Temporal trend of microsporidial keratoconjunctivitis and correlation with environmental and air pollution factors in India.

Citation metadata

Authors: Anthony Das and Sayan Basu
Date: May 2021
From: Indian Journal of Ophthalmology(Vol. 69, Issue 5)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 3,847 words
Lexile Measure: 1550L

Document controls

Main content

Article Preview :

Byline: Anthony. Das, Sayan. Basu

Purpose: The aim of this study was to describe the correlation between the temporal pattern of presentation of acute microsporidial keratoconjunctivitis (MKC) with meteorological parameters such as environmental temperature, rainfall, humidity, windspeed, and air pollution. Methods: This cross-sectional hospital-based study included 182,789 patients presenting between January 2016 and December 2019 hailing from the district of Hyderabad. Patients with a clinical diagnosis of MKC in at least one eye with an acute onset ([less-than or equal to]1 week) of presentation were included as cases. Correlation analysis was performed with the local environmental temperature, rainfall, humidity, and windspeed (Telangana State Development and Planning Society) and air pollution (Central Pollution Control Board, Government of India). Results: Overall, 84 (0.05%) patients were diagnosed with acute onset MKC from the district of Hyderabad. The mean monthly prevalence in this cohort was 0.05% with peak prevalence in the months of July (0.08%), August (0.09%), September (0.12%), and October (0.08%). The environmental parameters of rainfall (r2 = 0.87/P = < 0.0001), humidity (r2 = 0.78/P = 0.0001), windspeed (r2 = 0.38/P = 0.0321) were significantly positively correlated and the air pollution parameters such as ground level ozone (r2 = 0.89/P = < 0.0001), particulate matter PM[sub]10 (r2 = 0.65/P = 0.0013), PM[sub]2.5 (r2 = 0.50/P = 0.0095), nitrogen dioxide (r2 = 0.53/P = 0.0071), and carbon monoxide (r2 = 0.69/P = 0.0008) were significantly negatively correlated with the temporal pattern of MKC in the population. Conclusion: Parasitic infections like MKC show a distinct temporal trend peaking during the monsoon season in the population. An increase in humidity, wind speed, and especially rainfall contributes to a higher prevalence of MKC cases during the year. An increase in ground-level ozone seems to be protective against infection.

Microsporidia are eukaryotic, obligate, spore-forming unicellular parasites. They have been known to infect invertebrates and have increasingly gained prominence in affecting humans over the past few decades.[1] Microsporidia can cause a host of infections that includes myositis, diarrhea, bronchitis, and keratitis in both immune-compromised or immune-competent individuals. The infection with the microsporidial spores can occur via direct inoculation, inhalation, or ingestion. The ocular manifestations of microsporidial infection include keratoconjunctivitis or stromal keratitis.[2] A strong correlation with environmental exposure to soil,[3] sport activities,[4] and water contamination in swimming pools[5] have been described in literature. The cases are more commonly acute in nature and can sometimes run a chronic indolent course as well. A large cohort from South India described an increase in incidence of cases from July to December[6] and others reported cases after a recent rainfall as well.[3] Due to the rarity of its nature, a high degree of clinical suspicion is warranted to diagnose microsporidial keratoconjunctivitis (MKC) as it often can be misdiagnosed as a viral ocular infection of epidemic keratoconjunctivitis (EKC) which is more commoner of the two. The understanding of the correlation of environmental factors on the temporal trends of infections affecting the ocular surface like EKC is described in the Indian subcontinent.[7] The authors...

Source Citation

Source Citation   

Gale Document Number: GALE|A660644288