Corneal ulceration in South East Asia. II: A strategy for the prevention of fungal keratitis at the village level in Burma

Abstract

Both fungal and bacterial ulcers that occur following traumatic corneal abrasions can be effectively prevented in a village setting by using relatively simple measures that local volunteer public health workers can easily be taught to employ.

Corneal ulceration in south-east Asia III: prevention of fungal keratitis at the village level in south India using topical antibiotics

“…We have shown previously that microbial keratitis after corneal abrasion can be prevented at the village level by simple public health strategies using antibiotic and antifungal prophylaxis tailored to the prevalence of pathogens causing corneal ulcers in the population. 10 This study, however, raises the key question of which therapeutic regimen is actually most cost-effective in achieving this goal. At present, another trial with a larger population is being conducted in south India to determine whether antibiotics alone can indeed prevent both fungal and bacterial keratitis after corneal abrasion.…”

“…4 Unlike the studies in Nepal, 4 Bhutan 5 and Burma, 10 patients with corneal abrasions in south India reported for treatment over a longer period (table 2), but this did not seem to affect the efficacy of the ulcer prevention regimen. In addition, paid non-governmental VHWs hired locally in India were found to be as effective in implementing and sustaining a corneal ulcer prevention programme as were volunteer VHWs in Bhutan 5 and governmental VHWs in Burma.…”

“…In addition, paid non-governmental VHWs hired locally in India were found to be as effective in implementing and sustaining a corneal ulcer prevention programme as were volunteer VHWs in Bhutan 5 and governmental VHWs in Burma. 10 As in those countries, the compliance of the Indian population was directly related to the local involvement of the VHWs.…”

“…This was unexpected because it is known that 20% of culture-proved ulcers in Nepal 8 are fungal, and therefore at least a few of the breakthrough ulcers should have grown fungal pathogens. In a recent study in Burma, 10 where two thirds of all corneal ulcers are caused by fungi, microbial keratitis was found to be prevented in all patients presenting with a corneal abrasion, using a prophylactic combination of 1% chloramphenicol and 1% clotrimazole ointment for 3 days. It was assumed that clotrimazole was effective in preventing fungal ulcers, whereas chloramphenicol prevented bacterial infections, but is this assumption correct?…”

Kvinner med lungekreft lever lenger enn menn

“…I artikkelen fra Nigeria konkluderes det med at problemet kan minskes med enkel behandling. En studie i Burma har vist at opplaering i bruk av for eksempel kloramfenikol blant «barfotleger», har resultert i full tilheling hos nesten alle med overflatiske hornhinnesår (4 …”