A multi-center, cross-sectional study on the burden of infectious keratitis in China

PLoS One. 2014 Dec 1;9(12):e113843. doi: 10.1371/journal.pone.0113843. eCollection 2014.

Abstract

Objective: To understand the prevalence and demographic characteristics of infectious keratitis and infectious corneal blindness.

Methods: A multi-center, population-based cross-sectional study was conducted from January 1 to August 31, 2010. A total of 191,242 individuals of all age groups from 10 geographically representative provinces were sampled using stratified, multi-stage, random and systematic sampling procedures. A majority, 168,673 (88.2%), of those sampled participated in the study. The examination protocol included a structured interview, visual acuity testing, an external eye examination, and an anterior segment examination using a slit lamp. The causes and sequelae of corneal disease were identified using uniform customized protocols. Blindness in one eye caused by infectious keratitis was defined as infectious corneal blindness.

Results: The prevalence of past and active infectious keratitis was 0.192% (95% confidence interval [CI], 0.171-0.213%), and the prevalence of viral, bacterial, and fungal keratitis was 0.11%, 0.075%, and 0.007%, respectively. There were 138 cases of infectious corneal blindness in at least one eye in the study population (prevalence of 0.082% [95%CI, 0.068%-0.095%]). Statistical analysis suggested that ocular trauma, alcoholic consumption, low socioeconomic levels, advanced age, and poor education were risk factors for infectious corneal blindness.

Conclusions: Infectious keratitis is the leading cause of corneal blindness in China. Eye care strategies should focus on the prevention and rehabilitation of infectious corneal blindness.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blindness / epidemiology
  • Blindness / microbiology*
  • Child
  • China / epidemiology
  • Corneal Diseases / epidemiology
  • Corneal Diseases / microbiology
  • Cross-Sectional Studies
  • Eye Infections / epidemiology*
  • Eye Infections / microbiology
  • Female
  • Humans
  • Keratitis / epidemiology
  • Keratitis / microbiology*
  • Male
  • Middle Aged
  • Prevalence
  • Socioeconomic Factors
  • Young Adult

Grants and funding

This work was supported by a grant from the Consultation Program of Chinese Academy of Engineering (No. 2009-77). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.