Corneal ulceration in South East Asia. II: A strategy for the prevention of fungal keratitis at the village level in Burma. Issue 8 (17th May 2006)

• Record Type: Journal Article
• Authors: Maung, N; Thant, C C; Srinivasan, M; Upadhyay, M P; Priyadarsini, B; Mahalakshmi, R; Whitcher, J P
• Is Part Of: British journal of ophthalmology. Volume 90:Issue 8(2006)
• Page Start: 968
• Page End: 970
• Publication Date: 2006-05-17
• Subjects: VHWs, village health workers; corneal blindness -- corneal ulceration -- ulcer prevention -- fungal keratitis -- Burma; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.2006.094706
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aim: To prove that topical antifungal and antibiotic prophylaxis distributed by grass roots village health workers (VHWs) in Burma is an effective public health intervention for the prevention of post-traumatic microbial keratitis in a population where the majority of ulcers are fungal. Methods: Three villages in Bago District with a combined population of 16 987 were selected for the study. This defined population was followed prospectively for 12 months by 15 VHWs who were trained to identify post-traumatic corneal abrasions with fluorescein dye and a blue torch and to administer 1% chloramphenicol and 1% clotrimazole ointment three times a day for 3 days to the eyes of individuals who fulfilled the eligibility criteria. Results: During the 12 month period 273 individuals reported to VHWs with an ocular injury and 126 were found to have a corneal abrasion. All 126 were treated with 1% chloramphenicol and 1% clotrimazole ointment three times a day for 3 days, and all healed without sequelae. Conclusions: 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.