventional case series. Setting: Kikuyu Eye Unit. Subjects: Seventy-two eyes (of 61 patients) injected between January 2007 and August 2008. Methods: Data on intraocular pressure (IOP), diagnosis, additional procedures and treatment was collected using questionnaires and analysed using SPSS version 11.5.  Results: The mean pre-injection IOP was 16.0 (SD 5.2) mmHg, which increased to 23.8 (SD 11.5) mmHg after IVTA injection (p<0.001). IOP started increasing significantly within 2 weeks (p=0.006). The median post-injection time before IOP peak was 4.6 weeks, and IOP remained high for 24 weeks after injection. Intraocular pressure increase of 5 mmHg or more was found in 39 (54.2%) eyes, while that of 10 mmHg or more was found in 22 (30.1%). Thirty-three eyes (45.8%) had maximum post-injection IOP beyond 21 mmHg. Twenty-two eyes (30.6%) received treatment for IOP elevation. Eyes with pre-injection IOP of more than 21 mmHg were associated with significantly higher IOP increases (p<0.001) and all received pressure-lowering medication. No associations were noticed between age, sex, other procedures, diagnosis and pattern of IOP change. Conclusions: Intraocular increase was found to be a common complication of IVTA, and the increase occurred in the first six months.  
JEFITHA, DRKARIMURIO, MARTIN DRKOLLMANNKH.  2009.  Briesen S, Roberts H, Karimurio J, Kollmann M. Biometry in cataract camps : Experiences from north Kenya.Ophthalmologe. 2009 Oct 18. [Epub ahead of print][Article in German]. PMID: 19838712. : Korean Society of Crop Science and Springer Abstract
BACKGROUND: Biometry has the potential to improve refractive outcomes of cataract surgery in developing countries. However, the procedure is difficult to carry out in remote areas. PATIENTS AND METHODS: The feasibility of automated biometry using portable devices was assessed in an eye camp in a remote Kenyan community and reasons for failure were documented. PC-IOLs in the range of 17-27 dioptres (dpt) were implanted and a model was created to predict spherical refractive error if a standard 22 dpt lens had been used. RESULTS: In 104 out of 131 eyes (80%) biometry was possible. Failure to obtain K-readings in eyes with coexisting corneal pathology was the main limiting factor. The calculated mean IOL strength to achieve emmetropia was 21.56 dpt with a SD=1.96 (min: 14.78 dpt, max: 27.24 dpt). If 22dpt lenses had been implanted around 20% would have had an error of more than 2 dpt and 7% an error of more than 3 dpt. CONCLUSION: Biometry is a challenging procedure in remote areas where comorbidities are common. However, without biometry and implantation of different IOL powers poor refractive outcome can be expected in around 20% of patients.
JEFITHA, DRKARIMURIO.  2009.  Njeru SN, Otieno SA, Karimurio J. Prevalence of significant refractive errors in high school students, Meru municipality, Kenya. East Afr. j. ophthalmol. 2009 Dec; 15(2): 40-45.. East African Journal of Ophthalmology. : Korean Society of Crop Science and Springer Abstract
Objective: To estimate the prevalence and pattern of significant refractive errors in high school students in Meru Municipality, Kenya. Design: Cross-sectional, School based study. Setting:   High school students in Meru Municipality, Meru central District, Kenya. Subjects: 164 high school students of age range 13-18 years from Form one and Form three classes. Results:  The prevalence of significant refractive errors was 8.5% with girls contributing 5.5% and boys 3.0%. The pattern of significant refractive errors showed that myopia was the leading cause decreased visual acuity at 78.6% followed by astigmatism at 14.3% and last was hypermetropia with 7.1%. The proportion significant refractive errors was higher (71.4%) in the older age group of 15-18 years than lower age group of 13-16 years (28.6%). Conclusions:  Significant refractive errors are a common cause visual impairment in secondary schools in Meru Municipality. Myopia was found to be the leading cause of decreased visual acuity (VA <6/12).  

2008

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.. : Korean Society of Crop Science and Springer Abstract
Objective: To determine the prevalence and pattern of eye diseases and visual 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, 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.. PMID: 19838712. : Korean Society of Crop Science and Springer 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.

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.. : Korean Society of Crop Science and Springer
MARTIN, DRKOLLMANNKH, JEFITHA DRKARIMURIO, R. DRILAKODUNERA.  2008.  RH Kipkemboi, DR Ilako, KHM Kollmann, J Karimurio: Height as proxy for weight in mass azithromycin dosing of Kenyan children with active trachoma; East African Journal of Ophthalmology, Vol 14, No. 1 (2008). PMID: 19838712. : Korean Society of Crop Science and Springer Abstract
BACKGROUND: Biometry has the potential to improve refractive outcomes of cataract surgery in developing countries. However, the procedure is difficult to carry out in remote areas. PATIENTS AND METHODS: The feasibility of automated biometry using portable devices was assessed in an eye camp in a remote Kenyan community and reasons for failure were documented. PC-IOLs in the range of 17-27 dioptres (dpt) were implanted and a model was created to predict spherical refractive error if a standard 22 dpt lens had been used. RESULTS: In 104 out of 131 eyes (80%) biometry was possible. Failure to obtain K-readings in eyes with coexisting corneal pathology was the main limiting factor. The calculated mean IOL strength to achieve emmetropia was 21.56 dpt with a SD=1.96 (min: 14.78 dpt, max: 27.24 dpt). If 22dpt lenses had been implanted around 20% would have had an error of more than 2 dpt and 7% an error of more than 3 dpt. CONCLUSION: Biometry is a challenging procedure in remote areas where comorbidities are common. However, without biometry and implantation of different IOL powers poor refractive outcome can be expected in around 20% of patients.

2007

JEFITHA, DRKARIMURIO, WANJIKU DRNJUGUNAMARGARET.  2007.  Refractive errors in type 2 diabetic patients. East Afr Med J. 2007 Jun;84(6):259-63. PMID: 18254467 [PubMed - indexed for MEDLINE] Mwale C, Karimurio J, Njuguna M.. East Afr Med J. 2007 Jun;84(6):259-63.. : Korean Society of Crop Science and Springer Abstract
{ Mansa General Hospital, P.O. Box 710156, Chembe Road, Mansa, Luapula, Zambia. OBJECTIVES: To determine the prevalence and pattern of refractive errors among African type 2 diabetes mellitus patients and establish the relationship between baseline refractive status and degree of glycaemic control. DESIGN: A hospital based cross sectional study. SETTING: Diabetic medical and eye clinics at Kenyatta National Hospital (KNH). SUBJECTS: Ninety six type 2 diabetes mellitus patients. RESULTS: Ninety six patients aged 28 to 76 years were examined. The male to female ratio was 1:1.5 and about half of the patients (52.1%) had good glycaemic control. The prevalence of myopia was 39.5% and that of hypermetropia was 19.0%. Twenty two percent of the study patients had mild diabetic retinopathy (DR). Of the eyes with DR, 20% (15/75) were myopic, 19.4% (7/36) were hypermetropic and 26.6% (21/79) were emmetropic. There was no statistically significant correlation between baseline refractive status with DR (p = 0.358), or HBA1C (glycosylated haemoglobin) (rho = 0.130
JEFITHA, DRKARIMURIO.  2007.  Trachoma control using the who adopted "safe with azithromycin". East Afr Med J. 2007 Mar;84(3):127-35. PMID: 17600982 [PubMed - indexed for MEDLINE] Karimurio J, Ilako F, Gichangi M.. East Afr Med J. 2007 Mar;84(3):127-35.. : Korean Society of Crop Science and Springer Abstract
{ Community Eye Health Training, Department of Ophthalmology, College of Health Sciences, University of Nairobi, P.O. Box 19676-00202, Nairobi, Kenya. OBJECTIVE: To report on and share the experiences, accomplishments and lessons learnt by African Medical and Research Foundation (AMREF), Sight Savers International (SSI), University of Nairobi (UON) and the Ministry of Health (MOH) during implementation of a three year Shompole trachoma control pilot study using azithromycin. The target of the project was to reduce the prevalence of active and potentially blinding trachoma by 50% by the year 2005. DESIGN: Community based survey. SETTING: Shompole location, Magadi division, Kajiado district of the Rift Valley Province of Kenya. SUBJECTS: Five hundred and twenty six randomly selected households from 166 manyattas (bomas/ homesteads) proportionately distributed in all the 13 villages of the four sub-locations of Shompole location were visited. Nine hundred and ninety eight children (1-9 years) and 898 adults (215 years) were examined for active trachoma (TF) and potentially blinding trachoma (TT) respectively. RESULTS: The prevalence of active trachoma (TF) in children has dropped from 46.4% in 2002 to 16.0% in 2006 and that of potentially blinding trachoma (TT) from 4.5% to 1.7% in the same period. Women have more TT than men. Out of the 15 cases of TT reported in the survey, only two were recurrences. The prevalence of active trachoma (TF) is higher in boys than girls

2006

JEFITHA, DRKARIMURIO, R. DRILAKODUNERA.  2006.  Prevalence of trachoma in six districts of Kenya. East Afr Med J. 2006 Apr;83(4):63-8. Karimurio J,Gichangi M,Ilako DR,Adala HS,Kilima P.. East Afr Med J. 2006 Apr;83(4):63-8.. : Korean Society of Crop Science and Springer Abstract
OBJECTIVES: To estimate the prevalence of active trachoma (TF) in children aged one to nine years and potentially blinding trachoma (TT) in adults aged 15 years and older in six known trachoma-endemic districts in Kenya. DESIGN: Community based survey. SETTING: Six known trachoma endemic districts in Kenya (Samburu, Narok, West Pokot, Kajiado Baringo and Meru North). SUBJECTS: A total of 6,982 children aged one to nine years and 8,045 adults aged 15 years and older were randomly selected in a two stage random cluster sampling method: Twenty sub-locations (clusters) per district and three villages per sub-location were randomly selected. Eligible children and adults were enumerated and examined for signs of trachoma. RESULTS: Blinding trachoma was found to be a public health problem in all the surveyed districts. Active trachoma was a district wide public health problem in four districts (Samburu, Narok, West Pokot and Kajiado) and only in some of the sub-locations of the other two (Baringo and Meru North). CONCLUSIONS: There is need for district trachoma control programmes preferably using the WHO recommended SAFE strategy in all the surveyed districts. Extrapolation of these survey results to the entire country could not be justified. There is need to survey the remaining 12 suspected endemic districts in Kenya.
JEFITHA, DRKARIMURIO, MARTIN DRKOLLMANNKH.  2006.  Conjunctival squamous cell carcinoma in patients with human immunodeficiency virus infection seen at two hospitals in Kenya.J.East Afr Med J. 2006 May;83(5):267-70 Chisi SK,Kollmann MK,Karimurio.. J.East Afr Med J. 2006 May;83(5):267-70. : Korean Society of Crop Science and Springer Abstract
OBJECTIVE: To estimate the prevalence and pattern of conjuctival squamous cell carcinoma (CSCC) in patients with HIV infection. DESIGN: A hospital based cross sectional study. SETTING: Kenyatta National Hospital (KNH) and Kikuyu Eye Unit (KEU) during the period November 2003 and May 2004. SUBJECTS: Four hundred and nine HIV positive patients. RESULTS: Four hundred and nine HIV positive patients aged 25 to 53 years were screened. Male to Female ratio was 1:1. One hundred and three had conjunctival growths. Thirty two had histologically proven conjunctiva squamous cell carcinoma (CSCC). Estimated prevalence of CSCC among HIV positive patients was 7.8%. The average duration of growth of the conjunctival masses was 21.8 months. The average size of the lesions at the time of presentation was 6.6 mm. Twenty two (68.8%) patients had primary CSCC, while ten (31.2%) had recurrent lesions. The pattern of the histopathology results was: fifteen (46.9%) patients had poorly differentiated squamous cell carcinoma; nine (28%) had moderately differentiated squamous cell carcinoma; five patients (15.6%) had CIN; two patients (6.3%) had dysplasia and one patient (3.1%) had a well differentiated squamous cell carcinoma. CONCLUSIONS: Prevalence of CSCC in HIV/AIDS patients was 7.8%. Patients present late with advanced lesions. Recurrence rates from previous surgery are high. The often uncharacteristic complaints and findings on presentation complicate the clinical diagnosis. Active search for early manifestations of CSCC in HIV / AIDS patients, complete surgical excision and close follow up is necessary. Alternative treatment methods and techniques like the topical use of antimetabolites should be explored further.
JEFITHA, DRKARIMURIO, JEFITHA DRKARIMURIO.  2006.  Prevalence of visual impairment and blindness in a Nairobi urban population. East Afri. Med. J. 2006; 83: 69-72 Ndegwa L, Karimurio J, Okelo R, Adala H.. East Afri. Med. J. 2006; 83: 69-72.. : Korean Society of Crop Science and Springer Abstract
ABSTRACT: OBJECTIVE: To determine the prevalence and causes of visual impairment and blindness among Kibera slum dwellers. DESIGN: Population based Survey. SETTING: Kibera Slums, Kibera Division, Nairobi, Kenya. SUBJECTS: One thousand four hundred and thirty eight randomly selected slum dwellers. RESULTS: The prevalence of blindness and visual impairment was 0.6% (95% CI: 0.21 to 1.0), and 6.2% (95% CI: 4.95 to 7.15) respectively. 37.5% of those found blind were due to cataract followed by refractive errors 25.0%. 58.1% of those with visual impairment had refractive errors while 35.5% had cataracts. Females had a higher prevalence of visual impairment compared to males but the difference was not statistically significant (P = 0.104). CONCLUSIONS: Prevalence of blindness in Kibera slums is slightly lower than the estimated national average (0.7%) while that of visual impairment is almost three times higher. The leading causes of blindness are cataract followed by refractive errors. For visual impairment, refractive error was the leading cause followed by cataract. Recommendation: Kibera slum dwellers are in need of comprehensive eye care services offering cataract surgery and low cost spectacles.

2005

JEFITHA, DRKARIMURIO, JEFITHA DRKARIMURIO.  2005.  Barriers to utilisation of eye care services in Kibera slums of Nairobi. East Afr Med J. 2005 Oct;82(10):506-8 Ndegwa LK, Karimurio J, Okelo RO, Adala HS.. East Afr Med J. 2005 Oct;82(10):506-8.. : Korean Society of Crop Science and Springer Abstract
ABSTRACT: OBJECTIVES: To identify the main barriers to utilisation of eye care services among the slum population of Kibera in Nairobi, Kenya. DESIGN: Community based survey. SETTING: Kibera slums, Nairobi City, Kenya. SUBJECTS: Randomly selected 1,438 Kibera slum dwellers aged over two years. RESULTS: Majority of subjects (83.3%) do not utilise the nearby well-established eye clinics. Twenty one percent of those with poor vision do not seek treatment at all. The main barriers to seeking eye care services were lack of money, ignorance and the problem not causing much discomfort to warrant medical attention. There was significant, association between the level of education and health seeking behaviour (P = 0.008). CONCLUSION: Majority of Kibera slum dwellers have no access to eye care. RECOMMENDATION: There is need to establish a comprehensive primary eye care project to provide low cost but quality services affordable to Kibera slum dwellers.

2001

JEFITHA, DRKARIMURIO.  2001.  2001: Topic . Clinical and Experimental Ophthalmology. : Korean Society of Crop Science and Springer Abstract
ABSTRACT: OBJECTIVES: To identify the main barriers to utilisation of eye care services among the slum population of Kibera in Nairobi, Kenya. DESIGN: Community based survey. SETTING: Kibera slums, Nairobi City, Kenya. SUBJECTS: Randomly selected 1,438 Kibera slum dwellers aged over two years. RESULTS: Majority of subjects (83.3%) do not utilise the nearby well-established eye clinics. Twenty one percent of those with poor vision do not seek treatment at all. The main barriers to seeking eye care services were lack of money, ignorance and the problem not causing much discomfort to warrant medical attention. There was significant, association between the level of education and health seeking behaviour (P = 0.008). CONCLUSION: Majority of Kibera slum dwellers have no access to eye care. RECOMMENDATION: There is need to establish a comprehensive primary eye care project to provide low cost but quality services affordable to Kibera slum dwellers.

2000

JEFITHA, DRKARIMURIO.  2000.  African Programme: Kenya Community Eye Health. 2000; 13 (36) : 53. Community Eye Health. : Korean Society of Crop Science and Springer Abstract
Kenya is one of the East African countries with a coastline bordering the Indian Ocean and astride the equator. The country has an area of 225,000 square miles and a population of about 30 million people. The prevalence of blindness is estimated as 0.7%, with cataract contributing 43%, trachoma 19% and glaucoma 9%. The Kenya Ophthalmic Programme (KOP) is a Ministry of Health (MOH) programme receiving administrative support from the Kenya Society for the Blind (KSB). It started as a small project in 1956 but has grown into a major National Programme rendering comprehensive eye care (CEC) through a network of about 70 Government and NGO static and outreach service delivery points scattered all over the country. About half a million patients are treated annually.
JEFITHA, DRKARIMURIO, JEFITHA DRKARIMURIO.  2000.  Karimurio J. National Prevention of Blindness Programmes and VISION 2020; Africa programme: Kenya. J. Comm Eye Health 2000; 13: 53-54.. J. Comm Eye Health 2000; 13: 53-54.. : Korean Society of Crop Science and Springer Abstract
Abstarct not available yet.

1992

JEFITHA, DRKARIMURIO, S PROFMASINDEMICHAEL.  1992.  Masinde, M. S., Karimurio, J. Epidemiology of concomitant esotropia at Kenyatta National Hospital. E. African Journal of Ophthalmology 8: 42 . Community Eye Health. : Korean Society of Crop Science and Springer Abstract
Kenya is one of the East African countries with a coastline bordering the Indian Ocean and astride the equator. The country has an area of 225,000 square miles and a population of about 30 million people. The prevalence of blindness is estimated as 0.7%, with cataract contributing 43%, trachoma 19% and glaucoma 9%. The Kenya Ophthalmic Programme (KOP) is a Ministry of Health (MOH) programme receiving administrative support from the Kenya Society for the Blind (KSB). It started as a small project in 1956 but has grown into a major National Programme rendering comprehensive eye care (CEC) through a network of about 70 Government and NGO static and outreach service delivery points scattered all over the country. About half a million patients are treated annually.

UoN Websites Search