Indian Journal of Ophthalmology

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 67  |  Issue : 10  |  Page : 1593--1598

Demographic and socioeconomic barriers and treatment seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty


Hem Shah1, Naveen Radhakrishnan1, Shivaa Ramsewak2, Stephan Chiu3, Sanil Joseph4, Jennifer Rose-Nussbaumer5, N Venkatesh Prajna1 
1 Department of Cornea and Refractive Services, Aravind Eye Hospital, Madurai, Tamil Nadu, India
2 London School of Hygiene and Tropical Medicine, London, United Kingdom
3 Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
4 Lions Aravind Institute of Community Ophthalmology, Madurai, Tamil Nadu, India
5 Francis I. Proctor Foundation, University of California-San Francisco, San Francisco, CA, United States of America

Correspondence Address:
Dr. N Venkatesh Prajna
Department of Cornea and Refractive Services, Aravind Eye Hospital, 1, Anna Nagar, Madurai - 625 020, Tamil Nadu
India

Purpose: To understand demographic and socioeconomic barriers and treatment-seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty (TPK) in a developing country. Methods: This prospective non-comparative questionnaire- based study included all patients presenting to Aravind Eye Hospital, Madurai with infectious keratitis that eventuated to TPK between November 2015 and October 2016. A structured questionnaire was administered on post-operative day 3 to collect data on the demographic details, predisposing factors, prior treatment received, and treatment expenditures. Results: In total, 227 patients underwent TPK between November 2015 and October 2016 for infectious keratitis. The majority of patients were males (n = 132, 58.1%), illiterate (n = 129, 56.8%), and had a family monthly income of less than INR 6000 (n = 142, 62.5%). Most of the patients (n = 163, 71.8%) had prior treatment with an ophthalmologist before presenting to our hospital. The mean distance travelled to reach our centre was 269.2 ± 298.5 km. The mean duration of disease before the presentation was 20.3 ± 21.1 days. Corneal smear was positive for fungus in 163 (88.1%) and Aspergillus was the most commonly isolated fungi in 55 (41.3%) cultures. The mean total cost of treatment was INR 8752.87 ± 7615.39 per patient. There was a positive correlation between the duration of the disease (rho 0.19, P = 0.0034) and the costs of treatment (rho 0.2, P = 0.0024) with the distance travelled by the patient. Conclusion: Patients who travelled a farther distance had a delayed onset of presentation and spent significantly more than their respective counterparts.


How to cite this article:
Shah H, Radhakrishnan N, Ramsewak S, Chiu S, Joseph S, Rose-Nussbaumer J, Prajna N V. Demographic and socioeconomic barriers and treatment seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty.Indian J Ophthalmol 2019;67:1593-1598


How to cite this URL:
Shah H, Radhakrishnan N, Ramsewak S, Chiu S, Joseph S, Rose-Nussbaumer J, Prajna N V. Demographic and socioeconomic barriers and treatment seeking behaviors of patients with infectious keratitis requiring therapeutic penetrating keratoplasty. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 22 ];67:1593-1598
Available from: http://www.ijo.in/article.asp?issn=0301-4738;year=2019;volume=67;issue=10;spage=1593;epage=1598;aulast=Shah;type=0