PMID- 37322658
OWN - NLM
STAT- MEDLINE
DCOM- 20230619
LR  - 20231116
IS  - 1998-3689 (Electronic)
IS  - 0301-4738 (Print)
IS  - 0301-4738 (Linking)
VI  - 71
IP  - 6
DP  - 2023 Jun
TI  - The effect of social determinants of health on severity of microbial keratitis 
      presentation at a tertiary eye care hospital in Southern India.
PG  - 2448-2454
LID - 10.4103/IJO.IJO_331_23 [doi]
AB  - PURPOSE: Understanding the association between social determinants of health 
      (SDoHs) and microbial keratitis (MK) can inform underlying risk for patients and 
      identify risk factors associated with worse disease, such as presenting visual 
      acuity (VA) and time to initial presentation. METHODS: This was a cross-sectional 
      study was conducted with patients presenting with MK to the cornea clinic at a 
      tertiary care hospital in Madurai, India. Patient demographics, SDoH survey 
      responses, geographic pollution, and clinical features at presentation were 
      collected. Descriptive statistics, univariate analysis, multi-variable linear 
      regression models, and Poisson regression models were utilized. RESULTS: There 
      were 51 patients evaluated. The mean age was 51.2 years (SD = 13.3); 33.3% were 
      female and 55% did not visit a vision center (VC) prior to presenting to the 
      clinic. The median presenting logarithm of the minimum angle of resolution 
      (logMAR) VA was 1.1 [Snellen 20/240, inter-quartile range (IQR) = 20/80 to 
      20/4000]. The median time to presentation was 7 days (IQR = 4.5 to 10). The 
      average particulate matter 2.5 (PM2.5) concentration, a measure of air pollution, 
      for the districts from which the patients traveled was 24.3 mug/m3 (SD = 1.6). 
      Age- and sex-adjusted linear regression and Poisson regression results showed 
      that higher levels of PM2.5 were associated with 0.28 worse presenting logMAR VA 
      (Snellen 2.8 lines, P = 0.002). Patients who did not visit a VC had a 100% longer 
      time to presentation compared to those who did (incidence rate ratio = 2.0, 95% 
      confidence interval = 1.3-3.0, P = 0.001). CONCLUSION: Patient SDoH and 
      environmental exposures can impact MK presentation. Understanding SDoH is 
      important for public health and policy implications to mitigate eye health 
      disparities in India.
FAU - Annadanam, Anvesh
AU  - Annadanam A
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Hicks, Patrice M
AU  - Hicks PM
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Lu, Ming-Chen
AU  - Lu MC
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Pawar, Mercy
AU  - Pawar M
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Kochar, Prabhleen
AU  - Kochar P
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Selvaraj, Suvitha
AU  - Selvaraj S
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Kuppuraj, Dhanya
AU  - Kuppuraj D
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Rathod, Chetan
AU  - Rathod C
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Muppala, Rekha Sravya
AU  - Muppala RS
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Gaur, Smriti
AU  - Gaur S
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Krishnan, Abinaya
AU  - Krishnan A
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Sumithra, S R
AU  - Sumithra SR
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
FAU - Woodward, Maria A
AU  - Woodward MA
AD  - Department of Ophthalmology and Visual Sciences, University of Michigan, Ann 
      Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of 
      Michigan, Ann Arbor, USA.
FAU - Prajna, N Venkatesh
AU  - Prajna NV
AD  - Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil 
      Nadu, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian J Ophthalmol
JT  - Indian journal of ophthalmology
JID - 0405376
RN  - 0 (Particulate Matter)
SB  - IM
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Male
MH  - Cross-Sectional Studies
MH  - *Social Determinants of Health
MH  - India/epidemiology
MH  - *Keratitis
MH  - Particulate Matter
MH  - Hospitals
PMC - PMC10417972
OTO - NOTNLM
OT  - Air pollution
OT  - South India
OT  - corneal ulcers
OT  - international eye care
OT  - microbial keratitis
OT  - social determinants of health
COIS- None
EDAT- 2023/06/16 06:42
MHDA- 2023/06/19 13:08
PMCR- 2023/06/01
CRDT- 2023/06/16 00:24
PHST- 2023/06/19 13:08 [medline]
PHST- 2023/06/16 06:42 [pubmed]
PHST- 2023/06/16 00:24 [entrez]
PHST- 2023/06/01 00:00 [pmc-release]
AID - IndianJOphthalmol_2023_71_6_2448_378513 [pii]
AID - IJO-71-2448 [pii]
AID - 10.4103/IJO.IJO_331_23 [doi]
PST - ppublish
SO  - Indian J Ophthalmol. 2023 Jun;71(6):2448-2454. doi: 10.4103/IJO.IJO_331_23.