The aim of this review is to evaluate the prevalence of and factors associated with keratoconus in Africa. Method: A systematic online literature search was conducted for articles on keratoconus in Africa. Meta-analysis was performed to estimate the prevalence of keratoconus in Africa. The Freeman-Tukey double arcsine transformation was used to minimize the effects of studies with extremely high or low prevalence estimates on the overall pooled estimates. Leave-one-out sensitivity analysis was used to assess the robustness of the pooled effects and potential outliers. Meta-regression was performed to explore associations between keratoconus, gender and age. Results: Twelve studies were included in the review; 5 from Egypt, 2 from South Africa, 2 from Kenya, 1 from Sudan, 1 from Ghana and 1 from Nigeria. Two studies were conducted in allergic conjunctivitis patients, 4 in keratoconus patients, 1 in contact lens service seekers, 1 in pre-LASIK patients, 1 in refractive patients and 1 in a student population. Eight studies were included in the meta-analysis. The overall prevalence estimate of keratoconus in Africa was 7.9% (95% CI: 2.5%-16.0%). The prevalence of keratoconus among males and females in Africa was estimated to be 9.3% (95% CI: 2.5%-19.5%) and 5.8% (95% CI: 1.5%-12.7%) respectively. The estimated prevalence of unilateral and bilateral keratoconus was 2.6% (95% CI: 0.4%-6.5%) and 5.8% (95% CI: 1.6%-12.3%), respectively. The estimated prevalence of mild keratoconus was 2.2% (95% CI: 0.7%-4.7%), moderate keratoconus was 3.5% (95% CI: 0.0%-11.8%) and severe keratoconus was 4.0% (95% CI: 0.0%-19.6%). There was no significant association between gender and the prevalence of keratoconus in Africa (p = 0.63), and age and the prevalence of keratoconus in Africa (p = 0.78). Conclusion:The estimated prevalence of keratoconus reported here is higher than prevalence values reported in other meta-analyses or different geographical locations. This is mainly because studies included in this meta-analysis were either conducted on a cohort at high risk of keratoconus or a population with high possibility of finding keratoconus patients. There is a dearth of well-designed population-based studies on keratoconus in Africa, resulting in a lack of epidemiological information. This highlights the urgent need for research on keratoconus in Africa.

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Background. The purpose of the study was to determine the prevalence of computer vision syndrome (CVS) and poor sleep quality among university students and assess the relationship between digital device usage, CVS, and sleep quality. Methods. A cross-sectional study including undergraduate students was conducted in Ghana between January–March 2020. Information on digital device use and CVS symptoms was collected using a structured questionnaire. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was used to determine the relationship between CVS and digital device use behavior, and linear regression analysis was used to explore the association between sleep quality and digital device use behavior. Statistical significance was set at p  < 0.05. Results. Mean (SD) age of participants was 20.95 (1.68) years and most (54.97%) of them were females. The prevalence of CVS was 64.36%. Factors associated with CVS included hours of digital device use per day (OR = 4.1, p  < 0.001), years of digital device use (OR = 3.0, p  < 0.001), adjustment of digital device screen contrast to the surrounding brightness (OR = 1.95, p  = 0.014), and presence of glare (OR = 1.79, p  = 0.048). Prevalence of poor sleep quality was 62.43%. There was a significant association between poor sleep quality and number of years participants had used a digital device ( p  = 0.015) and the number of hours they used a digital device per day ( p  = 0.005). Conclusion. There is a high prevalence of both CVS and poor sleep quality among undergraduate students in Ghana. This represents a significant public health issue that needs attention.

Studies in recent times have shown that health trainees across the world usually report that they felt not properly positioned to deal with ethical issues or dilemmas they came across during clinical work. Medical code of ethics, etiquette and conduct of professionals are guidelines that have been stipulated to protect the patient. The main aim of this research was to assess the knowledge ophthalmic trainees had in ethics and also assess their observations made while under tutelage. A descriptive study with a cross-sectional design was used in this research. Fifty (50) final year ophthalmic trainees were sampled conveniently from the