Traditional eye medicine use in microbial keratitis in Uganda: a mixed methods study [version 1; peer review: awaiting peer review]

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dc.contributor.authorArunga, Simon
dc.contributor.authorAsiimwe, Allen
dc.contributor.authorApio Olet, Eunice
dc.contributor.authorKagoro-Rugunda, Grace
dc.contributor.authorAyebazibwe, Bosco
dc.contributor.authorOnyango, John
dc.contributor.authorNewton, Robert
dc.contributor.authorLeck, Astrid
dc.contributor.authorMacleod, David
dc.contributor.authorHu, Victor H.
dc.contributor.authorSeeley, Janet
dc.contributor.authorBurton, Matthew J.
dc.date.accessioned2023-03-28T17:54:44Z
dc.date.available2023-03-28T17:54:44Z
dc.date.issued2019
dc.description.abstractTraditional eye medicine (TEM) is frequently used to treat microbial keratitis (MK) in many parts of Africa. Few reports have suggested that this is associated with a worse outcome. We undertook this large prospective study to determine how TEM use impacts presentation and outcome of MK and to explore reasons why people use TEM for treatment in Uganda. Methods: In a mixed method prospective cohort study, we enrolled patients presenting with MK at the two main eye units in Southern Uganda between December 2016 and March 2018 and collected information on history, TEM use, microbiology and 3-month outcomes. We conducted qualitative interviews with patients, carers traditional healers on reasons why people use TEM. Outcome measures included presenting vision and at 3-months, comparing TEM Users versus Non-Users. A thematic coding framework was deployed to explore reasons for use of TEM. Results: 188 out of 313 participants reported TEM use. TEM Users had a delayed presentation; median presenting time 18 days versus 14 days, p= 0.005; had larger ulcers 5.6 mm versus 4.3 mm p=0.0005; a worse presenting visual acuity median logarithm of the minimum angle of resolution (Log MAR) 1.5 versus 0.6, p=0.005; and, a worse visual acuity at 3 months median Log MAR 0.6 versus 0.2, p=0.010. In a multivariable logistic regression model, distance from the eye hospital and delayed presentation were associated with TEM use. Reasons for TEM use included lack of confidence in conventional medicine, health system breakdown, poverty, fear of the eye hospital, cultural belief in TEM, influence from traditional healers, personal circumstances and ignorance. : TEM users h Conclusion ad poorer clinical presentation and outcomes. Capacity building of the primary health centres to improve access to eye care and community behavioural change initiatives against TEM use should be encouraged.en_US
dc.identifier.citationArunga S, Asiimwe A, Apio Olet E et al. Traditional eye medicine use in microbial keratitis in Uganda: a mixed methods study [version 1; peer review: awaiting peer review] Wellcome Open Research 2019, 4:89 ( https://doi.org/10.12688/wellcomeopenres.15259.1)en_US
dc.identifier.urihttps://doi.org/10.12688/wellcomeopenres.15259.1
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/8321
dc.language.isoenen_US
dc.publisherWellcome open researchen_US
dc.subjectMicrobial Keratitisen_US
dc.subjectTraditional Eye Medicineen_US
dc.subjectTraditional Healersen_US
dc.subjectBlindnessen_US
dc.titleTraditional eye medicine use in microbial keratitis in Uganda: a mixed methods study [version 1; peer review: awaiting peer review]en_US
dc.typeArticleen_US
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