Traditional Medicine Use Strongly Associated with Incidence of Microbial Keratitis

A traditional healer prepares a treatment. Photograph: Simon Arunga

The incidence of microbial keratitis (MK), a major cause of blindness, is strongly associated with use of traditional eye medicine, a new study from ICEH has found.

Microbial keratitis is an infection of the cornea, the clear covering of the front of the eye. It can be caused by various infectious agents such as bacteria, viruses and fungi. The condition can scar the cornea, making it difficult to see and leading to blindness. The burden of the disease is particularly strong in lower and middle-income countries, where patients often seek treatment too late, when little can be done.

This study looked at data from two major eye units in Southern Uganda, analysing factors reported in patients presenting with MK. Time to presentation, treatment history, use of traditional medicine, trauma and visual acuity were tested for their relationship with the disease.

The study found a strong association with use of traditional eye medicine, as well as distance from an eyecare centre. Traditional medicine is a widely used form of medicine in Africa, based on herbal or spiritual practices, but without scientific analysis or testing. Medicines are often based on wild plant products, which are unregulated and may contain toxins or infectious agents.

The study suggests that traditional eye medicine methods used increase the likelihood of MK, likely through applying products directly to the eye, causing further scratching, scarring and infections. The use of traditional medicines may also be compounded by the distance to modern treatment centres, as people with the condition prefer to try a local treatment before travelling a long distance.

The results have already led to improvements in services within the eye centres studied, including the introduction of consistent recording of visual acuity for all patients, and routine microbiological testing for people with MK, which will help towards identifying the specific causes of the disease.

From a wider perspective, the study provides evidence for improving geographical access to eye treatment centres, and the regulation and provision of information for traditional medicine use. Improving these factors will have an impact on the prevalence of MK and eye health overall.


Publication

https://journals.coecsa.org/index.php/joecsa/article/view/175

Future projects

https://www.lshtm.ac.uk/newsevents/news/2018/lshtm-lead-vital-research-severe-corneal-infections-low-and-middle-income

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