| Title: |
Risk factors for corneal ulcers: a population-based matched case-control study in Nepal |
| Authors: |
Byanju, Raghunandan; Kandel, Ram Prasad; Poudyal, Bimal; Bhandari, Sadhan; Ligal, Anju; Pradhan, Sangita; Gautam, Maria; Shrestha, Puspa; Sah, Ranjeet Kumar; Gonzales, John A; Porco, Travis C; Whitcher, John P; Srinivasan, Muthiah; Upadhyay, Madan Prasad; Lietman, Thomas M; Keenan, Jeremy David; O'Brien, Kieran S; The Village-Integrated Eye Worker Trial Group; the Village-Integrated Eye Worker Trial Group; Khadka, Kamal Bahadur; Bista, Dikshya; Gautam, Mariya; Giri, Puspa; Kayastha, Sajani; Parajuli, Tulsi Prasad; Sharma, Niraj; Sharma, Prafulla; Shrestha, Anju; Shrestha, Manisha; Subedi, Pradeep; Chaudhary, Daya Shankar; Ghimire, Ramesh; Adhikari, Manmohan; Hamal, Vivek; Bhandari, Gopal; Dahal, Gokul; Gurung, Jeevan; Bhattarai, Dipak; Bhattarai, Rabin; Chapagain, Dipak; Chaudhary, Ajay Kumar; Gautam, Shree Krishna; Gurau, Dhanmaya; Kandel, Deepak; Lamichhane, Pradip Chandara; Rijal, Rajendra; Giri, Gaurav; Acharya, Nisha R; McLeod, Stephen D; Ramirez, David A; Ray, Kathryn J; Rose-Nussbaumer, Jennifer; Cotter, Sun Y; Kim, Jessica; Lee, Salena; Maamari, Robi N; Basset, Ken; Chase, Heidi; Evans, Lauren; Gilbert, Suzanne; Moses, Deborah; Tenzing, Chundak; Choudhary, Shravan; Dhakwa, Parami; Fletcher, Daniel A; Reber, Clay D |
| Publisher Information: |
BMJ Publishing Group Ltd |
| Publication Year: |
2023 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Original articles - Clinical science |
| Description: |
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. |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://bjo.bmj.com/cgi/content/short/107/12/1771; http://dx.doi.org/10.1136/bjo-2022-322141 |
| DOI: |
10.1136/bjo-2022-322141 |
| Availability: |
http://bjo.bmj.com/cgi/content/short/107/12/1771; https://doi.org/10.1136/bjo-2022-322141 |
| Rights: |
Copyright (C) 2023, BMJ Publishing Group Ltd |
| Accession Number: |
edsbas.CB53E0DD |
| Database: |
BASE |