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S Resnikoff

Publications and source records attributed to S Resnikoff.

At least 19 recordsLinked to original sources
PubMed2003

Blindness prevention programmes: past, present, and future.

Blindness and visual impairment have far-reaching implications for society, the more so when it is realized that 80% of visual disability is avoidable. The marked increase in the size of the elderly population, with their greater propensity for visually disabling conditions, presents a further challenge in this respect. However, if available knowledge and skills were made accessible to those communities in greatest need, much of this needless blindness could be alleviated. Since its inception over 50 years ago, and beginning with trachoma control, WHO has spearheaded efforts to assist Member States to meet the challenge of needless blindness. Since the establishment of the WHO Programme for the Prevention of Blindness in 1978, vast strides have been made through various forms of technical support to establish national prevention of blindness programmes. A more recent initiative, "The Global Initiative for the Elimination of Avoidable Blindness" (referred to as "VISION 2020--The Right to Sight"), launched in 1999, is a collaborative effort between WHO and a number of international nongovernmental organizations and other interested partners. This effort is poised to take the steps necessary to achieve the goal of eliminating avoidable blindness worldwide by the year 2020.

Blindness↗
PubMed2002

Visual impairment and blindness in Europe and their prevention.

The European region currently differs in many aspects, such as political, socioeconomic, and geographical. After substantial political changes at the beginning of the 1990s, the majority of central and eastern European countries started to rebuild their healthcare systems. It is apparent that eastern Europe represents a highly diverse region where the difference among countries broadens year after year. In highly industrialised countries of Europe, the leading causes of childhood serious visual loss are lesions of the central nervous system, congenital anomalies and retinal disorders. In the middle income countries of Europe, congenital cataract, glaucoma and, mainly, retinopathy of prematurity are highly expressed. The major cause of serious visual loss in adults in industrialised countries is age related macular degeneration. The other conditions comprise cataract, glaucoma, diabetic retinopathy, and uncorrected/uncorrectable refractive errors, along with low vision. In people of working age, diabetic retinopathy, retinopathy pigmentosa, and optic atrophy are the most frequently reported causes of serious visual loss. In the middle income countries of Europe, advanced cataract, glaucoma, and diabetic retinopathy are more frequently observed.

Adolescent↗
PubMed2002

Eye healthcare services in eastern Europe: Part 1. Cataract surgery.

AIM: To describe cataract surgical services in 1998 in 12 eastern European countries and to identify their needs to reduce cataract blindness. METHODS: All inpatient eye departments in the 12 countries received a standardised questionnaire; the data obtained were further processed at the coordinating centre in Prague. RESULTS: All 458 eye departments in the region were involved. The response rate was 100%, except for Bulgaria (93%) and Romania (93%). The total number of cataract surgeries per one million inhabitants in 1998 was calculated: Belarus (800), Federation of Bosnia and Herzegovina (1275), Bulgaria (1730), the Czech Republic (4210), Estonia (2530), Hungary (3530), Latvia (1860), Lithuania (1550), Trans-Dniester Moldova (1300), Poland (1475), Romania (1260), and Slovakia (2430). Cataracts were mostly operated on by the extracapsular technique. Intracapsular extractions were frequently performed in Federation of Bosnia and Herzegovina (47%), Belarus (46%), Bulgaria (18%), and Romania (14.3%). Phacoemulsification was uncommonly used in 1998, except for the Czech Republic (86%), Estonia (50%), Slovakia (38%), and Hungary (16%). An IOL was implanted in more than 90% of patients in the Czech Republic, Estonia, Hungary, Latvia, Lithuania, and Slovakia. CONCLUSIONS: Conditions for cataract surgery in the eastern European region differ. The main barriers to cataract surgery were state budget limitations, insufficient supply of consumables, underutilisation of operating theatres, and poor detection of patients requiring surgery.

Aged↗
PubMed2002

Eye healthcare services in eastern Europe: Part 2. Vitreoretinal surgical services.

AIM: To describe vitreoretinal surgical services in 1998 in 12 eastern European countries and to identify ways for their further improvement. METHODS: All inpatient eye departments in the 12 countries received a standardised questionnaire; the data obtained were processed at the international study coordinating centre in Prague. RESULTS: All 458 eye departments in the region were involved. The number of retinal detachments treated by extraocular surgery, or pars plana vitrectomy, per one million inhabitants respectively, were as follows: Belarus (52; 6), Federation of Bosnia and Herzegovina (21; 2), Bulgaria (39; 19), the Czech Republic (78; 40), Estonia (60; 17), Hungary (81; 88), Latvia (82; 36), Lithuania (68; 6), Trans-Dniester Region of Moldova (6; -), Poland (70; data not available), Romania (24; 25), and Slovakia (67; 55). The number of people per one retinal laser was assessed (in millions): Belarus (1.26), Federation of Bosnia and Herzegovina (2.23), Bulgaria (0.59), the Czech Republic (0.22), Estonia (0.24), Hungary (0.23), Latvia (0.41), Lithuania (0.62), Poland (0.36), Romania (2.25), and Slovakia (0.14). CONCLUSIONS: Conditions for posterior eye segment surgery in the central and eastern European region vary substantially. Underserved regions require (1) more eye doctors trained in surgical and laser retinal treatment; (2) improvement in screening for diabetic eye complications and retinopathy of prematurity; (3) technical equipment for places in need.

Aged↗
PubMed2000

Urbanisation and vitamin A deficiency in children: comparison between a traditional district and a new settlement in Mali.

OBJECTIVES: The purpose of this study was to assess the vitamin A status of pre-school urban children and to compare the situation between a traditional district and a new settlement after two decades of intense urbanisation. SUBJECTS AND METHODS: A cross-sectional stratified survey was carried out in Bamako, Mali, on a representative sample of children (aged 4-6 years). 532 children were involved from a traditional district and 453 from a new settlement (NS). The vitamin A status was assessed by: clinical indicators (ophthalmic examination), subclinical indicators (questionnaire looking for night blindness, impression cytology with transfer test (ICT), modified relative dose response test (MRDR), and a diet inquiry about vitamin A intakes. Acute malnutrition was assessed by a weight/height measure. RESULTS: In both districts, all the clinical indicators were below the WHO criteria that define a public health problem. Both the ICT test, respectively 19 and 21% of abnormal tests, and the MRDR, 67.3 and 73.1% of tests > or = 0.06, indicated a subclinical vitamin A deficiency as defined by WHO thresholds. During the preceding week only four children in NS had consumed vitamin A-rich food less than seven times. No significant difference between the two districts was found either for clinical or subclinical indicators (p > 0.5). CONCLUSION: Despite a rapid urbanisation, the vitamin A status of the children seemed to be rather homogeneous among the different districts. The population remained vulnerable with peripheral depletion and low hepatic stores of vitamin A. The urban children should be carefully monitored regarding vitamin A status.

Anthropometry↗
PubMed2000

[Acanthamoeba keratitis: search for a healthy carrier in Mali].

The first cases of Acanthamoeba keratitis in Africa were reported in 1990 at the Institute of African Tropical Ophthalmology (IOTA) in Bamako, Mali. From 1990 to 1995, a total of 22 cases of corneal ulcers involving Acanthamoeba sp. were diagnosed at the IOTA. To improve our understanding of the epidemiological characteristics of these lesions in tropical areas, we attempted to identify healthy carriers of Acanthamoeba sp. by studying the normal eye flora of 149 patients examined at the IOTA in February 1996. Acanthamoeba sp. was not detected in any sample. Fungi were detected in 22.15 p. 100 of the samples. Thus, it would appear that, unlike fungi, Acanthamoeba sp. is not present in normal eye flora in Mali. This findings suggests that the occurrence of Acanthamoeba in corneal ulcers is not an accident. Our results also emphasize the need for screening to detect Acanthamoeba in developing countries such as Mali. However, further study will be needed to confirm these findings in a larger group of subjects more closely matched with the patients presenting the corneal ulcers diagnosed at the IOTA, especially with regard to geographical origin.

Acanthamoeba↗
PubMed1997

Ganciclovir ophthalmic gel (Virgan; 0.15%) in the treatment of herpes simplex keratitis.

PURPOSE: Ganciclovir is a broad-spectrum virustatic agent. Its efficacy and safety after ocular application have been demonstrated in studies of herpetic keratitis in rabbits. Two strengths of ganciclovir gel (0.05 and 0.15%) were compared with 3% acyclovir ointment in the treatment of superficial herpes simplex keratitis in humans. METHODS: Two multicenter randomized clinical trials were carried out in Africa (Trial 1) and Europe (Trial 2). Sixty-seven patients (Trial 1) and 37 patients (Trial 2) from herpetic ulceration were recruited. RESULTS: The results showed no statistically significant difference between the treatment groups, although the healing rates tended to be better in the group receiving 0.15% ganciclovir gel, with healing rates of 85% (Trial 1) and 83% (Trial 2) as compared with 72% (Trial 1) and 71% (Trial 2) in the group receiving acyclovir ointment. Local tolerance was found to be superior with the gel formulation of ganciclovir with fewer complaints of discomfort (stinging, burning) or blurred vision after application of the drug. Systemic absorption of the drug was low. No hematologic changes were detected. CONCLUSIONS: These findings support the efficacy of ganciclovir gel in the treatment of ulcerative herpes simplex keratitis and demonstrate its superior local tolerance when compared with acyclovir ointment.

Acyclovir↗
PubMed1996

[Ophthalmologic complications due to human immunodeficiency virus infection at Bamako (Mali)].

AIDS ocular complications have been researched in 70 hospitalised patients in the two main hospitals of Bamako (Mali) during one year (1992-1993). Men were predominant (sex ratio 1.6). HIV1 infections (67%) were most frequent than HIV1 + HIV2 (21.4%) or HIV2 infections (11.4%). Most of the patients were on the WHO's clinical stage III; 34% of them had ocular complications, quite often non infectious: cotonous nodules (10%), vascularitis (5.7%) and retineous haemorrhages (4.3%). Ocular opportunistic infections were rare: only one case of toxoplasmic chorio-retinitis was reported. Ocular complications were observed with all types of HIV. Vascular abnormalities were observed in the stage II or IV of AIDS and seemed, in Bamako, as a serious sign during the AIDS course.

Adolescent↗
PubMed1995

Health education and antibiotic therapy in trachoma control.

The objective of this study was to confirm whether the combination of a health education programme with a mass treatment campaign was able to improve the effectiveness of trachoma control. An open controlled clinical trial with a 2 x 2 factorial design was carried out. Four villages, matched for size and epidemiological, economic and social conditions, were included in the study. The first village received mass treatment with 1% oxytetracycline eye drops combined with a specific health education programme. The second village received only a health education programme. The third village received only mass treatment and the fourth village did not receive any intervention during the study (control village). 1810 subjects were enrolled of whom 76% were successfully followed for 6 months. The incidence of new cases ranged between 1.6% and 14.2%. In this study the combination of a health education programme with mass treatment failed to increase the cure rate. There was even a negative interaction (P = 0.03). The best results were obtained in the village where antibiotic treatment was used alone, both in terms of cure rate (82%) and reduction of C trachomatis transmission. These results suggest that the addition of a health education programme does not systematically improve the performances of a mass treatment campaign. The efficacy of this combination depends essentially on the capacity of the community to modify its hygiene behaviour.

Anti-Bacterial Agents↗
PubMed1994

[Course of trachoma under treatment with 1% oxytetracycline ophthalmic solution].

PURPOSE: In order to optimize the trachoma treatment duration, we carried out a prospective study to observe the disease course over a long period of treatment by a 1% oxytetracycline (chlorhydrate) suspension. METHODS: The study involved 50 children between 2 and 12 years living in three Malian villages. The existence of an active trachoma was clinically characterized by the presence of at least 5 follicles associated with a papillary hypertrophy of the upper tarsal conjunctiva. The treatment was administered daily 4 times a day, for two months. All patients were examined before being treated, then on the 15th, 30th and 60th day. The presence and the importance of the follicles, papillae and trachomatous scarring were scored. During treatment, no patient manifested a case of follicular score aggravation. The moderate cases reacted more rapidly than the severe ones. In most cases the reduction in the number of follicles became evident only after two weeks of treatment. On the other hand, the inflammatory hyperplasia diminished rapidly from the 15th day. The cicatricial score was constant and pre-existing scars were not aggravated. After treatment, 33 patients out of 50 (66%) could be considered cured. CONCLUSION: The analysis of data suggests that a longer period of treatment would have led to a higher healing percentage. In fact, all forms of intense trachomatous inflammation, likely to cause blindness, diminished before the end of the control period.

Child↗
PubMed1994

[Effect of water supply on the incidence of trachoma: preliminary results of a prospective study in Mali].

This prospective study (January 1993-January 1994) was carried out in two groups of villages of the district of Ouelessebougou (Mali). The objective of the study was to assess the impact of installing water supply boreholes on the incidence of trachoma. A prospective group of 4 villages, where boreholes were sunk at the beginning of the study, was compared to a control group of 4 villages where there are no boreholes. The examination concerned children below the age of 10 years (N = 700) and was carried out using binocular loupes, according to the simplified procedure for trachoma grading proposed by the WHO. Our results show that in the prospective group, the annual rate of incidence of inflammatory trachoma was 8% (cl: 5.8-10.7) while in the control group it was 14% (cl: 9.6-10.9). RR: 0.58 (0.37-0.90). Likewise the rate of spontaneous healing was 12% (Cl: 9.1-14.9) in the prospective group and 5% (cl: 2.4-9) in the control group. Relative Risk was 2.60 (1.36-4.9). These statistically significant results show that the risk of contracting trachoma is reduced by half in the villages where a borehole has been sunk.

Child↗
PubMed1992

Impression Cytology with Transfer in xerophthalmia and conjunctival diseases.

During a countrywide survey, we assessed the prevalence of clinical signs of xerophthalmia and of major conjunctival diseases in a randomized sample of 2,445 subjects representative of the population of the Republic of Djibouti. On a part of this sample, conjunctival Impression Cytology with Transfer (ICT) test and a plasma retinol determination were performed. Xerophthalmia as a public health problem was displayed by clinical signs (Bitot's spots, corneal scars among preschool children), low plasma retinol levels and ICT test results: 9.3% with deficient cytology in the rural area and 12.3% in the urban one (age-standardized rates). Results of ICT were related to age (p < 0.00001). Vitamin A deficiency was prevalent not only in preschool children but also up to 15 years. Moreover, ICT results are influenced by conjunctival diseases: compared to age-matched controls, there were more abnormal cytologies among patients with trachomatous inflammation (p = 0.025), conjunctivitis (p = 0.024) or Limbal Vernal Keratoconjunctivitis (p = 0.015). Thus ICT shouldn't be performed among children with conjunctival diseases. In the region under study conjunctival diseases had high rates of prevalence: 16.4% of trachomatous scarrings in the urban area (standardized rate), 8% of conjunctivitis among rural preschool children, and 5% of Limbal Vernal Keratoconjunctivitis among children between 5 and 14 years in both areas.

Adolescent↗
PubMed1992

Assessment of vitamin A deficiency in a rural area in Mali. Estimation of sample size for the impression cytology test.

The prevalence of vitamin A deficiency among two to ten years old children in a rural area of Mali was assessed by ophthalmic examination, determination of plasma retinol levels and impression cytology with transfer tests. A Public Health problem of vitamin A deficiency was identified in this rural area by: the prevalence of nightblindness significantly (p < 0.001) above the cut-off (1%) defined by the World Health Organization (WHO); the prevalence of corneal scarring significantly (p < 0.001) above the WHO's cut-off (0.05%); the percentage of subjects with plasma retinol levels below 0.35 mumol/l (10 micrograms/dl) significantly (p < 0.001) higher than the WHO's threshold (5%); and 52.8 +/- 8.2% children with "Abnormal" impression cytology as determined by the impression cytology test (IC). This preliminary survey confirmed widespread vitamin A deficiency in Mali. The minimum sample size required for a study using the impression cytology test to determinate a Public Health problem in a population was calculated for different situations. Ophthalmic examination indicated a very high rate of active trachoma (29.6 +/- 7.0%), and a relationship between active trachoma and impression cytology results was identified.

Child↗
PubMed1992

Assessment of vitamin A deficiency in the Republic of Djibouti.

In a countrywide survey, we assessed the prevalence of vitamin A deficiency by clinical examination and impression cytology with transfer method (ICT) in a randomized sample of 2445 subjects representative of the population of the Republic of Djibouti. A plasma retinol determination was made on a part of this sample. Results lead to believe that serious vitamin A deficiency may periodically occur in Republic of Djibouti when nutritional conditions become poor. Meanwhile a large number of children, mostly in the rural area, have a marginal vitamin A status and are exposed to a high level of risk.

Adolescent↗
PubMed1991

Climatic droplet keratopathy, exfoliation syndrome, and cataract.

During a countrywide survey we assessed the prevalence of climatic droplet keratopathy (CDK) in a randomised sample of 2446 subjects representative of the population of the Republic of Djibouti. The investigation of the relationship between CDK and two diseases considered to be related to exposure to ultra-violet light--namely, exfoliation syndrome and cataract--was planned as a case control study. In the rural area prevalence of CDK was five times higher than in the urban one (2.8% vs 0.5%) and varied according to districts. The highest rates were observed where the inhabitants' activities were related to the sea. The case control study revealed that the opacification of the lens was about three times commoner in patients with CDK than in patients without CDK (p = 0.03) and that the exfoliation syndrome was about six times commoner in patients with CDK than in controls of similar age, sex, climatic conditions, and lens status (p = 0.02). Moreover, we noticed that the sequelae of corneal perforations were about 30 times commoner in patients with CDK than in controls of similar age (p less than 0.00001).

Adult↗
PubMed1991

[Tropical conjunctivitis: infectious etiology and validation of its clinical features].

173 nontrachomatous conjunctivitis studied at the I.O.T.A. in Bamako, Mali, have shown a majority of bacterial aetiology, especially gram-negative. 1 out of 10 conjunctivitis was due to virus, mostly to adenovirus. 4% of the cases were due to Chlamydia Trachomatis. The try of validation of the clinical characters in comparison with the etiology has shown that Chemosis was an indicator of a bacterial conjunctivitis (OR = 2.4) and that the lack of purulent discharge was in connexion with the presence of a keratitis (OR = 7.7). On the one hand the frequency of gram-negative bacteria, on the other hand the potential gravity of the conjunctivitis in tropical area, would justify the use of gentamycin at first in nontrachomatous conjunctivitis.

Adenoviridae Infections↗