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Epidemiology of Microbial Keratitis in Uganda: A Cohort Study
- Source :
- Ophthalmic Epidemiology, article-version (VoR) Version of Record
- Publication Year :
- 2019
- Publisher :
- TAYLOR & FRANCIS INC, 2019.
-
Abstract
- Purpose: To describe the epidemiology of Microbial Keratitis (MK) in Uganda. Methods: We prospectively recruited patients presenting with MK at two main eye units in Southern Uganda between December 2016 and March 2018. We collected information on clinical history and presentation, microbiology and 3-month outcomes. Poor vision was defined as vision < 6/60). Results: 313 individuals were enrolled. Median age was 47 years (range 18–96) and 174 (56%) were male. Median presentation time was 17 days from onset (IQR 8–32). Trauma was reported by 29% and use of Traditional Eye Medicine by 60%. Majority presented with severe infections (median infiltrate size 5.2 mm); 47% were blind in the affected eye (vision < 3/60). Microbiology was available from 270 cases: 62% were fungal, 7% mixed (bacterial and fungal), 7% bacterial and 24% no organism detected. At 3 months, 30% of the participants were blind in the affected eye, while 9% had lost their eye from the infection. Delayed presentation (overall p = .007) and prior use of Traditional Eye Medicine (aOR 1.58 [95% CI 1.04–2.42], p = .033) were responsible for poor presentation. Predictors of poor vision at 3 months were: baseline vision (aOR 2.98 [95%CI 2.12–4.19], p < .0001), infiltrate size (aOR 1.19 [95%CI 1.03–1.36], p < .020) and perforation at presentation (aOR 9.93 [95% CI 3.70–26.6], p < .0001). Conclusion: The most important outcome predictor was the state of the eye at presentation, facilitated by prior use of Traditional Eye Medicine and delayed presentation. In order to improve outcomes, we need effective early interventions.
- Subjects :
- Adult
Male
Microbial keratitis
medicine.medical_specialty
genetic structures
Epidemiology
Perforation (oil well)
Vision Disorders
Visual Acuity
Blindness
Eye Infections, Bacterial
Keratitis
Cohort Studies
Cornea
03 medical and health sciences
0302 clinical medicine
Outcome predictor
Clinical history
Internal medicine
Medicine
Humans
Fungal keratitis
Uganda
030212 general & internal medicine
Prospective Studies
Corneal Ulcer
Medicine, African Traditional
Aged
Aged, 80 and over
business.industry
bacterial keratitis
Middle Aged
medicine.disease
Prognosis
Anti-Bacterial Agents
Ophthalmology
Treatment Outcome
030221 ophthalmology & optometry
fungal keratitis
Female
Presentation (obstetrics)
business
Eye Infections, Fungal
Cohort study
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 09286586
- Database :
- OpenAIRE
- Journal :
- Ophthalmic Epidemiology, article-version (VoR) Version of Record
- Accession number :
- edsair.doi.dedup.....d66ab5d492bafb5a9d3b1340a1bc0afd