Frequency of Conjunctivitis among Farmers of District Vehari, Punjab, Pakistan: Conjuntivitis among farmers of Vehari

Zain Ul Abideen; Ahmed  Sohail; Ishrat  Perveen; Tallat Anwar  Faridi; Hafsa  Ayyub

doi:10.52229/pbmj.v4i1.69

Authors

Zain Ul Abideen Institute of Public Health, Faculty of Allied Health Sciences,The University of Lahore, Lahore, Pakistan.
Ahmed Sohail Department of Allied Health Sciences, Superior University, Lahore, Pakistan
Ishrat Perveen Department of Zoology, University of the Punjab, Lahore, Pakistan.
Tallat Anwar Faridi Institute of Public Health, Faculty of Allied Health Sciences,The University of Lahore, Lahore, Pakistan
Hafsa Ayyub University Institute of Radiology and Medical Imaging Technology, University of Lahore, Lahore, Pakistan

DOI:

https://doi.org/10.52229/pbmj.v4i1.69

Abstract

Conjunctivitis is a globally prevalent ocular and/eye infection. The basic motivation of the current study may be traced back to the association of conjunctivitis with unhygienic situations and sunlight exposure. The daily routine of farmers, overwhelming poverty, and illiteracy ratio may have further enhanced the incidence ratio of conjunctivitis. The ocular infection and/or conjunctivitis is caused by various pathogens, if not managed properly and appropriately may lead to corneal perforation or blindness.

Objective: The study has been designed to find out the prevalence of various pathogenic and allergic conjunctivitis among farmers in the district Vehari, Punjab, Pakistan.

Methods: It was a community-based and cross-sectional descriptive studyfrom October- November 2019. The study involved the quantitative analytical method.Anterior segments of eyes followed by posterior segments were examined by using an ophthalmoscope and torchlight for the diagnosisof conjunctivitis. Data on pathogenic and allergic conjunctiva was collected. Result: Our study indicated that 33(16.5%) farmers were found with the symptoms ascertained with conjunctivitis. Among the studied subjects, 29(14.5%) and 4(2%) farmers were found with bacterial and viral conjunctivitis, respectively. As far as the tendency of seeking medical help and ophthalmic consultation is concerned, 31(15.5%) and 19(9.5%) patients preferred to get examined by an eye specialist and traditional treatment, respectively. However, 150(75%) patients neglected to seek any medical aid. It was found 27 (13.5%), and 55 (27.5%) farmers were using glasses and traditional eye protective measures, respectively. However, almost sixty percent 118(59%) of farmers were not using any type of eye-protective measures. It was found that 59%, 30%, and 11% farmer population was exposed to sunlight for almost six, four, and two hours, respectively on daily basis. Conclusions:The use of prevalent traditional protective measures and lack of treatment or medical aid seeking trendby farmers has been found responsible for the high incidence of bacterial conjunctivitis. Moreover, long working hours and sunlight exposure alongwith the predominant unhygienic conditions may further quadruple the frequency of viral and bacterial conjunctivitis.The high prevalence ratio of conjunctivitis, eye infections, and ocular injuries highlight the need of observing universal eye safety and precautionary measures.Keeping in view the downtrodden economic conditions of the farmers and agriculturalists in the country and the financial repercussions associated with the infection, a state-ownedmedical awareness and relief process must be ensured and encouraged for the Pakistani community.

References

Li, J., Yang, Y., Lin, C., Li, W., Yang, Y., Zhang, Y. et al. (2014). Etiology of acute conjunctivitis due to coxsackievirus A24 variant, human adenovirus, herpes simplex virus, and Chlamydia in Beijing, China. Japanese Journal of Infectious Diseases, 67(5): 349-355. doi: https://doi.org/10.7883/yoken.67.349.

Sambursky RP, Fram N, Cohen EJ. (2007). The prevalence of adenoviral conjunctivitis at the wills eye hospital emergency room. Optometry, 78(5):236–239. doi: https://doi.org/10.1016/j.optm.2006.11.012.

Jhanji, V., Chan, T. C., Li, E. Y., Agarwal, K., Vajpayee, R. B. (2015). Adenoviral keratoconjunctivitis. Survey of Ophthalmology,60(5): 435-443. doi: https://doi.org/10.1016/j.survophthal.2015.04.001.

Visscher, K. L., Hutnik, C. M. L., Thomas, M. (2009). Evidence-based treatment of acute infective conjunctivitis: Breaking the cycle of antibiotic prescribing. Canadian Family Physician, 55(11):1071-1075.

Castillo, J., Verboven, Y., Stroman, D., Kodjikian, L. (2011). The role of topical moxifloxacin, a new antibacterial in Europe, in the treatment of bacterial conjunctivitis.Clinical Drug Investigation, 31(8):543-57. DOI: 10.2165/11589020-000000000-00000.

Chung C, Cohen E, Smith J. (2002). Bacterial conjunctivitis. Clinical Evidence, 7:574–579.

Donahue, S. P., Khoury, J. M., Kozvalski, R. P. (1996). Common ocular infections. Drugs, 52(4): 526-540. doi: https://doi.org/10.2165/00003495-199652040-00006

Frank F. Bodor, MD, FAAP. (1998). Diagnosis and management of acute conjunctivitis. Seminars in Pediatric Infectious Diseases, 9(1): 27-30.doi: https://doi.org/10.1016/S1045-1870(98)80047-2

Cavuoto, K. M., Zutshi, D., Miller, D., Karp, C., Feuer, W. J. (2006). Update on Bacterial Conjunctivitis in South Florida. Investigative Ophthalmology & Visual Science, 47(13): 1907-1907.

Lietman, P. S., Gigliotti, F., Hendley, J. O., Morgan, J., Michaels, R., Dickens, M., Lohr, J. (1984). Efficacy of topical antibiotic therapy in acute conjunctivitis in children. The Journal of pediatrics, 104(4): 623-626. doi: https://doi.org/10.1016/S0022-3476(84)80566-1

Sheikh, A., Hurwitz, B. (2005). Topical antibiotics for acute bacterial conjunctivitis: Cochrane systematic review and meta-analysis update. British Journal of General Practice, 55(521): 962-964.

Singh, K., Bielory, L. (2007) Ocular allergy: a national epidemiologic study. Journal of Allergy and Clinical Immunology,119(1):154.doi:10.1016/j.jaci.2006.11.538

Datta, G. (2020). Contaminated pond water may cause chronic allergic conjunctivitis in rural area–a case report. Science, Technology and Development, 9(11): 62-65.

Singh, K., Bielory, L. (2007). Epidemiology of ocular allergy symptoms in regional parts of the United States in the adult population (1988-1994). In annals of allergy asthma & immunology, 98 (1): A22-A22.

Isaacson, P., Wright, D. H. (1984). Extranodal malignant lymphoma arising from mucosa‐associated lymphoid tissue. Cancer,53(11): 2515-2524. DOI: https://doi.org/10.1002/1097-0142(19840601)53:11<2515::AID CNCR2820531125>3.0.CO;2-C

Bielory, L., Frohman, L. P. (1992). Allergic and immunologic disorders of the eye. Journal of Allergy and Clinical Immunology, 89(1): 1-15. doi: https://doi.org/10.1016/S0091-6749(05)80033-8.

Leonardi, A., Motterle, L., Bortolotti, M. (2008). Allergy and the eye. Clinical & Experimental Immunology, 153, 17-21. doi:https://doi.org/10.1111/j.1365-2249.2008.03716.x

Wong, A. H., Barg, S. S., Leung, A. K. (2009). Seasonal and perennial conjunctivitis. Recent Pat Inflamm Allergy Drug Discov, 3:118–127. doi: https://doi.org/10.1016/S0091-6749(05)80033-8.

Friedlaender, M. H. (2011). Ocular allergy. Current Opinion in Allergy and Clinical Immunology, 11(5), 477-482. doi: 10.1097/ACI.0b013e32834a9652.

Stokes, T. C., Feinberg, G. (1993). Rapid onset of action of levocabastine eye‐drops in histamine‐induced conjunctivitis. Clinical & Experimental Allergy, 23(9): 791-794. doi: https://doi.org/10.1111/j.1365-2222.1993.tb00368.x

Donshik, P. C., Pearlman, D., Pinnas, J., Raizman, M. B., Tauber, J., Tinkelman, D., Walters, T. R. (2000). Efficacy and safety of ketorolac tromethamine 0.5% and levocabastine 0.05%: a multicenter comparison in patients with seasonal allergic conjunctivitis. Advances in Therapy, 17(2): 94-102. doi: https://doi.org/10.1007/BF02854842.

Kari, O., Saari, K. M. (2010). Updates in the treatment of ocular allergies. Journal of Asthma and Allergy, 3:149-158. doi: 10.2147/JAA.S13705

Spector, S. L., Raizman, M. B. (1994). Conjunctivitis medicamentosa. Journal of Allergy and Clinical Immunology, 94(1): 134-136. doi: https://doi.org/10.1016/0091-6749(94)90081-7.

Dell, S. J., Shulman, D. G., Lowry, G. M., Howes, J., Loteprednol Allergic Conjunctivitis Study Group. (1997). A controlled evaluation of the efficacy and safety of loteprednoletabonate in the prophylactic treatment of seasonal allergic conjunctivitis. American Journal of Ophthalmology, 123(6): 791-797. doi: https://doi.org/10.1016/S0002-9394(14)71128-6.

Dell, S. J., Lowry, G. M., Northcutt, J. A., Howes, J., Novack, G. D., & Hart, K. (1998). A randomized, double-masked, placebo-controlled parallel study of 0.2% loteprednoletabonate in patients with seasonal allergic conjunctivitis. Journal of Allergy and Clinical Immunology, 102(2): 251-255. doi: https://doi.org/10.1016/S0091-6749(98)70094-6.

Fan, D. S., Christopher, B. O., Chiu, T. Y., Wong, C. Y., Ng, J. S., Pang, C. P., Lam, D. S. (2003). Ocular-hypertensive and anti-inflammatory response to rimexolone therapy in children. Archives of Ophthalmology, 121(12): 1716-1721.doi: 10.1001/archopht.121.12.1716

Pflugfelder, S. C., Maskin, S. L., Anderson, B., Chodosh, J., Holland, E. J., De Paiva, C. S., Vogel, R. (2004). A randomized, double-masked, placebo-controlled, multicenter comparison of loteprednoletabonate ophthalmic suspension, 0.5%, and placebo for treatment of keratoconjunctivitis sicca in patients with delayed tear clearance. American Journal of Ophthalmology, 138(3): 444-457. doi:https://doi.org/10.1016/j.ajo.2004.04.052

Ali, A., Erenstein, O. (2017). Assessing farmer use of climate change adaptation practices and impacts on food security and poverty in Pakistan. Climate Risk Management, 16: 183-194.

Lakho, K. A., Jadoon, M. Z., Mahar, P. S. (2012). Pattern of Ocular Problems in School going Children of District Lasbela, Balochistan. Pakistan Journal of Ophthalmology, 28(4): doi: https://doi.org/10.36351/pjo.v28i4.395

Majeed, A., Naeem, Z., Khan, D. A., Ayaz, A. (2005). Epidemic adenoviral conjunctivitis report of an outbreak in a military garison and recommendations for its management and prevention. Journal-Pakistan medical association, 55(7):273-275.

Liang, Q., Lu, X., Wang, M., Tian, L., Labbé, A., Hu, A. (2016). Study of infectious conjunctivitis among children in rural areas of Qinghai province. Science China Life Sciences, 59(6): 548-554. doi:https://doi.org/10.1007/s11427-016-5058-x

Baig, R., Ali, A. W., Ali, T., Ali, A., Shah, M. N., Sarfaraz, A., Ahmad, K. (2010). Prevalence of allergic conjunctivitis in school children of Karachi. Journal of the Pakistan Medical Association, 60(5):371-373.

Malu, K. N. (2014). Allergic conjunctivitis in Jos-Nigeria. Nigerian medical journal: Journal of the Nigeria Medical Association, 55(2):166-170. doi: 10.4103/0300-1652.129664.

Woodland, R. M., Darougar, S., Thaker, U., Cornell, L., Siddique, M., Wania, J., Shah, M. (1992). Causes of conjunctivitis and keratoconjunctivitis in Karachi, Pakistan.Transactions of the Royal Society of Tropical Medicine and Hygiene, 86(3): 317-320. DOI: 10.1016/0035-9203(92)90328-a.

Wazzan, K. A. A., Almas, K., Qahtani, M. Q. A., Shethri, S. E. A., Khan, N. (2001). Prevalence of ocular injuries, conjunctivitis and use of eye protection among dental personnel in Riyadh, Saudi Arabia. International dental journal, 51(2): 89-94. https://doi.org/10.1002/j.1875-595X.2001.tb00828.x.

Roberts-Harry, T. J., Cass, A. E., Jagger, J. D. (1991). Ocular injury and infection in dental practice. A survey and a review of the literature. British Dental Journal, 170(1): 20-22.doi:https://doi.org/10.1038/sj.bdj.4807396.

Azuamah, Y.C., Esenwah, E.C., Ahuama, O.C., Ikoro, N.C., Iwuagwu, F.C., Dozie, I.N.S. (2018). External eye infections and personal hygiene practices among patients attending optometry teaching clinic federal university of technology, owerri. Journal of the Nigerian Optometric Association, 20(2): 53 – 61.

Sethi, S., Sethi, M. J., Saeed, N., Kundi, N. K. (2008). Pattern of common eye diseases in children attending outpatient eye department Khyber Teaching Hospital. Pakistan Journal of Ophthalmology, 24(4):166-171.doi:https://doi.org/10.36351/pjo.v24i4.675 .

Fatima, K., Shahid, E., Shaikh, A. (2015). Frequency of Common Eye Diseases in Pediatric Outpatient Department of A Tertiary Care Hospital. Pakistan Journal of Ophthalmology,31(3): 154-157.

Kumah, D. B., Lartey, S. Y., Yemanyi, F., Boateng, E. G., Awuah, E. (2015). Prevalence of allergic conjunctivitis among basic school children in the Kumasi Metropolis (Ghana): a community-based cross-sectional study. BMC Ophthalmology,15:69. doi: 10.1186/s12886-015-0053-8.