Prevalence and Causes of Visual Impairment in Fundong District,North West Cameroon: Results of a Population-Based Survey

Purpose: To estimate the prevalence and causes of visual impairment in Fundong Health District, North West Cameroon.

Methods: A total of 51 clusters of 80 people (all ages) were sampled with probability proportionate to size and compact segment sampling. Visual acuity (VA) was measured with a tumbling “E” chart. An ophthalmic nurse examined people with VA<6/18 in either eye. The presence of hearing and physical impairments were assessed using clinical examination, and self-reported visual problems using the Washington Group Short Set.

Results: In total, 4080 people were enumerated of whom 3567 were screened (response rate 87%). The overall prevalence of visual impairment was 2.3% (95% CI 1.8–3.0%) and blindness was 0.6% (0.3–1.0%). The prevalence of both blindness and visual impairment increased rapidly with age, so that the vast majority of cases of visual impairment (84%) and blindness (82%) were in people aged 50+. Posterior segment disease and cataract were the main causes of blindness and visual impairment, with refractive error also an important cause of visual impairment. Cataract surgical coverage (proportion of all cataracts that had received surgery) was relatively high (87% of people at VA<6/60). Post-surgery outcomes were poor, with 31% of operated eyes having VA<6/60. Among the 82 people with visual impairment, 22% had a physical impairment or epilepsy and 30% had a hearing impairment. Self-reported difficulties in vision were relatively closely related to clinical measures of visual impairment.

Conclusions: Ophthalmic programmes in Cameroon need to incorporate control of posterior segment diseases while also working to improve outcomes after cataract surgery.     

Medicinal plants from Jordan in the treatment of cancer: traditional uses vs. in vitro and in vivo evaluations--part 1

Plant species have long been used as principal ingredients in traditional medicine. Different surveys showed that ethnomedicinal plant species used by the inhabitants of Jordan for the treatment of cancer are inadequately screened for their therapeutic/chemopreventive potential and phytochemical findings. In this mini review, traditional herbal medicines pursued indigenously with their methods of preparation and active constituents are listed. Studies of random screening for selective cytotoxicity and antiproliferative activity of local spices, domesticated greens, or wild plants are briefly discussed. Recommended future directives for the design and conduct of comprehensive trials are pointed out to validate the usefulness of these active plants or bioactive phytoconstituents either alone or in combination with existing therapies or complementing pharmacologies.     

Medicinal plants from Jordan in the treatment of diabetes: traditional uses vs. in vitro and in vivo evaluations--part 2

Diabetes mellitus is the most common metabolic disorder affecting millions worldwide. It is recognized as a global major health problem. As alternatives to the available orthodox medicines, plants are considered a potential source for the treatment of diabetes within traditional ethnomedicine practices. In the Jordanian traditional medicine a significant selection of ethnobotanicals is promoted for their antidiabetic activity. Literature surveys demonstrate the benefit of several ethnobotanicals as antidiabetic agents evaluated in in vitro and in vivo systems in the form of their crude extracts and/or isolated pure compounds with varying degrees of hypoglycemic or antihyperglycemic bioactivities. This mini review discusses the preparatory forms in which these plants are consumed, their reported phytoconstituents, and the results of their reported antidiabetic bioactivity.     

Same-visit HIV testing in Trinidad and Tobago

Background  

The Ministry of Health (hereafter, Ministry) of Trinidad and Tobago is responsible for delivery of all health services in the country. The Ministry takes responsibility for direct delivery of care in the public sector and has initiated a process whereby those seeking HIV test results could obtain confidential reports during a single-visit to a testing location. The Ministry requested technical assistance with this process from the Caribbean Epidemiology Centre (CAREC). The United States Centers for Disease Control and Prevention (CDC) played an important role in this process through its partnership with CAREC.     

Agrochemicals pose health risks to coffee factory workers in Githuguri (Kenya)

In this century, the use of pesticides and fertilizers (agrochemicals) is indispensable because they are seen as a panacea for protecting crops from insects and diseases. However, the manner in which these agrochemicals are handled poses significant health risks to manufacturers, transporters, vendors and farmers. In Kenya, for example, coffee factory workers (specifically storekeepers) apportion the agrochemicals and sell them to the coffee farmers. The process of apportioning and other factors expose these workers to health risks. In order to evaluate the extent of the problem, a pilot study was undertaken in the Githuguri location. The results showed that lack of use of protective clothing, poor handling of agrochemicals and poorly designed storage facilities were very common. As a result, 95% of the workers interviewed reported a variety of agrochemical health related problems. In conclusion, the government and the public role regarding possible preventive measures were proposed.     

The chemokine network: a target in cancer biology?

Chemokine gradients are central to the movement of cells in both homeostatic and pathological processes. Most cancers express a complex array of chemokines that influence the local microenvironment through recruitment of stromal cells and by stimulating angiogenesis. Recently, the discovery of chemokine receptors on tumor cells has led to speculation that the chemokine system may be involved in cancer cell growth and survival, and possibly the development of site-specific spread. Understanding the networks of chemokines and their receptors in cancer will enable manipulation of this system. Both chemokines and their receptors represent targets for therapeutic intervention either with antibodies or small molecule antagonists. However, due to the complexity of the system, and the number of chemokines and receptors that are also expressed by normal cells, issues remain concerning whether systemic or local drug delivery are preferable and whether the redundancy of the system will compensate if one chemokine or receptor is targeted. Nevertheless, efficacy has been demonstrated in a number of experimental models. By targeting this network, it may be possible to generate anti-tumor immune responses by altering the chemokine and/or leukocyte balance in tumors; alternatively, chemokine/chemokine receptor-expressing cancer cells could be directly targeted.