title: Risk factors for ocular surface squamous neoplasia in Kenya: a case-control study.
abstract: To determine modifiable risk factors of ocular surface squamous neoplasia (OSSN) in Kenya using disease-free controls.
  
  
  
  Adults with conjunctival lesions were recruited at four eye care centres in Kenya and underwent excision biopsy. An equal number of controls having surgery for conditions not affecting the conjunctiva and unrelated to ultraviolet light were group-matched to cases by age group, sex and eye care centre. Associations of risk factors with OSSN were evaluated using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Continuous variables were compared using the t-test or the Wilcoxon-Mann-Whitney U-test depending on their distribution.
  
  
  
  A total of 131 cases and 131 controls were recruited. About two-thirds of participants were female, and the mean age of cases and controls was 42.1 years and 43.3 years, respectively. Risk factors for OSSN were HIV infection without antiretroviral therapy (ART) use (OR = 48.42; 95% CI: 7.73-303.31) and with ART use (OR = 19.16; 95% CI: 6.60-55.57), longer duration of exposure to the sun in the main occupation (6.9 h/day vs. 4.6 h/day, OR = 1.24; 95% CI: 1.10-1.40) and a history of allergic conjunctivitis (OR = 74.61; 95% CI: 8.08-688.91). Wearing hats was protective (OR = 0.22; 95% CI: 0.07-0.63).
  
  
  
  Measures to prevent and control HIV, reduce sun exposure such as wearing hats and control allergic conjunctivitis are recommended.
authors.affiliation: International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.|Department of Ophthalmology, University of Nairobi, Nairobi, Kenya.
authors.forename: Stephen
authors.initials: S
authors.lastname: Gichuhi
authors.affiliation: PCEA Kikuyu Eye Unit, Kikuyu, Kenya.
authors.forename: Ephantus
authors.initials: E
authors.lastname: Macharia
authors.affiliation: PCEA Kikuyu Eye Unit, Kikuyu, Kenya.
authors.forename: Joy
authors.initials: J
authors.lastname: Kabiru
authors.affiliation: PCEA Kikuyu Eye Unit, Kikuyu, Kenya.
authors.forename: Alain M'bongo
authors.initials: AM
authors.lastname: Zindamoyen
authors.affiliation: International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.|Kitale District Hospital, Kitale, Kenya.
authors.forename: Hillary
authors.initials: H
authors.lastname: Rono
authors.affiliation: Sabatia Eye Hospital, Wodanga, Kenya.
authors.forename: Ernest
authors.initials: E
authors.lastname: Ollando
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Joseph
authors.initials: J
authors.lastname: Wachira
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Rhoda
authors.initials: R
authors.lastname: Munene
authors.affiliation: Department of Pathology, MP Shah Hospital, Nairobi, Kenya.
authors.forename: Timothy
authors.initials: T
authors.lastname: Onyuma
authors.affiliation: KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya.
authors.forename: Walter G
authors.initials: WG
authors.lastname: Jaoko
authors.affiliation: UCL Institute of Ophthalmology, London, UK.|Moorfields Eye Hospital, London, UK.|St. Bartholomew's Hospital, London, UK.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sagoo
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.affiliation: International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.|Moorfields Eye Hospital, London, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Burton
mesh_terms: D000328:Adult; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D003228:Conjunctiva / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000209:etiology* / Q000473:pathology; D003233:Conjunctivitis, Allergic / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D016017:Odds Ratio; D011481:Protective Clothing; D012307:Risk Factors; D013472:Sunlight / Q000009:adverse effects*
keywords: HIV; VIH; allergic conjunctivitis; antiretroviral therapy; conjonctivite allergique; conjuntivitis alérgica; facteurs de risque; factores de riesgo; neoplasia escamosa de la superficie ocular; néoplasie squameuse de la surface oculaire; ocular surface squamous neoplasia; radiación ultravioleta; rayonnement ultraviolet; risk factors; terapia antiretroviral; traitement antirétroviral; ultraviolet radiation