STOP Glaucoma in Sub Saharan Africa: enhancing awareness, detection, management, and capacity for glaucoma care

Damji, Karim F.; Nazarali, Samir; Giorgis, Abeba T.; Kiage, Dan; Marco, Sheila Akinyi; Philippin, Heiko; Daniel, Neema; Amin, Samreen

doi:10.1080/17469899.2017.1295848

Cited by 12 publications

(8 citation statements)

References 35 publications

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“…The cost of repairing imported equipment can be high in regions where specialised service personnel sometimes need to be flown in or the equipment needs to be shipped abroad for maintenance or repair. 36 The salaries of ophthalmologists and other eye care professionals are a crucial component. Both treatments can be offered as an affordable intervention for glaucoma using the annual gross domestic product per capita as a surrogate for income and an affordability threshold of 2·5%.…”

Section: Discussionmentioning

confidence: 99%

Selective laser trabeculoplasty versus 0·5% timolol eye drops for the treatment of glaucoma in Tanzania: a randomised controlled trial

Philippin

Matayan

Knoll

et al. 2021

The Lancet Global Health

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Background Glaucoma is a major cause of sight loss worldwide, with the highest regional prevalence and incidence reported in Africa. The most common low-cost treatment used to control glaucoma is long-term timolol eye drops. However, low adherence is a major challenge. We aimed to investigate whether selective laser trabeculoplasty (SLT) was superior to timolol eye drops for controlling intraocular pressure (IOP) in patients with open-angle glaucoma. MethodsWe did a two-arm, parallel-group, single-masked randomised controlled trial at the Eye Department of Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Eligible participants (aged ≥18 years) had open-angle glaucoma and an IOP above 21 mm Hg, and did not have asthma or a history of glaucoma surgery or laser. Participants were randomly assigned (1:1) to receive 0•5% timolol eye drops to administer twice daily or to receive SLT. The primary outcome was the proportion of eyes from both groups with treatment success, defined as an IOP below or equal to target pressure according to glaucoma severity, at 12 months following randomisation. Re-explanation of eye drop application or a repeat SLT was permitted once. The primary analysis was by modified intention-to-treat, excluding participants lost to follow-up, using logistic regression; generalised estimating equations were used to adjust for the correlation between eyes. This trial was registered with the Pan African Clinical Trials Registry, number PACTR201508001235339. Findings 840 patients were screened for eligibility, of whom 201 (24%) participants (382 eligible eyes) were enrolled between Aug 31, 2015, and May 12, 2017. 100 (50%) participants (191 eyes) were randomly assigned to the timolol group and 101 (50%; 191 eyes) to the SLT group. After 1 year, 339 (89%) of 382 eyes were analysed. Treatment was successful in 55 (31%) of 176 eyes in the timolol group (16 [29%] of 55 eyes required repeat administration counselling) and in 99 (61%) of 163 eyes in the SLT group (33 [33%] of 99 eyes required repeat SLT; odds ratio 3•37 [95% CI 1•96-5•80]; p<0•0001). Adverse events (mostly unrelated to ocular events) occurred in ten (10%) participants in the timolol group and in eight (8%) participants in the SLT group (p=0•61). Interpretation SLT was superior to timolol eye drops for managing patients with open-angle high-pressure glaucoma for 1 year in Tanzania. SLT has the potential to transform the management of glaucoma in sub-Saharan Africa, even where the prevalence of advanced glaucoma is high. Funding Christian Blind Mission, Seeing is Believing Innovation Fund, and the Wellcome Trust.

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Section: Discussionmentioning

confidence: 99%

Selective laser trabeculoplasty versus 0·5% timolol eye drops for the treatment of glaucoma in Tanzania: a randomised controlled trial

Philippin

Matayan

Knoll

et al. 2021

The Lancet Global Health

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“…Community based detection remains a veritable tool to discovering more cases of glaucoma and initiating early / prompt treatment. One of such novel programs worthy of emulation is the "STOP Glaucoma in SSA", built on four main pillars which include capacity development, enhancing disease awareness, and improving glaucoma detection and management [9]. The ultimate aim is to reduce glaucoma blindness in SSA.…”

Section: Discussionmentioning

confidence: 99%

Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Awoyesuku¹,

Chukwuka²

2018

Int J Clin Exp Ophthalmol

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To determine the proportion of participants with elevated intraocular pressure and abnormal vertical cup disc ratio in a glaucoma screening event in a rural community in Nigeria. Methods: 242 eyes of 121 participants at a one-day screening programme were examined. Visual acuity was accessed using Snellen literate and illiterate charts, followed by a pen torch examination of the anterior segment. The posterior segment was accessed using a direct ophthalmoscope (Welch Allyn, USA). All participants had intraocular accessed using Keeler non contact tonometer and those with signifi cant media opacity preventing view of the posterior pole had cycloplegic examination after dilatation with 1%Tropicamide drops. Data generated was expressed as percentages and means. Results: 121 participants (242 eyes) were examined. There were 42 males and 79 females giving a M:F ratio of 1:1.86. Age range of participants was 0-90years with a peak in the 5th decade. Mean age was 32 years. 79.3% of participants had normal visual acuity of 6/4-6/18, while 9.5% had visual acuity worse than 6/60. 83% of eyes had intraocular pressure within normal level, <21mmHg, 12.4% within 21-30mmHg and 4.6% >30mmHg. 73.1% of eyes had Vertical Cup disc ratio (VCDR) <0.5, 10.7% had 0.5-0.7 and 6.6%>0.7. 9.6% of eyes could not be accessed due to media opacities. Conclusion: 6.6% of participants had suspicious discs and 4.6% participants had intraocular pressures above 30mmHg. Opportunistic screening for glaucoma remains one of the important modes of case detection for glaucoma in the developing climes and should be encouraged as a way to address the scourge of this blinding disease.

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“…In 2012, the current department head, Dr. Karim Damji was selected as one of Canada's new rising stars in global health by Grand Challenges Canada and was awarded $100,000 to pilot teleglaucoma in East Africa, as part of an endeavor called 'STOP Glaucoma in Sub Saharan Africa'. 6 The STOP Glaucoma initiative is aimed at creating a self-sustaining system in which eye specialists based in academic institutions can be trained to detect and manage glaucoma in a collaborative environment that fosters international standard patient care, teaching and research.…”

Section: Patients Firstmentioning

confidence: 99%

“…Since 2006, Dr. Damji has been the lead of the "STOP Glaucoma" program which is aimed at reducing the rate of glaucoma-related blindness in sub-Saharan Africa. 6 He also initiated an interprofessional eye care forum that brings together various stakeholders in a collaborative educational environment centred on best patient care.…”

Section: From Bench To Bedsidementioning

confidence: 99%

Ophthalmology at the University of Alberta: Over 8 Decades of People-driven Contributions

Nazarali

Friedman

Damji

2017

Canadian Journal of Ophthalmology

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With a vision to lead patient-centred eye care through outstanding and integrated service, education, and research, the Department of Ophthalmology and Visual Sciences at the University of Alberta (referred to hereafter as the Department) serves over 3 million people residing in Edmonton, Northern Alberta, Northeastern British Columbia, Yukon Territory, Northwest Territories, and Northwestern Saskatchewan. Based on a recent celebration of the Department's 80th anniversary and research conducted by a historian (including archived and printed sources in addition to oral and written interviews), we have captured key people-driven contributions in education, patient care, research, and leadership, which we hope will be motivational and educational for learners, ophthalmologists, vision scientists, and leaders in the eye care field.

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STOP Glaucoma in Sub Saharan Africa: enhancing awareness, detection, management, and capacity for glaucoma care

Cited by 12 publications

References 35 publications

Selective laser trabeculoplasty versus 0·5% timolol eye drops for the treatment of glaucoma in Tanzania: a randomised controlled trial

Selective laser trabeculoplasty versus 0·5% timolol eye drops for the treatment of glaucoma in Tanzania: a randomised controlled trial

Is community based case detection of glaucoma relevant? Intraocular Pressure level and vertical Cup Disc ratio of participants at a screening programme in a rural setting in Nigeria

Ophthalmology at the University of Alberta: Over 8 Decades of People-driven Contributions

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