title: A new method to predict the epidemiology of fungal keratitis by monitoring the sales distribution of antifungal eye drops in Brazil.
abstract: OBJECTIVE
  Fungi are a major cause of keratitis, although few medications are licensed for their treatment. The aim of this study is to observe the variation in commercialisation of antifungal eye drops, and to predict the seasonal distribution of fungal keratitis in Brazil.
  
  
  METHODS
  Data from a retrospective study of antifungal eye drops sales from the only pharmaceutical ophthalmologic laboratory, authorized to dispense them in Brazil (Opthalmos) were gathered. These data were correlated with geographic and seasonal distribution of fungal keratitis in Brazil between July 2002 and June 2008.
  
  
  RESULTS
  A total of 26,087 antifungal eye drop units were sold, with a mean of 2.3 per patient. There was significant variation in antifungal sales during the year (p<0.01). A linear regression model displayed a significant association between reduced relative humidity and antifungal drug sales (R2 = 0.17,p<0.01).
  
  
  CONCLUSIONS
  Antifungal eye drops sales suggest that there is a seasonal distribution of fungal keratitis. A possible interpretation is that the third quarter of the year (a period when the climate is drier), when agricultural activity is more intense in Brazil, suggests a correlation with a higher incidence of fungal keratitis. A similar model could be applied to other diseases, that are managed with unique, or few, and monitorable medications to predict epidemiological aspects.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Marlon Moraes
authors.initials: MM
authors.lastname: Ibrahim
authors.forename: Rafael
authors.initials: R
authors.lastname: de Angelis
authors.forename: Acacio Souza
authors.initials: AS
authors.lastname: Lima
authors.forename: Glauco Dreyer
authors.initials: GD
authors.lastname: Viana de Carvalho
authors.forename: Fuad Moraes
authors.initials: FM
authors.lastname: Ibrahim
authors.forename: Leonardo Tannus
authors.initials: LT
authors.lastname: Malki
authors.forename: Marina
authors.initials: M
authors.lastname: de Paula Bichuete
authors.forename: Wellington
authors.initials: W
authors.lastname: de Paula Martins
authors.forename: Eduardo Melani
authors.initials: EM
authors.lastname: Rocha
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D015821:Eye Infections, Fungal / Q000188:drug therapy*; D006801:Humans; D007634:Keratitis / Q000188:drug therapy*; D009883:Ophthalmic Solutions; D012621:Seasons
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions