FACULTY OF CLINICAL SCIENCES
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Item Comparative evalaution of macular thickness in sickle cell and non-sickle cell disease patients at the University College Hospital Ibadan, Oyo State, Nigeria.(Wolters Kluwer - Medknow, 2025) Avuru, C. J.; Babalola, Y. O.; Ugalahi, M. O.; Sarimiye, T. F.; Olawoye, O. O.; Olaniyi, J. A.; Oluleye, T. S.Purpose: The purpose of this study was to determine the macular thickness of participants with sickle cell disease (SCD) and compare with their age and sex matched participants without SCD at the University College Hospital (UCH), Ibadan, to provide baseline data for adult Nigerians with SCD and how they compare with those without the disease. Materials and Methods: This was a hospital based comparative study conducted at the UCH, Ibadan. Patients with SCD aged 18 years and above were age and sex matched with non SCD controls (Haemoglobin AA genotype). All participants underwent a full ophthalmic examination, refraction, A scan biometry, and macular thickness were measured with an Optovue iScan spectral domain optical coherence tomography machine. Data from the left eye of each participant were analysed with IBM Statistical Package for Social Sciences (SPSS) version 25.0. Results: Seventy participants were recruited into the study and 30 (42.9%) were males. The mean age of all the subjects in the study was 35.9 ± 11.0. Group 1 (SCD) comprised 19 (27.1%) Hb SS and 16 (22.9%) Hb SC while Group 2 (non SCD) were 35 (50%) Hb AA subjects. The SCD group had a lower mean macular thickness (MMT) of 271.1 ± 20.2 microns compared to the non SCD group with an MMT of 278.5 ± 13.5 microns, but this was not statistically significant (P = 0.076). Macular thickness was generally lower in the SCD group in all the ETDRS map regions of the macular compared to the non SCD group with values ranging from 3.0 microns to 11.5 microns but statistically significant difference was observed only in the inner inferior macular (P = 0.026) and inner temporal macular (P = 0.046) regions. There was no statistically significant difference in distant visual acuity between non SCD and SCD participants (P = 0.605). Conclusion: This study observed focal macular thinning in SCD compared to non SCD. However, focal macular thinning was not associated with poorer distant visual acuity in patients with SCD.Item Ocular B-scan audit in a Sub-Saharan African retina Facility(Vitreoretinal Society of Nigeria, 2021) Megbelayin, E. O.; Babalola, Y. O.; Nkanga, D. E.Background: B-scan ultrasonography (USG) is a cost-effective, non-invasive, easy-to-learn diagnostic tool particularly useful in resource-constrained settings in Sub-Saharan Africa. Aim:To review all consecutive cases in which ophthalmic B-scan ultrasonography was indicated and carried out over a two-year period. Methods: A retrospective study involving patients' files and previously saved B-scans images of all cases seen between January 2019 to December 2020. Demographic data, indications for ultrasonography and diagnosis were all noted. Results: 325 eyes of 314 patients were scanned and subsequently analyzed. Mature cataract was the commonest indication for scanning while retinal detachment was the commonest diagnosis made. Endophthalmitis, phthisis bulbi, optic drusen, silicon oil filled eye among others were also reported. Conclusion: B-scan USG is an affordable and non-invasive tool in the diagnosis of posterior segment pathologies. It provides reproducible results that can assist in clinical decision making process and treatment plan of vitreoretinal diseases.Item Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020(BMJ, 2021) Ademola-Popoola, D. S.; Fajolu, I. B.; Gilbert, C.; Olusanya, B. A.; Onakpoya, O. H.; Ezisi, C. N.; Musa, O.; Chan, R. V. P.; Okeigbemen, V. W.; Rilwan, C. M.; Malik, N. J. A.; Adio, A. O.; Bodunde, O. T.; Rafindadi, A. L.; Oluleye, T. S.; Tongo, O. O.; Badmus, S. A.; Adegbara, O. V.; Tapas, R. P.; Ezenwa, B. N.; Obajolowo, T. S.; Olokoba, L. B.; Olatunji, V. A.; Babalola, Y. O.; Ugalahi, M. O.; Adenekan, A.; Adesiyun, O. O.; Sahoo, J.; Miller, M. T.; Uhumwangho, O. M.Objectives Retinopathy of prematurity (R0P) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for R0P between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff providing services for R0P, and 723 preterm infants screened for R0P who fulfilled screening criteria (gestational age <34 weeks or birth weight <2000 g, or sickness criteria). Methods and analysis A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity building, national and international collaborative activities between 2017 and 2018. A national protocol for R0P was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results In 2017 only six of the 84 public neonatal units in Nigeria provided R0P services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any R0P; and 29 (22.8%) developed type 1 R0P. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challengesincluded lack of equipment to regulate oxygen and to document and treat R0P, and lack of data systems. Conclusion R0P screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and R0P treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.Item Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020(BMJ, 2021) Ademola-Popoola, D. S.; Fajolu, I. B.; Gilbert, C.; Olusanya, B. A.; Onakpoya, O. H.; Ezisi, C. N.; Musa, O.; Chan, R. V. P.; Okeigbemen, V. W.; Rilwan, C. M.; Malik, N. J. A.; Adio, A. O.; Bodunde, O. T.; Rafindadi, A. L.; Oluleye, T. S.; Tongo, O. O.; Badmus, S. A; Adegbara, O. V.; Tapas, R. P.; Ezenwa, B. N.; Obajolowo, T. S.; Olokoba, L. B.; Olatunji, V. A.; Babalola, Y. O.; Ugalahi, M. O.; Adenekan, A.; Adesiyun, O. O.; Sahoo, J.; Miller, M. T.; Uhumwangho, O. M.Objectives Retinopathy of prematurity (R0P) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for R0P between 2017 and 2020 as well as the outcome of these activities in Nigeria. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff providing services for R0P, and 723 preterm infants screened for R0P who fulfilled screening criteria (gestational age <34 weeks or birth weight <2000 g, or sickness criteria). Methods and analysis A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity building, national and international collaborative activities between 2017 and 2018. A national protocol for R0P was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision. Results In 2017 only six of the 84 public neonatal units in Nigeria provided R0P services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any R0P; and 29 (22.8%) developed type 1 R0P. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challengesincluded lack of equipment to regulate oxygen and to document and treat R0P, and lack of data systems. Conclusion R0P screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and R0P treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.Item Retinopathy of prematurity in a tertiary facility: An initial report of a screening programme(Paediatric Association of Nigeria, 2020) Olusanya, B. A.; Oluleye, T. S.; Tongo, O. O.; Ugalahi, M. O.; Babalola, Y. O.; Ayede, A. I.; Baiyeroju, A. M.Retinopathy of prematurity (ROP) screening in Nigeria is at a nascent stage and at the moment there are no National guidelines for ROP screening in Nigeria. Thus it is desirable for screening programs to report findings amongst screened preterm infants in order to facilitate the development of national ROP screening criteria and guidelines. The aim of this report is to describe the frequency, severity and risk factors for retinopathy of prematurity (ROP) among preterm and very low-birth-weight babies screened within the first year of initiating an ROP screening program at a Nigerian tertiary facility. Methods: A cross-sectional study of infants born at less than 34 weeks gestational age; or with birth weight less than 1500g between May 2016 and May 2017. ROP screening examinations were performed by ophthalmologists with the use of an indirect ophthalmoscope, after pupillary dilation, in collaboration with the neonatology team. Information on gestational age at birth, birth weight, oxygen therapy and presence of other risk factors were recorded and analyzed. Results: A total of 74 infants were screened during the period. There were 36 (48.6%) males. Mean gestational age at birth was 29.6 (±2.35) weeks. Mean birth weight was 1.26 (±0.27) kg with a range of 800 to 1950g. ROP was detected in 9 (12.2%) infants. Two (22.2%) of these had Threshold ROP. There was no significant difference between the mean birth weight and mean gestational age of the infants who had ROP compared to those without ROP. The two infants with Threshold ROP were treated with intravitreal Bevazicumab and had regression of ROP. Conclusion: Retinopathy of pre maturity was diagnosed in at risk infants in this facility. There is, therefore, a need to establish ROP screening programs in all neonatal units across the country. In addition, established programs need to evaluate their screening criteria with a view towards developing country-specific screening guidelines.Item Optic disc coloboma in two Nigerian siblings; Case report & Review of Literature(Wolters Kluwer ‑ Medknow, 2017) Babalola, Y. O.; Olawoye, O. O.; Idam, P.We report two cases of bilateral asymmetric optic disc coloboma (ODC) in siblings. The index patient is a 9 year old Nigerian girl with severe cognitive deficit who presented with a poor vision of 3 years’ duration. She had a history of childhood febrile convulsions and delayed developmental milestones. Her visual acuity could not be assessed because she had a cognitive deficit and expressive aphasia. Ocular examination revealed a very large excavated right optic disc with only a strip of remnant neuro retinal rim superiorly, and a smaller left optic disc with inferior disc excavation, superior wedge of the pink neuro retinal rim as well as a temporal optic disc pit. No systemic features of syndromes associated with ODCs and intellectual disability were present in both patients. The younger sibling an 8 year old girl later presented to the eye clinic with a 5 month history of poor vision in the left eye. Ocular examination revealed visual acuity of 6/6 in the right eye and counting fingers in the left eye. Dilated binocular indirect ophthalmoscopy revealed a right large excavated colobomatous disc and a left small disc with infero temporal disc coloboma.Item How satisfied are patients attending a Nigerian Eye Clinic in University of Calabar teaching hospital?(Educational Society for Excellence, 2014) Megbeleyin, E. O.; Babalola, Y. O.; Musbahu, S. K.; Ibienmo, O.; Okonkwo, S. N.Background: Satisfaction surveys are periodically necessary to evaluate services rendered to clients/patients as a means of quality assurance and service improvement. Aim: To determine satisfaction to services rendered to ophthalmic patients in an outpatient eye clinic. Material and methods: It was an observational study carried out with validated questionnaires complemented with a focused group discussion. Statistical Package for Social Sciences (version 15-0) was used for data analysis. Observation: A total of 251 questionnaires were analyzed comprising 139 males and 112 females (M: F= 1: 0-8). Age range and mean age were 17-92 years and 37-2 + 15-6 years respectively. Overall satisfaction with quality of services was 80-1%. Specifically, 95-6%, 92%, 80-9%, 70-9%, and 59-8% were satisfied with cleanliness of hospital premises, doctors' willingness to listen to complaints, nursing care; doctors' following-up on treatment, and time nurses administered treatments respectively. However, only 37-8%, 38-6%, 39-8%, and 47-4% were satisfied with drug costs, cost of transportation to hospital, laboratory charges, and record keeping profile respectively. Conclusion: Costs of uptake of eye care services and record keeping profile were key sources of dissatisfaction in this study.Item Pre-Consultation waiting time in a Nigerian public eye facility - a source of patient dissatisfaction(Standard Research Journals, 2013) Megbeleyin, E. O.; Ibienemo, O.; Babalola, Y. O.In order to determine subjective responses of ophthalmic patients to pre-consultation waiting time, a cross-sectional study was carried out with pretested questionnaires. Statistical Package for Social Sciences version 15.0 was used for descriptive analysis. In the research a total of 251 patients were analyzed comprising 139 males (55 percent) and 112 females (45 percent), in the ratio of 1: 0.8 respectively. Their ages ranges from 17 to 92 years with a mean of 37.2 years + 15.6 Satisfaction with overall quality of services was 80.1 percent; only 25.5 percent were satisfied with waiting time. Bivariate analysis (validated by multiple logistic regressions of confounding variables) of waiting time and overall satisfaction showed a result of X 2 =44.586 and p-value = 0.0001. It is thus concluded that Pre-consultation waiting time is a major source of patient dissatisfaction to our facility.Item Sleep disturbance and associated factors among Nigerian adults living with HIV in the dolutegravir era(Frontiers Media S.A., 2022) Osiyemi, A. O.; Owoaje, E.; Mundt, J. M.; Oladeji, B.; Awolude, O.; Ogunniyi, A.; Okonkwo, P.; Berzins, B.; Taiwo, B. O.Sleep disturbance is common among persons living with HIV (PLWH) causing significant health impacts. Nigeria recently switched from efavirenz to dolutegravir (DTG) for first-line antiretroviral therapy (ART). This study aimed to assess the prevalence of sleep disturbance and to determine factors associated with sleep disturbance among treatment-experienced PLWH. Using a cross-sectional study design and systematic random sampling, 300 participants were recruited from the Infectious Diseases Institute, Ibadan, Nigeria (IDI). Interviewer administered questionnaire was used to collect data regarding sociodemographic, sleep disturbance (Pittsburgh Sleep Quality Index; PSQI), depression (Patient Health Questionnaire; PHQ-9), anxiety (Generalized Anxiety Disorder-7; GAD-7), and psychoactive substance use. HIV-specific data were retrieved from IDI’s medical records. The relationship between the PSQI score and the scores on the PHQ-9 and GAD-7 were explored with the Pearson correlation coeffcient. Chi-square global tests of independence were used to assess factors associated with sleep disturbance and a multivariable binary logistic model was used to determine independent predictors of sleep disturbance. The mean age of the sample was 44.5 ± 11.4 (years), the average duration of HIV diagnosis was 8.13 ± 5.33 (years) and the majority were on DTG-based regimens (95%). Depression and anxiety were present in 14 and 17.3%, respectively. Prevalence of sleep disturbance (PSQI score of 6 ormore) was 21.7%. Higher PSQI scores were associated with higher PHQ-9 scores (r = 0.526; p < 0.001) and higher GAD-7 scores (r = 0.529; p < 0.001). Sleep disturbance was associated with age ($ 2 = 4.483, p = 0.038), marital status ($ 2 = 7.187, p < 0.01), depression ($ 2 = 46.589, p < 0.001), and anxiety ($ 2 = 38.379, p < 0.001). There was no significant association between sleep disturbance and HIV clinical stage at diagnosis, virological suppression status, and ART regimen type (p > 0.05), whereas tea intake was associated with an absence of sleep disturbance ($ 2 = 6.334, p < 0.014). Age (>45 years), depression and anxiety were associated with higher odds of sleep disturbance among PLWH. Sleep disturbance remains common among PLWH in the DTG era. Depression and anxiety are significant factors associated with sleep disturbance. Assessing these factors in future studies may improve the sleep health of PLWH.Item Determinants of transition across the spectrum of alcohol use and misuse in Nigeria(Elsevier, 2013) Esan, O.; Makanjuola, V.; Oladeji, B.; Gureje, O.Many studies have examined the risk factors associated with alcohol use disorders. No information is available from developing countries about the factors that may determine the transitions across different levels of use and misuse. Alcohol use and its misuse were assessed in a cohort of 2143 Nigerians using Version 3.0 of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). This generated six levels of alcohol use and related disorders. Using age of onset variables created for the purpose, analysis was done to determine rates of and risk factor for transition between the levels. Lifetime prevalence estimates were 57.8% for alcohol use, 27.6% for regular use, 2.9% for abuse, and 0.3% for dependence. Whereas 47.8% transited to regular use from lifetime ever use, only 10.5% transited to abuse from regular use and 9.5% from abuse to dependence. Male sex, age 18e49 years and being never married predicted onset of alcohol use. Transition to regular use was predicted only by male sex while transition to abuse was predicted by male sex and age 35e49 years. Factors associated with recovery from abuse were female sex and a student status. Higher rates of transition occurred in the stages preceding the onset of alcohol use disorders. Sex and age were the main determinants of transition, with male gender and middle age being risk factors for transition to problematic use of alcohol.