Kwadwo Owusu Akuffo

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• OD, PhD
• Senior Lecturer at Kwame Nkrumah University of Science and Technology

Abstract Background Vision loss is a major public health concern that significantly affects developing countries, including South Africa. Although existing literature have reported on the prevalence, causes, and impact of vision loss on the quality of life of affected individuals (children and adults) in parts of South Africa, there is no evidence...

Background Although the equitable distribution of diabetic retinopathy (DR) services across Ghana remains paramount, there is currently a poor understanding of nationwide DR treatment services. This study aims to conduct a situation analysis of DR treatment services in Ghana and provide evidence on the breadth, coverage, workload, and gaps in servi...

Empirical antimicrobial therapy is linked to a surge in antimicrobial resistant infections. However, an insight on the bacteria etiology of ocular infections is essential in the appropriation of choice of antimicrobial among clinicians, yet there remains a dearth of data from Ghana. We investigated the bacteria etiology of external ocular and perio...

Background Macular pigment optical density (MPOD) remains an indispensable biomarker to measure fruit and vegetable intake, with a biologically plausible correlation to vision and cognition. However, evidence in the sub-Saharan regions, including Ghana, is lacking. Objective This study explored dietary carotenoid intake on MPOD and its influence o...

Purpose: To characterize practice patterns of low vision services among Optometrists in Ghana. Methods: The nationwide cross-sectional survey identified entities through the Ghana Optometrists Association (GOA) registry and utilized a semi-structured questionnaire to consolidate survey information that comprises practitioners' demographics, avai...

Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefull...

Introduction Following the formal launch of the AAO-African Chapter in October 2023, there was a renewed interest among African Optometrists to obtain the Fellowship of the American Academy of Optometry (FAAO). This paper investigates the awareness of the FAAO process among African optometrists and their perception of the newly established African...

Background Existing evidence on the burden of mental health problems among pregnant and postpartum women living with HIV, a vulnerable population in sub-Saharan Africa (SSA), is limited and fragmented, affecting the development of context-sensitive and integrated interventions. This systematic review aims to provide an up-to-date and comprehensive...

Background Obstetric fistulas are abnormal open connection(s) between the vagina and the urinary tract or the rectum resulting from tragic injuries sustained by mothers during childbirth that lead to urine and/or faecal incontinence. Due to the rapidly growing middle class in sub-Saharan Africa (SSA) and the corresponding quest for hospital deliver...

Background Ocular mycoses have a debilitating impact on ocular health and quality of life. However, the burden and etiology of ocular mycoses and the efficacy of clinical antifungal agents used in the management of ocular fungal infections remain unclear. The study assesses the prevalence of ocular fungal pathogens and multi-drug resistance pattern...

Background Hundreds of millions of doses of Praziquantel (PZQ) have been administered to persons with and without schistosomiasis living in schistosomiasis endemic settings, through the mass drug administration (MDA) strategy which started in the early 2000s. A recent publication suggested high risk of PZQ-related visual disorders, raising public h...

Despite their debilitating impact on eye health, it is unclear the fungal pathogens implicated in oculomycosis; and the efficacy of clinically used antifungal therapy among ophthalmic clinicians, especially from Ghana, remains enigmatic. Here we use a comprehensive clinical and laboratory data to fill this evidence gap. About ten percent (9.36%) of...

Introduction The RTS,S vaccine has been approved for use in children under 5 living in moderate to high malaria transmission areas. However, clinically important adverse events have been reported in countries in sub-Saharan Africa. This systematic review aims to assess the frequency, severity and clinical importance of vaccine-related adverse event...

Background The number of elderly people living with HIV (EPLHIV) has increased significantly as a result of antiretroviral treatment (ART) and this has brought about a variety of psychosocial challenges that have an impact on their quality of life (QoL). Various psychosocial interventions have been tried or implemented in Sub-Saharan Africa (SSA) t...

Background: Job satisfaction describes an employee's motivation and/or feeling of satisfaction towards his/her work. Globally, healthcare professionals' turnover and retention play a critical role in the delivery of essential health services. In Ghana, however, little has been done to ascertain job satisfaction levels among human resources for eye-...

Aim: To characterize practice patterns of low vision services among Optometrists in Ghana. Methods: The nationwide cross-sectional survey identified entities through the Ghana Optometrists Association (GOA) registry and utilized a semi-structured questionnaire to consolidate survey information that comprises practitioners demographics, available se...

Background Clinicians in areas where malaria and typhoid fever are co-endemic often treat infected patients irrationally, which may lead to the emergence of drug resistance and extra cost to patients. This study determined the proportion of febrile conditions attributable to either malaria and/or typhoid fever and the susceptibility patterns of Sal...

Background Malaria and typhoid fever coinfection presents major public health problems especially in the tropics and sub-tropics where malaria and typhoid fever are co-endemic. Clinicians often treat both infections concurrently without laboratory confirmation. However, concurrent treatment has public health implications as irrational use of antibi...

Millions of praziquantel doses have been delivered in schistosomiasis endemic populations through preventive chemotherapy. However, no comprehensive assessment of short and long-term safety has been conducted. This systematic review assessed safety of praziquantel in persons with and without schistosome infections who received praziquantel treatmen...

Background: Childhood cataract unlike adult-related cataract has received a little attention despite the devastating consequences on the early development of the visual system and the overall impact on the quality of life of children. The existence of accurate epidemiological data is a primary step towards management strategies, however, there rema...

Background The reporting of cataract surgical outcomes serves as quality control checks to optimize postoperative vision outcomes and/or minimize ensued complications. However, there is paucity of data from low-and-middle-income countries such as Ghana. This study determined postsurgical visual outcomes after cataract surgery and assessed factors a...

Background Spontaneous reporting of adverse drug reactions (ADR) is an effective means of ensuring postmarketing surveillance of drugs, and health professionals play a cardinal role through voluntary reporting of ADR. However, the pharmacovigilance system in Ghana is plagued with under-reporting issues, which is of public health concern. Method A...

Despite internationally recognized guidelines, amblyopia management varies among eye care professionals worldwide. Hence, we sought to investigate the practice patterns of amblyopia management and the factors associated with the decision to treat amblyopia among optometrists in Ghana. A cross-sectional survey was conducted among registered optometr...

Background: Access to skilled delivery services are crucial in reducing maternal mortality, however, the prevalence of women with assisted deliveries in our health facilities remains low with reasonable disparities between rural and urban Ghana. This study examined the utilization of skilled delivery by pregnant women and its associated factors in...

Empirical antimicrobial therapy is linked to a surge in antimicrobial resistant infections. However, an insight on the bacteria etiology of ocular infections is essential in the appropriation of choice of antimicrobial among clinicians, yet there remains a dearth of data from Ghana. We investigated the bacteria etiology of external ocular and perio...

Aims To assess the determinants of glycaemic control among patients with Type 2 diabetes mellitus (T2DM) presenting at the Greater Accra Regional Hospital, Ghana. Methods The study employed semi-structured questionnaires and review of clinical records of patients 16 years and above with Type 2 Diabetes. Results The mean age of participants was 56...

Background Easy access to medicines provided by private medicine retailing facilities including that of over-the-counter medicine retailers, have gained prominence in sub-Saharan Africa. Although over-the-counter medicine-sellers (OTCMS) facilities play an indispensable role in healthcare delivery, there is inadequate information about their regula...

Background: Artisanal mining creates enabling breeding ground for the vector of malaria parasites. There is paucity of data on the effects of artisanal mining on malaria. This study assessed burden of malaria and caregivers' health-seeking behaviour for children under five in artisanal mining communities in East Akim District in Ghana. Methods:...

Background: Artisanal mining creates enabling breeding ground for the vector of malaria parasites. There is paucity of data on the effects of artisanal mining on malaria. This study assessed burden of malaria and caregivers' health-seeking behaviour for children under five in artisanal mining communities in East Akim District in Ghana. Methods: A c...

Background HIV/AIDS remains a threat to global development and human security. Sub-Saharan Africa is the worst affected, with an estimated 25.7 million people living with HIV as at 2018 and the youth accounting for 33% of new infections. Despite the high proportion, there is paucity of data on testing and counselling among the youth and which facto...

Background HIV/AIDS remains a threat to global development and human security. Sub-Saharan Africa is the worst affected, with an estimated 25.7 million people living with HIV as at 2018 and the youth accounting for 33% of new infections. Despite the high proportion, there is paucity of data on testing and counselling among the youth and which facto...

Background Seroprevalence of SARS Cov-2 provides a good indication of the extent of exposure and spread in the population, as well as those likely to benefit from a vaccine candidate. To date, there is no published or ongoing systematic review on the seroprevalence of COVID-19 in Low- and Middle-Income Countries (LMICs). This systematic review and...

Background Job satisfaction refers to the feeling of contentment one experiences with their job. Job satisfaction among opticians is a crucial variable in determining their motivation and has consequential influence on the quality of eye health care, systems and services. Nevertheless, little has been done to assess job satisfaction levels among hu...

Background WHO-recommended prevalence thresholds for deciding schistosomiasis mass drug administration (MDA) are based on anecdotal evidence and unclear. Objectives This systematic review and meta-analysis commissioned by the WHO, as part of its new schistosomiasis evidence-based guideline development, was to generate a single and ‘global’ prevalen...

Background Psychological distress in vision impairments and blindness is a complex issue and a major public health concern. Sudden adjustments in routine lifestyle and career aspirations in such persons culminate in and/or aggravate their level of stress. Yet, psychological distress in persons with visual difficulties and vision loss in South Afric...

Background: Spontaneous reporting of adverse drug reactions (ADR) is an effective means of ensuring postmarketing surveillance of drugs, and health professionals play a cardinal role through voluntary reporting of ADR. However, the pharmacovigilance system in Ghana is plagued with under-reporting issues, which is of public health concern. Method: A...

Background Job satisfaction describes an employee’s motivation and/or feeling of satisfaction towards his/her work. Globally, healthcare professionals’ turnover and retention play a critical role in the delivery of essential health services. In Ghana, however, little has been done to ascertain job satisfaction levels among human resources for eye-h...

Sensory impairment is common in ageing, as are approaches to treat it. However, the impact of age-related sensory impairment upon multisensory perception remains unex-plored, despite the multisensory nature of our environment. Here, we used data from The Irish Longitudinal Study of Ageing (TILDA) to investigate whether common, age-related eye disea...

Objective: Diabetes is a chronic disease of uncontrolled blood sugar levels. People with diabetes are at an increased risk of developing visual impairment and other diabetes-related visual complications. The study aims to determine the eyecare utilization pattern and its associated determinants among diabetics in the South African National Health...

Background: Eye examinations are recommended for all persons throughout life. However, there is disparity in the uptake of eye care services in different populations. Using data from a nationally representative population-based cross-sectional study (the South African National Health and Nutrition Examination Survey, [SANHANES-1]), this paper inve...

Amblyopia is a developmental ocular disease of childhood-onset which may lead to persistent sequelae into adulthood. Early detection and management of amblyopia usually result in an improved visual outcome. The purpose of this study was to determine the prevalence and pattern of amblyopia in a rural hospital in Ghana. Clinical records of patients s...

Optometry students in clinical years are usually faced with the challenges of making a career choice in or outside optometry. This cross sectional study was conducted to investigate the career aspirations of optometry students in Ghana. All students in their fourth to sixth year who consented to participate in the study responded to a questionnaire...

Background Regardless of the importance of preschool vision screening (PSVS), there is limited data on the current state of these programs in Africa (particularly Ghana). This study sought to investigate the level of awareness and perception of stakeholders regarding PSVS, its availability and related policies/programmes in the Kumasi Metropolis, G...

Pattern of Amblyopia in a Rural Hospital in Ghana

Theme: Universal Access to Healthcare - the Role of the Health Scientist.

Background: Hypertension is established to cause vascular end-organ damage. Other forms of dysregulated blood pressure (BP) behaviour, such as orthostatic hypotension have also been associated with cardiovascular (CV) events. The eye is potentially vulnerable to dysregulated systemic BP if ocular circulation autoregulation is impaired. We investig...

Purpose: Age related macular degeneration (AMD) is a leading cause of irreversible visual loss in developed countries. It is associated with vascular risk factors including hypertension. Dysregulated blood pressure (BP) behaviour including orthostatic hypertension (OHTN), hypotension (OH) and BP variability (BPV) are associated with end-organ dama...

Purpose: To investigate plasma lutein (L) and zeaxanthin (Z) concentrations with grading-confirmed and self-reported prevalence of age-related macular degeneration (AMD). Material and methods: Data collected from a nationally representative prospective cohort study of community-dwelling adults aged 50 years and over in the Republic of Ireland. Part...

Purpose: The purpose of this study was to evaluate the impact of supplemental macular carotenoids (including versus not including meso-zeaxanthin) in combination with coantioxidants on visual function in patients with nonadvanced age-related macular degeneration. Methods: In this study, 121 participants were randomly assigned to group 1 (Age-Rel...

The macular carotenoids lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ) accumulate at the macula, where they are collectively referred to as macular pigment (MP). Augmentation of this pigment, typically achieved through diet and supplementation, enhances visual function and protects against progression of age-related macular degeneration. Howev...

Purpose: The high-performance visual function associated with central vision is mediated by the macula (the central retina), which accumulates three diet-derived pigments (the carotenoids lutein [L], zeaxanthin [Z], and meso-zeaxanthin [MZ]). Our study sought to investigate the impact on visual function, including contrast sensitivity (CS), of supp...

Purpose: To investigate the effect of cataract (and cataract surgery) on macular pigment (MP) measurements using the Heidelberg Spectralis HRA+OCT MultiColor device. Methods: Thirty-six patients (age, 54-87 years) scheduled for cataract surgery at the Institute of Eye Surgery, Ireland, were enrolled in this study. Cataracts were graded using the...

Objective To investigate non-dietary correlates and determinants of plasma lutein (L) and zeaxanthin (Z) concentrations in The Irish Longitudinal Study on Ageing (TILDA) sample. SettingCommunity dwelling adults in the Republic of Ireland (ROI). Participants: 3,681 participants aged 50 years and older. MeasurementsTILDA is a nationally representativ...

Purpose To investigate the relationship between macular pigment (MP) and visual function in subjects with early age-related macular degeneration (AMD). Methods 121 subjects with early AMD enrolled as part of the Central Retinal Enrichment Supplementation Trial (CREST; ISRCTN13894787) were assessed using a range of psychophysical measures of visual...

Objective: The aim was to obtain interpupillary distance (IPD) measurements of students in the Kumasi Metropolis. The study will provide a database for manufacturers of spectacle frames and optical equipment with Ghana as the target population. The IPD is a crucial measure that needs to be considered before frames can be selected for patients who h...

Objective: The aim was to obtain interpupillary distance (IPD) measurements of students in the Kumasi Metropolis. The study will provide a database for manufacturers of spectacle frames and optical equipment with Ghana as the target population. The IPD is a crucial measure that needs to be considered before frames can be selected for patients who h...

Purpose: We compared macular pigment (MP) measurements using customized heterochromatic flicker photometry (Macular Metrics Densitometer) and dual-wavelength fundus autofluorescence (Heidelberg Spectralis HRA + OCT MultiColor) in subjects with early age-related macular degeneration (AMD). Methods: Macular pigment was measured in 117 subjects wit...

Background Manifestations of neurocardiovascular instability (NCVI), including orthostatic hypotension (OH) orthostatic hypertension (OHTN) and impaired blood pressure variability (BPV), have been associated with cardiovascular (CV) events. The eye is highly vascular and we propose an ideal target end organ to investigate pathological implications...

Background: Macular pigment (MP) levels correlate with brain concentrations of lutein (L) and zeaxanthin (Z), and have also been shown to correlate with cognitive performance in the young and elderly. Objective: To investigate the relationship between MP, serum concentrations of L and Z, and cognitive function in subjects free of retinal disease wi...

PurposeTo compare the impact of sustained supplementation using different macular carotenoid formulations on macular pigment (MP) and visual function in early age-related macular degeneration (AMD).Patients and methodsSixty-seven subjects with early AMD were randomly assigned to: Group 1 (20 mg per day lutein (L), 0.86 mg per day zeaxanthin (Z); Ul...

Age-related macular degeneration (AMD) remains the most common cause of visual loss among subjects over 50 years of age in the developed world. The Irish Longitudinal study on Ageing (TILDA) is a population-based study of subjects aged 50 years or older, designed to investigate factors that influence ageing, and has enabled this investigation of th...

The aim was to determine the prevalence of obesity and overweight among students in the Kumasi metropolis. In a descriptive cross-sectional study, 500 students aged 10 to 20 years were examined from two junior high schools selected by multistage sampling technique and three randomly selected senior high schools. Height and weight were measured in a...

Purpose. To compare measures of visual acuity (VA) and contrast sensitivity (CS) from the Thompson Xpert 2000 and MultiQuity (MiQ) devices. Methods. Corrected distance VA (CDVA) and CS were measured in the right eye of 73 subjects, on an established system (Thompson Xpert) and a novel system (MiQ 720). Regression was used to convert MiQ scores into...

Background Patients with Alzheimer's disease (AD) exhibit significantly less macular pigment (MP) and poorer vision when compared to control subjects. Objective To investigate supplementation with the macular carotenoids on MP, vision, and cognitive function in patients with AD versus controls. Methods A randomized, double-blind clinical trial wi...

The study aimed to determine the prevalence of eye diseases among women engaged in the local extraction of palm kernel oil in the Kumasi Metropolis. A cross-sectional study was carried out in five women groups purposively sampled. A total of 150 women were sampled. History taken from the women included participants’ demographics and ocular and occu...

Background The macula (central retina) contains a yellow pigment, comprising the dietary carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin, known as macular pigment (MP). The concentrations of MP’s constituent carotenoids in retina and brain tissue correlate, and there is a biologically-plausible rationale, supported by emerging evidence,...

Background: The xanthophyll carotenoids lutein (L) and zeaxanthin (Z) are found in green leafy vegetables (e.g. spinach), colored fruits (e.g. kiwi) and egg yolk.(1) These carotenoids have been studied widely, but mainly because of their likely benefit for macular and cognitive health/function. For example, these carotenoids are believed to protect...

Purpose: To investigate the impact of three different macular carotenoid formulations on macular pigment optical density and visual performance in subjects with early age-related macular degeneration. Methods: Fifty-two subjects were supplemented and followed for 12 months, 17 of them were in intervention Group 1 (20 mg/day lutein and 2 mg/day z...

Purpose The Central Retinal Enrichment Supplementation Trials (CREST) aim to investigate the potential impact of macular pigment (MP) enrichment, following supplementation with a formulation containing 10 mg lutein (L), 2 mg zeaxanthin (Z) and 10 mg meso-zeaxanthin (MZ), on visual function in normal subjects (Trial 1) and in subjects with early age...