title: Hookworm infestation as a risk factor for Mooren's ulcer in South India.
abstract: OBJECTIVE
  To investigate the association between Mooren's ulcer and intestinal hookworm infestation in South India.
  
  
  METHODS
  Prospective observational case-control study.
  
  
  METHODS
  Fifteen patients with Mooren's ulcer and 30 age- and gender-matched controls seen at Aravind Eye Hospital.
  
  
  METHODS
  Stool samples from the Mooren's ulcer patients and controls were collected and analyzed for presence of hookworm infestation.
  
  
  METHODS
  Prevalence of hookworm infestation in Mooren's ulcer patients and controls.
  
  
  RESULTS
  There was a statistically significant correlation between intestinal hookworm infestation and the occurrence of Mooren's ulcer (P = 0.009). Retrospective exploratory subgroup analyses suggested that the correlation between intestinal hookworm infestation and the occurrence of Mooren's ulcer in men (P<0.0001) was stronger than the correlation in women, with no statistically significant difference being observed in the prevalence of hookworm infestation between women with Mooren's ulcer and female control subjects (P>0.99). Similarly, when both the Mooren's ulcer and the control subject groups were analyzed retrospectively by age > 50 years or age < 50, subjects with an age over 50 demonstrated a stronger correlation between hookworm infestation and Mooren's ulcer than controls (P = 0.017), whereas there was no statistically significant difference in the prevalence of hookworm infection between Mooren's ulcer subjects and control subjects < or = 50 (P = 0.31).
  
  
  CONCLUSIONS
  Intestinal hookworm infestation appears to be associated with the development of Mooren's ulcer in South India. Although the power of our retrospective exploratory subgroup analyses was limited by multiple testing and small sample sizes, these data suggest further that the correlation between intestinal hookworm infestation and the development of Mooren's ulcer may be greatest in male patients with more advanced age.
authors.affiliation: New York University School of Medicine, New York, New York, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Zelefsky
authors.forename: Muthaiah
authors.initials: M
authors.lastname: Srinivasan
authors.forename: Arunava
authors.initials: A
authors.lastname: Kundu
authors.forename: Thomas
authors.initials: T
authors.lastname: Lietman
authors.forename: John P
authors.initials: JP
authors.lastname: Whitcher
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Marc
authors.initials: M
authors.lastname: Buyse
authors.forename: Emmett T
authors.initials: ET
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003320:Corneal Ulcer / Q000469:parasitology*; D005260:Female; D006725:Hookworm Infections / Q000150:complications*; D006801:Humans; D007194:India; D007411:Intestinal Diseases, Parasitic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors