Access to community-based eye services in Meru, Kenya: a cross-sectional equity analysis.

Background: Over 80% of blindness in Kenya is due to curable or preventable causes and 7.5 m Kenyans currently need eye services. Embedding sociodemographic data collection into screening programmes could help identify the groups facing systematic barriers to care.

Sociodemographic characteristics of community eye screening participants: protocol for cross-sectional equity analyses in Botswana, India, Kenya, and Nepal.

Background: Attendance rates for eye clinics are low across low- and middle-income countries (LMICs) and exhibit marked sociodemographic inequalities. We aimed to quantify the association between a range of sociodemographic domains and attendance rates from vision screening in programmes launching in Botswana, India, Kenya and Nepal.

Methods: We performed a literature review of international guidance on sociodemographic data collection.

Effectiveness of an mHealth system on access to eye health services in Kenya: a cluster-randomised controlled trial.

Background: There is limited access to eye health services in many low-income and middle-income populations. We aimed to assess the effectiveness in increasing service utilisation of the Peek Community Eye Health (Peek CEH) system, a smartphone-based referral system comprising decision support algorithms (Peek Community Screening app), SMS reminders, and real-time reporting.

Methods: In this cluster-randomised controlled trial of eye health in Kenya, community unit clusters were defined as one health centre and its catchment population.

Smartphone-Guided Algorithms for Use by Community Volunteers to Screen and Refer People With Eye Problems in Trans Nzoia County, Kenya: Development and Validation Study.

Background: The provision of eye care services is currently insufficient to meet the requirements of eye care. Many people remain unnecessarily visually impaired or at risk of becoming so because of treatable or preventable eye conditions. A lack of access and awareness of services is, in large part, a key barrier to handle this unmet need.

Peek Community Eye Health - mHealth system to increase access and efficiency of eye health services in Trans Nzoia County, Kenya: study protocol for a cluster randomised controlled trial.

Background: Globally, eye care provision is currently insufficient to meet the requirement for eye care services. Lack of access and awareness are key barriers to specialist services; in addition, specialist services are over-utilised by people with conditions that could be managed in the community or primary care. In combination, these lead to a large unmet need for eye health provision.

Incidence of Visually Impairing Cataracts Among Older Adults in Kenya.

Importance: Half of all the cases of blindness worldwide are associated with cataract. Cataract disproportionately affects people living in low- and middle-income countries and persons of African descent.

Objective: To estimate the 6-year cumulative incidence of visually impairing cataract in adult participants in the Nakuru Eye Disease Cohort Study in Kenya.

Mortality during 6 years of follow-up in relation to visual impairment and eye disease: results from a population-based cohort study of people aged 50 years and above in Nakuru, Kenya.

Objective: To estimate the association between (1) visual impairment (VI) and (2) eye disease and 6-year mortality risk within a cohort of elderly Kenyan people.

Design, Setting And Participants: The baseline of the Nakuru Posterior Segment Eye Disease Study was formed from a population-based survey of 4318 participants aged ≥50 years, enrolled in 2007-2008. Ophthalmic and anthropometric examinations were undertaken on all participants at baseline, and a questionnaire was administered, including medical and ophthalmic history.

3D images as a field grader training tool for trachomatous trichiasis: A diagnostic accuracy study in Ethiopia.

Background: Trachomatous trichiasis (TT) will continue to develop among those people who have had repeated infections after active trachoma is controlled. Detecting and treating affected individuals will remain necessary for years; a long "tail" of incident cases is anticipated. As the prevalence of TT declines, there will be fewer cases available for training trachoma graders (TG), necessitating alternative methods.

Evidence for national universal eye health plans.

Many low- and middle-income countries use national eye-care plans to guide efforts to strengthen eye-care services. The World Health Organization recognizes that evidence is essential to inform these plans. We assessed how evidence was incorporated in a sample of 28 national eye-care plans generated since the was endorsed by the World Health Assembly in 2013.

Smartphone-based screening for visual impairment in Kenyan school children: a cluster randomised controlled trial.

Background: Childhood visual impairment is a major public health concern that requires effective screening and early intervention. We investigated the effectiveness of Peek school eye health, a smartphone-based sight test and referral system (comprising Peek Acuity test, sight simulation referral cards, and short message service [SMS] reminders), versus standard care (Snellen's Tumbling-E card and written referral).

Methods: We initially compared the performance of both the Snellen Tumbling-E card and the Peek Acuity test to a standard backlit EDTRS LogMAR visual acuity test chart.

Glaucoma Features in an East African Population: A 6-Year Cohort Study of Older Adults in Nakuru, Kenya.

Purpose: Glaucoma is a leading cause of blindness in people of African descent. Minimal data is available from African population-based cohort studies. The primary aims of this study were to describe the normative distribution of glaucoma features to enable glaucoma classification and to assess risk factors for those with glaucoma at follow-up among people aged 50 years and above in Kenya.

Factors associated with the high prevalence of oesophageal cancer in Western Kenya: a review.

Oesophageal carcinoma (OC) is highly prevalent in Western Kenya especially among the members of the Kalenjin community who reside in the Northern and Southern areas of the Rift Valley. Previous authors have suggested potential association of environmental and genetic risk factors with this high prevalence. The environmental factors that have been suggested include contamination of food by mycotoxins and/or pesticides, consumption of traditional alcohol (locally referred to and ), use of fermented milk , poor diet, tobacco use and genetic predisposition.

Use of validated community-based trachoma trichiasis (TT) case finders to measure the total backlog and detect when elimination threshold is achieved: a TT methodology paper.

Introduction: The World Health Organization recommends TT surveys to be conducted in adults aged 15+ years (TT 15 survey) and certifies elimination of TT as a public health problem when there is less than 1 unknown case per 1,000 people of all ages. There is no standard survey method to accurately confirm this elimination prevalence threshold of 0.1% because rare conditions require large and expensive prevalence survey samples.

Delay along the care-seeking journey of patients with ocular surface squamous neoplasia in Kenya.

Background: In Africa, accessing eye health services is a major challenge. Ocular surface squamous neoplasia (OSSN) is a substantial ocular health problem in Africa related to solar UV light exposure and HIV infection among other risk factors. The disease causes visual loss and even death in advanced cases.

Six-Year Incidence and Progression of Age-Related Macular Degeneration in Kenya: Nakuru Eye Disease Cohort Study.

Importance: The incidence of age-related macular degeneration (AMD) is unknown in Africa.

Objective: To estimate the 6-year cumulative incidence and progression of AMD in older adults (≥50 years old) in Nakuru, Kenya.

Design, Setting, And Participants: This study assessed a population-based cohort with 6-year follow-up of 4414 participants who had a complete assessment.

The incidence of diabetes mellitus and diabetic retinopathy in a population-based cohort study of people age 50 years and over in Nakuru, Kenya.

Background: The epidemic rise of diabetes carries major negative public health and economic consequences particularly for low and middle-income countries. The highest predicted percentage growth in diabetes is in the sub-Saharan Africa (SSA) region where to date there has been no data on the incidence of diabetic retinopathy from population-based cohort studies and minimal data on incident diabetes. The primary aims of this study were to estimate the cumulative six-year incidence of Diabetes Mellitus (DM) and DR (Diabetic Retinopathy), respectively, among people aged ≥50 years in Kenya.

Six-Year Incidence of Blindness and Visual Impairment in Kenya: The Nakuru Eye Disease Cohort Study.

Purpose: To describe the cumulative 6-year incidence of visual impairment (VI) and blindness in an adult Kenyan population. The Nakuru Posterior Segment Eye Disease Study is a population-based sample of 4414 participants aged ≥50 years, enrolled in 2007-2008. Of these, 2170 (50%) were reexamined in 2013-2014.

Risk factors for ocular surface squamous neoplasia in Kenya: a case-control study.

Objective: To determine modifiable risk factors of ocular surface squamous neoplasia (OSSN) in Kenya using disease-free controls.

Methods: Adults with conjunctival lesions were recruited at four eye care centres in Kenya and underwent excision biopsy. An equal number of controls having surgery for conditions not affecting the conjunctiva and unrelated to ultraviolet light were group-matched to cases by age group, sex and eye care centre.

Knowledge, practices and perceptions of trachoma and its control among communities of Narok County, Kenya.

Background: Trachoma is the leading infectious cause of blindness in the world. It is commonly found in cultural groups with poor hygiene. Trachoma control includes urgery, ntibiotics, acial cleanliness and nvironmental Improvement (SAFE).

Clinical Validation of a Smartphone-Based Adapter for Optic Disc Imaging in Kenya.

Importance: Visualization and interpretation of the optic nerve and retina are essential parts of most physical examinations.

Objective: To design and validate a smartphone-based retinal adapter enabling image capture and remote grading of the retina.

Design, Setting, And Participants: This validation study compared the grading of optic nerves from smartphone images with those of a digital retinal camera.

Development and Validation of a Smartphone-Based Visual Acuity Test (Peek Acuity) for Clinical Practice and Community-Based Fieldwork.

Importance: Visual acuity is the most frequently performed measure of visual function in clinical practice and most people worldwide living with visual impairment are living in low- and middle-income countries.

Objective: To design and validate a smartphone-based visual acuity test that is not dependent on familiarity with symbols or letters commonly used in the English language.

Design, Setting, And Participants: Validation study conducted from December 11, 2013, to March 4, 2014, comparing results from smartphone-based Peek Acuity to Snellen acuity (clinical normal) charts and the Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart (reference standard).

Elimination of blinding trachoma by 2020: a call for rapid scale-up and strengthening programmes.

Elimination of blinding trachoma is targeted for the year 2020, making scale-up extremely urgent. Preferred practices have been developed for mass drug administration and trichiasis surgery to assist new countries and districts. However, these need to be utilised on a broader scale to ensure quality output of programmes and the highest coverage possible of their implementation.

The Nakuru eye disease cohort study: methodology & rationale.

Background: No longitudinal data from population-based studies of eye disease in sub-Saharan-Africa are available. A population-based survey was undertaken in 2007/08 to estimate the prevalence and determinants of blindness and low vision in Nakuru district, Kenya. This survey formed the baseline to a six-year prospective cohort study to estimate the incidence and progression of eye disease in this population.

A study of the medicinal plants used by the Marakwet Community in Kenya.

Background: The medicinal plants used by herbalists in Kenya have not been well documented, despite their widespread use. The threat of complete disappearance of the knowledge on herbal medicine from factors such as deforestation, lack of proper regulation, overexploitation and sociocultural issues warrants an urgent need to document the information. The purpose of the study was to document information on medicinal plants used by herbalists in Marakwet District towards the utilization of indigenous ethnobotanical knowledge for the advancement of biomedical research and development.