Influence of socioeconomic and demographic factors on fungal keratitis: A prospective study in a public Medical college hospital

Abstract

Background: Fungal corneal ulcer is one of the most important cause of preventable blindness, particularly in developing countries. It usually affects people from lower socioeconomic strata , agricultural background and from rural areas. So, this study regarding the aetiology and clinical evaluation of fungal corneal ulcer and its management was carried out to find out the demographic distribution and socioeconomic factors that influence fungal corneal ulcer. Objectives: To investigate the relationship between socioeconomic and demographic factors in fungal corneal ulcer. Methods: This was a cross sectional, observational study which was conducted from January 2022 to May 2022 in the department of ophthalmology, Sher-E-Bangla Medical College Hospital in Barishal.100 cases were enrolled who met the inclusion criteria, All patients were examined before initiation of treatment, during ongoing treatment and 1 month after baseline examination. For the purpose of recording a proforma was prepared containing patients name, age, sex, occupation, address, chief complaints, history of present as well as past ocular and systemic illness, family history, treatment history, personal and socioeconomic history. Results: The most important predisposing factor for developing fungal corneal ulcer was ocular trauma by vegetative material 66 (66%) followed by unknown cause 23 (23%), finger nail 03 (03%),insect 03 (03%),metallic foreign body 02 (02%),sand 02 (02%),cow’s tail 01 (01%). Among 100 patients 64(64%) were agricultural worker,15(15%) were housewife, 14 (14%) were laborer,3(3%) were student,2(2%) were professional and 2(2%) were unemployed. Rural population  83(83%) were found to be more affected than   urban 17(17%) areas. Those with low socio-economic status 72(72%) were more affected than the higher socioeconomic status of  middle class consisting of 28 (28%) cases. Conclusions: The burden of corneal blindness induced by corneal ulcers is more on the illiterate ,rural, population  and  largely affects the young and male patients. Agricultural workers especially labourers and those in poor socio-economic conditions and poor hygiene are more at risk. Prevention with antibiotics, education and knowledge about the disease may be of help. The possibility of a fungal cause should be considered when known risk factors apply.