title: Aetiology of suppurative corneal ulcers in Ghana and south India, and epidemiology of fungal keratitis.
abstract: BACKGROUND
  A multicentre study was carried out in Ghana and southern India to determine the aetiology of suppurative keratitis in two regions located at similar tropical latitudes. Studies of fungal keratitis from the literature were reviewed.
  
  
  METHODS
  Patients presenting at rural and urban eye units with suspected microbial keratitis were recruited to the study. Corneal ulceration was defined as loss of corneal epithelium with clinical evidence of infection with or without hypopyon. Microscopy and culture were performed on all corneal specimens obtained.
  
  
  RESULTS
  1090 patients were recruited with suspected microbial keratitis between June 1999 and May 2001. Overall the principal causative micro-organisms in both regions were filamentous fungi (42%): Fusarium species and Aspergillus species were the commonest fungal isolates. Pseudomonas species were most frequently isolated from cases of bacterial keratitis in Ghana but in India the commonest bacterial isolates were streptococci.
  
  
  CONCLUSIONS
  Infections of the cornea due to filamentous fungi are a frequent cause of corneal damage in developing countries in the tropics and are difficult to treat. Microscopy is an essential tool in the diagnosis of these infections. A knowledge of the "local" aetiology within a region is of value in the management of suppurative keratitis in the event that microscopy cannot be performed.
authors.affiliation: Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. a.leck@ucl.ac.uk
authors.forename: A K
authors.initials: AK
authors.lastname: Leck
authors.forename: P A
authors.initials: PA
authors.lastname: Thomas
authors.forename: M
authors.initials: M
authors.lastname: Hagan
authors.forename: J
authors.initials: J
authors.lastname: Kaliamurthy
authors.forename: E
authors.initials: E
authors.lastname: Ackuaku
authors.forename: M
authors.initials: M
authors.lastname: John
authors.forename: M J
authors.initials: MJ
authors.lastname: Newman
authors.forename: F S
authors.initials: FS
authors.lastname: Codjoe
authors.forename: J A
authors.initials: JA
authors.lastname: Opintan
authors.forename: C M
authors.initials: CM
authors.lastname: Kalavathy
authors.forename: V
authors.initials: V
authors.lastname: Essuman
authors.forename: C A N
authors.initials: CA
authors.lastname: Jesudasan
authors.forename: G J
authors.initials: GJ
authors.lastname: Johnson
mesh_terms: D001228:Aspergillosis / Q000453:epidemiology; D003320:Corneal Ulcer / Q000453:epidemiology / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000453:epidemiology; D015821:Eye Infections, Fungal / Q000453:epidemiology* / Q000382:microbiology; D005670:Fusarium; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007634:Keratitis / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000453:epidemiology