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2007 OMIG, Abstract 17

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Twenty years of Acanthamoeba Keratitis in Brazil
Freitas D, Carvalho FRS, Foronda AS, Aoki AM, Zorat-Yu MC, Belfort Jr R, Höfling-Lima AL.
Ophthalmology Department, Federal University of São Paulo

Purpose: Incidence rate of Acanthamoeba keratitis (AK) in reference eye center in São Paulo state, Brazil, was investigated in a long-term epidemiological study, from 1987 to 2006.
Methods: Five hundred and eighty-two individuals were investigated in a retrospective review of all laboratory records looking for Acanthamoebic infections. Suspected individuals with typical clinical manifestations underwent protozoologic studies of corneal scrapings samples and interview regarding risk factors. Statistical analyses were applied to epidemiological data in order to compare the positivity rates observed between two decades.
Results: Since January 1987, Acanthamoeba spp were cultured from corneal scrapings of one hundred and eighty-five patients, with four of them having bilateral infection. Among all infectious keratitis positivity rate of AK was thirty percent in both decades (p=0.746). There was no significant difference of corneal infection between male and female (p=0.070), neither between right or left eye (p=0.733).  Positivity rate was higher in patients with bilateral disease and both eyes sampled (p=0.013). The most important risk factors were contact lens wear, improper storage and handling of lenses, coming into contact with contaminated water such as swimming and showering while wearing lenses and introduction of tap water rinsing of storage cases. 
Conclusions: This is the first epidemiological data on AK reported in Brazil. The results point for a constant positivity rate of AK cases throughout the years confirming the emergent disease.  Early clinical and laboratorial diagnoses of AK are helpful for prompt recognition and treatment of the infection avoiding high rates of corneal transplantation and blindness observed in this disease. Detection of risk factors for Acanthamoeba infection will allow recommendations for its prevention.

Disclosure code: N
Financial support: FADA – Grant for Faculty Research, Federal University of São Paulo, SP, Brazil



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