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Characteristics and visual outcome of ocular trauma patients at Queen Elizabeth Central Hospital in Malawi

Thokozani Zungu, Shaffi Mdala, Chatonda Manda, Halima Sumayya Twabi, Petros Kayange, Itamar Ashkenazi
2021 PLoS ONE  
To describe the epidemiology and visual outcome of patients with ocular trauma treated at Queen Elizabeth Central hospital in Malawi. Methods A prospective, observational study was undertaken from September 2017 to December 2017. Data on socio-demographic features, aetiology of trauma, type of ocular injury pre-referral pathway and treatment of ocular trauma was collected as the exposure variables. The main outcome variable was best corrected visual acuity at 8 weeks following initial visit.
more » ... ults A total of 102 patients (103 eyes) with ocular trauma were recruited with loss of follow up of 11 participants at 8 weeks following recruitment. The most affected age group were children under 11 years old (35.3%), followed by young adults of age between 21–30 years (22.5%). The male-to-female ratio for ocular injury was 2.8:1. Most participants had closed globe injuries (n = 72, 70.6%), with over half the population injured by blunt objects (n = 62, 60.8%). Furthermore, among the adult population, majority (n = 19 38%) were injured on the road during assaults (n = 24, 48%), while most paediatric injuries (n = 32, 61.5%) occurred at home during play. The incidence of monocular blindness was 25.3% at eight weeks after the first presentation. Factors that were associated with monocular blindness on multivariate analysis were living in rural areas and open globe injuries. Conclusion Ocular trauma led to monocular blindness in a quarter of the study population. There is need for preventive education of ocular injuries at both family and community level.
doi:10.1371/journal.pone.0246155 pmid:33780448 fatcat:s7vs5didgbhz7hna3ytji5bday

Profile of primary childhood glaucoma at a child eye health tertiary facility in Malawi

Shaffi Mdala, Thokozani Zungu, Chatonda Manda, Chinsisi Namate, Elizabeth Fernando, Halima Sumayya Twabi, Gerald Msukwa, Petros Cyrus Kayange
2022 BMC Ophthalmology  
Methodology: Thokozani Zungu, Petros Kayange, Chatonda Manda, Shaffi Mdala, Halima Twabi. Supervision: Chatonda Manda, Gerald Msukwa, Petros Kayange.  ...  Authors' contributions Conceptualisation: Thokozani Zungu, Shaffi Mdala, Chatonda Manda, Gerald Msukwa, Chinsisi Namate, Petros Kayange.  ... 
doi:10.1186/s12886-022-02279-0 pmid:35101025 pmcid:PMC8805399 fatcat:jpfpgni7r5d7njilfpf2grhppi

Ophthalmic features of HIV associated cryptococcal meningitis in Malawian Adults: an observational study

Jayne P. Ellis, Kate Gaskell, Mary Peirse, Jack Gormley, Newton Kalata, Philip I. Burgess, Patty Mopamboli, Chatonda A. Manda, Christine A. Kiire, Ian Maccormick, Ebbie Gondwe, Sile Molloy (+3 others)
2019 Wellcome Open Research  
Review & Editing; : Data Curation, Investigation, Writing - Burgess PI Mopamboli P Review & Editing; : Data Curation, Investigation; : Data Curation, Investigation, Writing -Review & Editing; : Manda  ... 
doi:10.12688/wellcomeopenres.15067.1 fatcat:7yusussrfndybpnrlmugfk4fgy

Ophthalmic features of HIV associated cryptococcal meningitis in Malawian Adults: an observational study

Jayne P. Ellis, Kate Gaskell, Mary Peirse, Jack Gormley, Newton Kalata, Philip I. Burgess, Patty Mopamboli, Chatonda A. Manda, Christine A. Kiire, Ian Maccormick, Ebbie Gondwe, Sile Molloy (+3 others)
2019 Wellcome Open Research  
Review & Editing; : Data Curation, Investigation, Writing - Burgess PI Mopamboli P Review & Editing; : Data Curation, Investigation; : Data Curation, Investigation, Writing -Review & Editing; : Manda  ... 
doi:10.12688/wellcomeopenres.15067.2 fatcat:kew7xp5diremxdeend4uknrrja

Opinions on medical ethics. Do you think doctors are practising compassionate medical ethics?

Thengo Kavinya
2008 Malawi Medical Journal  
Chatonda Manda Student, College of Medicine "Yes, because of the inclusion of ethics in their training.  ... 
pmid:19537437 pmcid:PMC3345664 fatcat:b5nj7dhky5cr5nmiokaaul5f2e

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

Ido Didi Fabian, Andrew W Stacey, Allen Foster, Tero T Kivelä, Francis L Munier, Naama Keren-Froim, Nir Gomel, Nathalie Cassoux, Mandeep S Sagoo, M Ashwin Reddy, Lamis Al Harby, Marcia Zondervan (+191 others)
2020 British Journal of Ophthalmology  
The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with
more » ... lastoma residing in 43 African countries. Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
doi:10.1136/bjophthalmol-2020-316613 pmid:32933936 fatcat:fqencaijhjeezi5fjx2ta2djfi

Global Retinoblastoma Presentation and Analysis by National Income Level

Global Retinoblastoma Study Group, Ido Didi Fabian, Elhassan Abdallah, Shehu U. Abdullahi, Rula A. Abdulqader, Sahadatou Adamou Boubacar, Dupe S. Ademola-Popoola, Adedayo Adio, Armin R. Afshar, Priyanka Aggarwal, Ada E. Aghaji, Alia Ahmad (+461 others)
2020 JAMA Oncology  
Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to
more » ... vestigate risk factors for advanced disease at diagnosis. A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.
doi:10.1001/jamaoncol.2019.6716 pmid:32105305 pmcid:PMC7047856 fatcat:xbvqt3lgnfbkzlgsh2g52owece