Risk factors for corneal ulcers: a population-based matched case-control study in Nepal.
cornea
epidemiology
public health
Journal
The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041
Informations de publication
Date de publication:
22 11 2023
22 11 2023
Historique:
received:
30
06
2022
accepted:
16
09
2022
pmc-release:
06
04
2024
medline:
24
11
2023
pubmed:
7
10
2022
entrez:
6
10
2022
Statut:
epublish
Résumé
We aimed to examine risk factors for corneal ulcer in a rural and peri-urban setting in Nepal. This population-based matched case-control study was nested in a cluster randomised trial in 24 village development committees in Nepal. Incidence density sampling was used to match incident corneal opacity cases to controls, matching on time of opacity, age, sex and location. Cases and controls were invited to participate in a survey of risk factors for corneal ulcer. Risk factors were evaluated using conditional logistic regression to account for matching. Of the 540 participants with incident opacities identified in the trial, 433 were willing to participate in this substudy and matched to a control. Compared with controls, cases had lower odds of having any education vs no education (adjusted OR, aOR 0.60, 95% CI 0.39 to 0.94), working in non-manual labour occupations vs manual labour occupations (aOR 0.64, 95% CI 0.42 to 0.95) and preferring medical shops for ocular trauma versus eye care system centres (aOR 0.58, 95% CI 0.37 to 0.92). Cases had higher odds of protective goggle use versus no protection (aOR 3.8, 95% CI 1.3 to 11.0) and having an ocular injury vs none (aOR 7.7, 95% CI 4.3 to 13.6) compared with controls. We found ocular injury, manual labour and lower education to be strongly associated with the development of corneal ulcer. Given the persistent burden of corneal blindness in this area, prevention efforts could target efforts to increase access to care in areas where these factors are common.
Sections du résumé
BACKGROUND/AIMS
We aimed to examine risk factors for corneal ulcer in a rural and peri-urban setting in Nepal.
METHODS
This population-based matched case-control study was nested in a cluster randomised trial in 24 village development committees in Nepal. Incidence density sampling was used to match incident corneal opacity cases to controls, matching on time of opacity, age, sex and location. Cases and controls were invited to participate in a survey of risk factors for corneal ulcer. Risk factors were evaluated using conditional logistic regression to account for matching.
RESULTS
Of the 540 participants with incident opacities identified in the trial, 433 were willing to participate in this substudy and matched to a control. Compared with controls, cases had lower odds of having any education vs no education (adjusted OR, aOR 0.60, 95% CI 0.39 to 0.94), working in non-manual labour occupations vs manual labour occupations (aOR 0.64, 95% CI 0.42 to 0.95) and preferring medical shops for ocular trauma versus eye care system centres (aOR 0.58, 95% CI 0.37 to 0.92). Cases had higher odds of protective goggle use versus no protection (aOR 3.8, 95% CI 1.3 to 11.0) and having an ocular injury vs none (aOR 7.7, 95% CI 4.3 to 13.6) compared with controls.
CONCLUSION
We found ocular injury, manual labour and lower education to be strongly associated with the development of corneal ulcer. Given the persistent burden of corneal blindness in this area, prevention efforts could target efforts to increase access to care in areas where these factors are common.
Identifiants
pubmed: 36202599
pii: bjo-2022-322141
doi: 10.1136/bjo-2022-322141
pmc: PMC10076439
mid: NIHMS1854687
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1771-1775Subventions
Organisme : NEI NIH HHS
ID : U10 EY022880
Pays : United States
Investigateurs
Kamal Bahadur Khadka
(KB)
Dikshya Bista
(D)
Mariya Gautam
(M)
Puspa Giri
(P)
Sajani Kayastha
(S)
Tulsi Prasad Parajuli
(TP)
Niraj Sharma
(N)
Prafulla Sharma
(P)
Anju Shrestha
(A)
Manisha Shrestha
(M)
Pradeep Subedi
(P)
Daya Shankar Chaudhary
(DS)
Ramesh Ghimire
(R)
Manmohan Adhikari
(M)
Vivek Hamal
(V)
Gopal Bhandari
(G)
Gokul Dahal
(G)
Jeevan Gurung
(J)
Dipak Bhattarai
(D)
Rabin Bhattarai
(R)
Dipak Chapagain
(D)
Ajay Kumar Chaudhary
(AK)
Shree Krishna Gautam
(SK)
Dhanmaya Gurau
(D)
Deepak Kandel
(D)
Pradip Chandara Lamichhane
(PC)
Rajendra Rijal
(R)
Gaurav Giri
(G)
Nisha R Acharya
(NR)
Stephen D McLeod
(SD)
David A Ramirez
(DA)
Kathryn J Ray
(KJ)
Jennifer Rose-Nussbaumer
(J)
Sun Y Cotter
(SY)
Jessica Kim
(J)
Salena Lee
(S)
Robi N Maamari
(RN)
Ken Basset
(K)
Heidi Chase
(H)
Lauren Evans
(L)
Suzanne Gilbert
(S)
Deborah Moses
(D)
Chundak Tenzing
(C)
Shravan Choudhary
(S)
Parami Dhakwa
(P)
Daniel A Fletcher
(DA)
Clay D Reber
(CD)
Informations de copyright
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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