Eye

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    Comprehensive analysis of pathogens, resistomes, and inflammatorymarkers in the cornea
    (Kamuzu University of Health Sciences, 2022-09-08) Kalua, Khumbo; Misanjo, Esther
    Type of research study This will be a hospital-based, prospective, cross-sectional study which will be conducted at Lions Sight First Eye Hospital, as part of the global collaborative network. Problem to be studied A descriptive study on Pathogens, Resistomes, and Inflammatory-markers in the cornea at Lions sight first eye hospital (LSFEH) in Malawi. Objectives Main objective To identify etiology, antimicrobial resistance (AMR) and local host immune response, and correlate with presentation and outcome. Specific Objectives 1. To identify pathogens causing infectious keratitis in an unbiased manner. 2. To determine the optimal diagnostic technique (stains, cultures, MDS) for corneal ulcers. 3. To determine the effect of seasonality on pathogen profile and visual outcomes. 4. To determine the frequency and richness of AMR in pathogens causing keratitis. 5. To determine AMR genotype and phenotype correlation with clinical outcomes. 6. To determine the host transcriptional signatures for pathogen types. 7. To determine the host transcriptional signatures for clinical outcomes. Methodology The study will enroll all patients aged 1 month and above who will present at LSFEH with a corneal ulcer during the study period. A minimum sample size of 100 patients will be recruited in this study. All patients that will meet inclusion criteria will be administered a questionnaire. They will also undergo comprehensive anterior ocular examination. Ocular tissues sample will be collected from both eyes and will be used for high-throughput sequencing (conjunctival swabs, corneal swabs). High through put sequencing, in theory, should allow for the unbiased detection of any pathogen and biomarkers in a clinical sample. The sample will be stored in a minus 20 freezer up until the analysis is done. Expected findings This is a multicenter study, led by University of California San Francisco UCSFA (USA). It is expected that the spectrum of etiology will vary significantly with geographic location. In addition, seasonality will affect pathogen profile and disease outcomes. It is also expected that AMR will differ by global location and predict clinical outcome. Finally, it is hypothesized that immune signatures can predict pathogen types and clinical outcome. Dissemination The results will be disseminated at College of Medicine Research Ethics Committee (COMREC), hospital director for Queen Elizabeth central hospital (QECH), Malawi National Prevention of Blindness Committee, Ministry of Health (MOH) and brief presentation to clinical and nursing staff of Lions sight first eye hospital (LSFEH).
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    Global retinoblastoma outcome study
    (Kamuzu University of Health Sciences, 2021-05-21) Namate-Nyirenda, Chinsisi
    approximately 1 in 17,000 live births, is a disorder initiated by mutation of the RB1 gene. The cancer, which is thought to originate in a photoreceptor precursor cell, develops in early childhood, may be heritable or non-heritable, and involves one or both eyes. Untreated, Retinoblastoma is fatal by spread to the central nervous system (via the optic nerve) and/or by haematogenous spread. In 2017, data was collected to report the clinical presentation and management of patients with Retinoblastoma from 278 treatment centers worldwide. It is now 3 years since this data was collected and it is time to collect the 3-year outcome data of the 2017 cohort of patients. Study design: Longitudinal cohort study The broad objective of the study to investigate the outcome of 4,351 patients that were diagnosed with Retinoblastoma in 2017 in 278 treatment centers across the world. The specific objectives are: 1. To investigate the 3-year outcome of patients with Retinoblastoma who were diagnosed in 2017, treated and monitored thereafter in local centers across the world. 2. To investigate the eye survival rate and patient survival rate. 3. To analyze these outcomes by national-income level. 4. To investigate the rate of treatment abandonment and analyze it by national income level. Study period: 10 months This study will be conducted in 278 worldwide and specifically at Lions Sight First Eye Hospital, Blantyre for the Malawi chapter. The files of children who presented with Retinoblastoma in the period of interest will be extracted from the HMIS department. The documented demographics, treatment and outcome will be recorded in the data collection sheet. It is expected that most outcomes will be difficult to extrapolate from the files so patients will have to be called to establish the outcome. A written report will be submitted to the Queen Elizabeth Center Hospital Ethics Committee and the College of Medicine Research and Ethics Committee (COMREC), College of Medicine Library and LSFEH Clinical Director.
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    The prevalence of dry eye disease among adult patients with diabetes at Queen Elizabeth Central Hospital
    (Kamuzu University of Health Sciences, 2022-06-06) Nkume, Harold Ismael
    Type of study This is a hospital-based cross-sectional study Problem Dry eye disease (DED) is one of the most common reasons for consultation. It is classified as a condition that does not typically cause visual impairment. Reliable global prevalence data for DED is lacking, since the focus of eye care strategies is on eye conditions that cause vision impairment and blindness. From subnational epidemiological data, the prevalence of DED can range from 8% to 30%. Diabetes mellitus (DM) is a risk factor for corneal epithelial abnormalities and DED. It causes epithelial barrier dysfunction, leading to corneal complications and then lacrimal function unit dysfunction. There is a scarcity of prevalence data for DED among patients with diabetes in Malawi. This study aims to estimate the prevalence of DED among patients with diabetes at a tertiary hospital in Blantyre. Objectives of the study Broad To estimate the prevalence of dry eye among adult patients with diabetes at QECH Specific 1. To describe the presentation of dry eye among adult patients with diabetes 2. To evaluate risk factors associated with DED among adult patients with diabetes 3. To assess impact of dry eye on quality of life (QOL) among adult patients with diabetes Methodology This study will recruit consecutive consenting adult subjects with diabetes, attending diabetic retinopathy screening clinic every Tuesday at Queen Elizabeth Central hospital, for a period of four months. After pre-clinic health talks and visual acuity check, subjects will be triaged as per study criteria. Demographic data and Ocular Surface Disease Index (OSDI) quality of life questionnaires will be filled, followed by a Tear break-up time test; before proceeding to diabetic retinopathy screening. Results will be recorded on data collection sheets and entered onto an (JASP) for analysis. Primary outcome measures include, Tear Break-up Time, and OSDI Score. Ocular examination summary statistics will include DED prevalence alongside the tabulated categorical frequencies based on demographic, social history and medical history variable categories. Frequency tables summarizing the severity of DED across various categorical variables will be tabulated to estimate risk factor association. Then to reveal correlations between the study variables, a contingency table Pearson’s chi square (χ2) test will be conducted. Expected Findings and dissemination We expect to find between 15-54% prevalence of dry eye disease among patients with diabetes based on previous studies. Results of the study will be presented at the College of medicine research dissemination conference and it is planned that the findings should be published in peerreviewed journals as well as presented at international conferences. A written report of the results will be submitted to, The College of Medicine Research and Ethics Committee (COMREC), Kamuzu University of Health Sciences library and Lions Sight First Eye Hospital (LSFEH)Blantyre Clinical Director.