Purpose: The aim of this study is to investigate the usage, ingredients, and microbiological profile of traditional eye medicine (TEM) at a teaching hospital in southwest Uganda.
Methods: This was a single-center prospective pilot study that included 11 individuals who used TEM before presenting to a tertiary eye center of the Mbarara University of Science and Technology between Feb 15, 2017, and Feb 24, 2017. We noted the patients’ demographics, chief complaints, reasons for using TEM, and duration of treatment. We obtained the 19 samples of TEM and reviewed botanical contents and the microbiologic profile via gram staining, KOH staining, and cultures on blood-heart infusion agar, blood agar, chocolate agar, and potato dextrose agar.
Results: The most common reason for using TEM was cultural belief, followed by the cost of western medications and distance to the eye clinic. Cataracts and allergic conjunctivitis were the most common diagnoses made. The major contents were botanical sources. Sixteen out of 19 samples (84%) showed positive microbial culture; 6 samples were polymicrobial, and 10 were monomicrobial. Klebsiella species was the most common microorganism, being isolated from 13 samples. Other bacterial organisms included Staphylococcus aureus and Bacillus species. Fungal species such as candida and aspergillus species were isolated as well.
Conclusion: Most of our patients used TEM due to cultural beliefs. Eighty-five percent of the TEM samples showed positive microbiology culture, predominantly with Klebsiella species. Further microbiologic studies are warranted to identify the correlation between the use of TEM, corneal contamination, and corneal ulcers.
Organization. WH. Fact Sheet: Visual impairment and blindness [Available from: http://www.who.int/mediacentre/factsheets/fs282/en/.
Mbulaiteye SM, Reeves BC, Karabalinde A, Ruberantwari A, Mulwanyi F, Whitworth JA, et al. Evaluation of E-optotypes as a screening test and the prevalence and causes of visual loss in a rural population in SW Uganda. Ophthalmic epidemiology. 2002;9(4):251-62.
Waddell KM. Childhood blindness and low vision in Uganda. Eye (Lond). 1998;12 ( Pt 2):184-92.
Bisika T, Courtright P, Geneau R, Kasote A, Chimombo L, Chirambo M. Self treatment of eye diseases in Malawi. African journal of traditional, complementary, and alternative medicines : AJTCAM. 2008;6(1):23-9.
Hagan M, Wright E, Newman M, Dolin P, Johnson G. Causes of suppurative keratitis in Ghana. Br J Ophthalmol. 1995;79(11):1024-8.
Kaggwa G. Ophthalmic clinical officers: developments in Uganda. Community Eye Health. 2014;27(86):34.
Sheila Maregesi M KB, Kagashe G, Kaali Reuben. Traditional Eye Medicines in Tanzania: Products, Health Risk Awareness and Safety Evaluation. Herb Med. 2016;2:1.
Ukponmwan CU, Momoh N. Incidence and complications of traditional eye medications in Nigeria in a teaching hospital. Middle East Afr J Ophthalmol. 2010;17(4):315-9.
Eze BI, Chuka-Okosa CM, Uche JN. Traditional eye medicine use by newly presenting ophthalmic patients to a teaching hospital in south-eastern Nigeria: socio-demographic and clinical correlates. BMC complementary and alternative medicine. 2009;9:40-.
Klauss V, Adala HS. Traditional herbal eye medicine in Kenya. World health forum. 1994;15(2):138-43.
Ebeigbe JA. Traditional eye medicine practice in Benin-City, Nigeria. 2013. 2013:6.
Ezegwui IR, Umeh RE, Ezepue UF. Causes of childhood blindness: results from schools for the blind in south eastern Nigeria. The British journal of ophthalmology. 2003;87(1):20-3.
Aghaji AE, Ezeome IV, Ezeome ER. Evaluation of content and cost of traditional eye medication in a resource-poor country - Implications for eye care practice and policy. Niger J Clin Pract. 2018;21(11):1514-9.
Nxumalo N, Alaba O, Harris B, Chersich M, Goudge J. Utilization of traditional healers in South Africa and costs to patients: findings from a national household survey. J Public Health Policy. 2011;32 Suppl 1:S124-36.
Lasker JN. Choosing among therapies: illness behavior in the Ivory Coast. Social science & medicine Medical psychology & medical sociology. 1981;15a(2):157-68.
Ademola-Popoola DS, Owoeye JF. Traditional couching for cataract treatment: a cause of visual impairment. West African journal of medicine. 2004;23(3):208-10.
Kayoma DH, Ukponmwan CU. DETERMINANTS OF THE USE OF TRADITIONAL EYE MEDICATION IN A SEMI-URBAN COMMUNITY IN SOUTHERN NIGERIA. Journal of the West African College of Surgeons. 2016;6(3):49-67.
Baba I. The red eye - first aid at the primary level. Community Eye Health. 2005;18(53):70-2.
Cumurcu T, Firat P, Ozsoy E, Cavdar M, Yakupogullari Y. Contact-lens-related corneal ulcer caused by Klebsiella pneumoniae. Clinics (Sao Paulo, Brazil). 2011;66(8):1509-10.
Sridhar J, Flynn HW, Jr., Kuriyan AE, Dubovy S, Miller D. Endophthalmitis caused by Klebsiella species. Retina (Philadelphia, Pa). 2014;34(9):1875-81.
Lin JC, Chang FY, Fung CP, Yeh KM, Chen CT, Tsai YK, et al. Do neutrophils play a role in establishing liver abscesses and distant metastases caused by Klebsiella pneumoniae? PloS one. 2010;5(11):e15005.
Courtright P, Lewallen S, Kanjaloti S. Changing patterns of corneal disease and associated vision loss at a rural African hospital following a training programme for traditional healers. Br J Ophthalmol. 1996;80(8):694-7.