Risk factors for corneal ulcers: a population-based matched case-control study in Nepal.
Risk factors for corneal ulcers: a population-based matched case-control study in Nepal.
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角膜溃疡的危险因素：尼泊尔一项基于人群的匹配病例对照研究。
DOI：
10.1136/bjo-2022-322141
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发表时间：
2023
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作者：
Byanju,Raghunandan;Kandel,RamPrasad;Poudyal,Bimal;Bhandari,Sadhan;Ligal,Anju;Pradhan,Sangita;Gautam,Maria;Shrestha,Puspa;Sah,RanjeetKumar;Gonzales,JohnA;Porco,TravisC;Whitcher,JohnP;Srinivasan,Muthiah;Upadhyay,MadanPrasad;
背景/aimsWe的目的是研究角膜溃疡的危险因素在农村和城郊设置在Nepal.MethodsThis人口为基础的匹配病例对照研究嵌套在一个集群随机试验在24个村发展委员会在尼泊尔。发病密度抽样用于匹配角膜混浊病例与对照，匹配混浊时间、年龄、性别和位置。病例组和对照组被邀请参加一项角膜溃疡危险因素的调查。风险因素进行了评估，使用条件Logistic回归占matching.ResultsOf事件混浊在试验中确定的540名参与者，433人愿意参加这个子研究，并匹配到一个控制。与对照组相比，接受过任何教育的病例比没有接受过任何教育的病例的几率低。（调整后OR，aOR 0.60，95% CI 0.39 - 0.94），从事非体力劳动职业vs体力劳动职业（aOR 0.64，95% CI 0.42至0.95），眼外伤患者更喜欢医疗商店而不是眼科护理系统中心（aOR 0.58，95% CI 0.37至0.92）。病例有较高的几率保护护目镜使用与无保护（aOR 3.8，95%CI 1.3至11.0），并有一个眼损伤与无（aOR 7.7，95%CI 4.3至13.6）相比，与controls.ConclusionWe发现眼损伤，体力劳动和较低的教育与角膜溃疡的发展密切相关。鉴于该地区角膜失明的持续负担，预防工作可以针对这些因素常见的地区增加获得护理的机会。
Background/aimsWe aimed to examine risk factors for corneal ulcer in a rural and peri-urban setting in Nepal.MethodsThis 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.ResultsOf 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.ConclusionWe 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.