Clinical Presentation and Diagnosis of OSSN in Kenya

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Clinical Presentation and Diagnosis of OSSN in Kenya

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The broad aim was to improve understanding of the epidemiology, aetiology, pathophysiology, diagnosis and treatment of OSSN in East Africa.

Regions & Participants:

There were 4 recruitment centers in Kenya – Kenyatta National Referral Hospital in Nairobi the capital city, PCEA Kikuyu Eye Unit in Central Kenya, Sabatia Eye Unit in Western Kenya and Kitale District Hospital Eye Unit in the North Rift Valley.

Laboratory support was provided by 5 centers in Kenya and UK – i) MP Shah Hospital in Nairobi – histopathology ii) The Kenya Aids Vaccine Institute (KAVI) Institute for Clinical Research laboratory at the University of Nairobi – HIV and CD4 testing and frozen tissue storage (serum for vitamin A and fresh frozen tumour samples). iii) The Tropical Diseases Research Centre’s (TDRC) Nutrition Unit in Ndola Hospital, Zambia – vitamin A analysis. iv) The University College London (UCL) Institute of Ophthalmology, Department of Eye Pathology at the Moorfields Eye Hospital in London – Immunohistochemistry v) The London School of Hygiene & Tropical Medicine – DNA extraction from tumour specimens.

We enrolled 496 adults at least 18 years of age who presented to these eye clinics with any conjunctival lesions requiring excision and 131 controls from among adults at least 18 years of age scheduled for surgery that involved a conjunctival incision such as trauma, squint or retinal surgery.

Acknowledgements and funding:

  1. British Council for Prevention of Blindness (BCPB)
  2. The Commonwealth Eye Health Consortium
  3. The Wellcome Trust funded free full-text access to the publications out of our research through one of the co-authors (Matthew Burton)

Associated publications:

  1. Ong Beng Seng M, Meyer D, Gichuhi S, Tong L, Sudharshan S, Biswas J, Testi I, Agrawal R. Ocular surface disorders in patients with Human Immunodeficiency Virus (HIV) infection. Ocul Immunol Inflamm. 2020; 28(7):1015-1021.
  2. Gichuhi S, Arunga S. HIV and the eye. Community Eye Health. 2020; 33(108): 76-78.
  3. Gichuhi S, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wachira J, Munene R, Onyuma T, Sagoo MS, Macleod D, Weiss HA, Burton MJ. Delay in the care-seeking journey of patients with ocular surface squamous neoplasia in Kenya. BMC Health Services Research. 2017, 17(1):485.
  4. Gichuhi S, Sagoo MS. Squamous cell carcinoma of the conjunctiva. Community Eye Health. 2016; 29(95): 52-53.
  5. Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wachira J, Munene R, Onyuma T, Jaoko WG, Sagoo MS, Weiss HA, Burton MJ. Risk factors for ocular surface squamous neoplasia in Kenya; a case-control study. Trop Med Int Health. 2016; 21(12): 1522-1530.
  6. Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wachira J, Munene R, Maina J, Onyuma T, Sagoo MS, Weiss HA, Burton MJ. Topical 5-Fluorouracil following surgery for ocular surface squamous neoplasia in Kenya: a randomised, double-masked, placebo-controlled trial. Lancet Glob Health 2016; 4(6): e378-e385.
  7. Gichuhi, S; (2016) Epidemiology and Management of Ocular Surface Squamous Neoplasia in Kenya.PhD thesis, London School of Hygiene & Tropical Medicine. DOI: https://doi.org/10.17037/PUBS.02572610
  8. Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wanyonyi L, Wachira J, Munene R, Onyuma T, Jaoko WG, Sagoo MS, Weiss HA, Burton MJ. Toluidine blue 0.05% vital staining for diagnosis of ocular surface squamous neoplasia in Kenya. JAMA Ophthalmol. 2015; 133(11): 1314-1321.
  9. Gichuhi S, Macharia E, Kabiru J, Zindamoyen AM, Rono H, Ollando E, Wanyonyi L, Wachira J, Munene R, Onyuma T, Sagoo MS, Weiss HA, Burton MJ. Clinical presentation of ocular surface squamous neoplasia in Kenya. JAMA Ophthalmol. 2015; 133(11): 1305-1313.
  10. Gichuhi S, Ohnuma A, Sagoo MS, Burton MJ. Pathophysiology of ocular surface squamous neoplasia. Exp Eye Res. 2014; 129:172-182.
  11. Gichuhi S, Onyuma T, Macharia E, Kabiru J, Zindamoyen AM, Sagoo MS, Burton MJ. Ocular rhinosporidiosis mimicking conjunctival squamous papilloma in Kenya. BMC Ophthalmology 2014; 14(1):45.
  12. Nguena MB, van den Tweel JG, Makupa W, Hu VH, Weiss HA, Gichuhi S, Burton MJ. Diagnosing ocular surface squamous neoplasia in East Africa: case-control study of clinical and in vivo confocal microscopy assessment. Ophthalmology. 2014; 121(2):484-491.
  13. Gichuhi S, Sagoo MS, Weiss HA, Burton MJ. Epidemiology of ocular surface squamous neoplasia in Africa. Trop Med Int Health. 2013; 18(12):1424-1443.
  14. Gichuhi S, Irlam JH. Interventions for squamous cell carcinoma of the conjunctiva in HIV-infected individuals. Cochrane Database Syst Rev. 2013 28; 2:CD005643. doi: 10.1002/14651858.CD005643.pub3. PubMed PMID: 23450564. Update of 2008.

Contact: 

If you have any questions regarding this topic or project, please contact Stephen Gichuhi: sgichuhi@uonbi.ac.ke[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]