Cargando…
Epidemiology of Microbial Keratitis in Uganda: A Cohort Study
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...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446037/ https://www.ncbi.nlm.nih.gov/pubmed/31830848 http://dx.doi.org/10.1080/09286586.2019.1700533 |
_version_ | 1783574097929699328 |
---|---|
author | Arunga, Simon Kintoki, Guyguy M. Mwesigye, James Ayebazibwe, Bosco Onyango, John Bazira, Joel Newton, Rob Gichuhi, Stephen Leck, Astrid Macleod, David Hu, Victor H. Burton, Matthew J. |
author_facet | Arunga, Simon Kintoki, Guyguy M. Mwesigye, James Ayebazibwe, Bosco Onyango, John Bazira, Joel Newton, Rob Gichuhi, Stephen Leck, Astrid Macleod, David Hu, Victor H. Burton, Matthew J. |
author_sort | Arunga, Simon |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7446037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-74460372020-09-14 Epidemiology of Microbial Keratitis in Uganda: A Cohort Study Arunga, Simon Kintoki, Guyguy M. Mwesigye, James Ayebazibwe, Bosco Onyango, John Bazira, Joel Newton, Rob Gichuhi, Stephen Leck, Astrid Macleod, David Hu, Victor H. Burton, Matthew J. Ophthalmic Epidemiol Research Article 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. Taylor & Francis 2019-12-12 /pmc/articles/PMC7446037/ /pubmed/31830848 http://dx.doi.org/10.1080/09286586.2019.1700533 Text en © 2019 The Author(s). Published with license by Taylor & Francis Group, LLC. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Arunga, Simon Kintoki, Guyguy M. Mwesigye, James Ayebazibwe, Bosco Onyango, John Bazira, Joel Newton, Rob Gichuhi, Stephen Leck, Astrid Macleod, David Hu, Victor H. Burton, Matthew J. Epidemiology of Microbial Keratitis in Uganda: A Cohort Study |
title | Epidemiology of Microbial Keratitis in Uganda: A Cohort Study |
title_full | Epidemiology of Microbial Keratitis in Uganda: A Cohort Study |
title_fullStr | Epidemiology of Microbial Keratitis in Uganda: A Cohort Study |
title_full_unstemmed | Epidemiology of Microbial Keratitis in Uganda: A Cohort Study |
title_short | Epidemiology of Microbial Keratitis in Uganda: A Cohort Study |
title_sort | epidemiology of microbial keratitis in uganda: a cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446037/ https://www.ncbi.nlm.nih.gov/pubmed/31830848 http://dx.doi.org/10.1080/09286586.2019.1700533 |
work_keys_str_mv | AT arungasimon epidemiologyofmicrobialkeratitisinugandaacohortstudy AT kintokiguyguym epidemiologyofmicrobialkeratitisinugandaacohortstudy AT mwesigyejames epidemiologyofmicrobialkeratitisinugandaacohortstudy AT ayebazibwebosco epidemiologyofmicrobialkeratitisinugandaacohortstudy AT onyangojohn epidemiologyofmicrobialkeratitisinugandaacohortstudy AT bazirajoel epidemiologyofmicrobialkeratitisinugandaacohortstudy AT newtonrob epidemiologyofmicrobialkeratitisinugandaacohortstudy AT gichuhistephen epidemiologyofmicrobialkeratitisinugandaacohortstudy AT leckastrid epidemiologyofmicrobialkeratitisinugandaacohortstudy AT macleoddavid epidemiologyofmicrobialkeratitisinugandaacohortstudy AT huvictorh epidemiologyofmicrobialkeratitisinugandaacohortstudy AT burtonmatthewj epidemiologyofmicrobialkeratitisinugandaacohortstudy |