Between 1 and 1.4 million fungal eye infections occur in the developing world per year, leaving over 600,000 blind say researchers from Manchester, London and Nairobi.
Lead researcher Lottie Brown from the University of Manchester today published the first estimation of global Fungal keratitis figures in Lancet Infectious Diseases.
Infection of the transparent cornea of the eye can be devastating, especially if it is caused by a fungus, say the team. Fungal keratitis is one of the most devastating fungal eye infections.
Most fungal keratitis cases are diagnosed too late to save vision, and overall about 100,000 eyes have to be removed as a result. In contrast early diagnosis usually saves both vision and the eye, although a high level of expertise, antifungal therapy and often surgery is required.
The researchers identified high rates of fungal keratitis in a number of African countries as well as Nepal, Pakistan and India. Lower rates were identified in Europe.
Professor David Denning of The University of Manchester and Chief Executive of the Global Action Fund for Fungal Infections (GAFFI) said:
“Fungal keratitis is so neglected among neglected tropical diseases, even the WHO and G-Finder don’t list it. Poor agricultural workers are most affected, yet high quality care can takes days to access in most high incidence areas.”
Professor Matthew Burton, practicing ophthalmologist at The International Centre for Eye Health, part of the London School of Hygiene &Tropical Medicine, declared:
“Among all the major causes of eye infection in adults, fungal keratitis is too often devastating. My own experiences in Tanzania, Uganda, Nepal and India taught me what a challenge this problem can be – but enabled my team to develop pathways for major improvements in care.”
The authors examined all 241 papers published listing the causes of microbial keratitis to derive country and regional estimates of annual incidence. In Kenya, Dr Michael Gichangi from the Ministry of Health had collected cases from each district over several years, enabling an estimate for Africa. The authors also checked for the ratio between fungal and bacterial keratitis which varied from 1% in Spain to 60% in Vietnam, typically ~45% in tropical and subtropical areas.
|Estimated annual incidence*
|Annual incidence per 100,000 population
|Latin America and Caribbean
* rates are ~40% higher if culture and microscopy negative cases are assumed to be fungal.