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J.R. Zelefsky, M. Srinivasan, T. Lietman, J.P. Whitcher, K. Wang, M. Buyse, E.T. Cunningham, Jr.; Hookworm Infestation as a Risk Factor for Mooren’s Ulcer in South India . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4383.
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To investigate the association between Mooren’s Ulcer and Hookworm infection in South India.
Stool samples from 15 patients with Mooren’s Ulcer and 30 age and sex matched controls seen at Aravind Eye Hospital were collected and analyzed for presence of hookworm infestation.
There was no significant difference in the age (P = 0.58) and sex (P = 0.50) distribution of cases vs. controls. There was, however, a statistically significant correlation between hookworm infestation and the occurrence of Mooren’s ulcer (P = 0.009). A retrospective subgroup analysis by sex suggested that the correlation between 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 corneal ulcer and female control subjects (P = 1.0). Similarly, when both the Mooren’s ulcer and control subject groups were retrospectively analyzed by age greater or less than 50 years, subjects with an age greater than 50 demonstrated a stronger correlation between hookworm infestation and Mooren’s ulcer compared to 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 less than or equal to the age of 50 (P = 0.31).
Intestinal infestation with hookworm appears to be associated with the development of Mooren’s Ulcer in South India. Although subgroup analyses are limited by multiple testing and small sample sizes, the data suggests further that the correlation between hookworm infestation and the development of Mooren’s Ulcer may be greatest in male patients with more advanced age. Such findings support the hypothesis that risk increases with exposure over time.
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