{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:22:56Z","timestamp":1789690976589,"version":"4.0.1"},"reference-count":14,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["207472"],"award-info":[{"award-number":["207472"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns5:p>Purpose To determine the knowledge, attitude, and practice of pharmacy attendants in the management of microbial keratitis. Methods This mixed-methods study was conducted in selected pharmacies and drug shops located in Mbarara City between March and May 2022. We administered questionnaires assessing the knowledge, attitudes, and practices (KAP) related to microbial keratitis (MK) to 140 pharmacy attendants (PAs) in the drug shops and pharmacies. We also conducted 40 in-depth interviews (IDI) and three focus group discussions (FGD) with pharmacy attendants to discuss practices, challenges, and opportunities to improve the management of MK. Results Of the 140 pharmacy attendants, almost half (49.29%) reported that they were not confident when making diagnoses in patients with eye problems, and 19.29% were uncertain of which drug to prescribe. In the IDIs and FGDs, the pharmacy attendants reported that they receive and manage patients with MK. Some immediately refer any patients they receive with eye complaints without prescribing any medication while others only refer those who are not responding to medication. The challenges faced in managing patients with MK included inadequate knowledge of managing eye diseases including MK, patients presenting with severe diseases because of delays in seeking healthcare, and the use of traditional eye medicine. The pharmacy attendants suggested ways of improving the management of MK and other eye diseases in the community including community sensitisation on eye diseases and conducting continued professional development lecture sessions on MK in pharmacies, drug shops, and clinics. Conclusion The study showed that probable MK was a common presentation among patients seeking to buy drugs from pharmacies and drug shops. Pharmacies are key stakeholders in the health seeking journey of patients and hence need to be supported through capacity building and strengthening the referral network to improve the outcomes of patients with eye diseases and MK.<\/ns5:p>","DOI":"10.12688\/wellcomeopenres.22594.1","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:05:06Z","timestamp":1737975906000},"page":"30","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of microbial keratitis by private pharmacies in Uganda: a study of knowledge, attitude, and practice."],"prefix":"10.12688","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0608-7337","authenticated-orcid":false,"given":"Abel","family":"Ebong","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Arunga","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"},{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3436-0162","authenticated-orcid":false,"given":"Tara B.","family":"Mtuy","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"},{"name":"Moshi Kilimanjaro Christian Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Meric","family":"Birungi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Onyango","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Arinda","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9646-7074","authenticated-orcid":false,"given":"Francis","family":"Orishaba","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teddy","family":"Kwaga","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Kageni","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Mbarara Western Region Mbarara University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2371-5709","authenticated-orcid":false,"given":"David","family":"Macleod","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3501-3771","authenticated-orcid":false,"given":"Reena","family":"Yadav","sequence":"additional","affiliation":[{"name":"Lahan Sagarmatha Choudhary Eye Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0554-8441","authenticated-orcid":false,"given":"Sandip Das","family":"Sanyam","sequence":"additional","affiliation":[{"name":"Lahan Sagarmatha Choudhary Eye Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9454-2131","authenticated-orcid":false,"given":"Jeremy J.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer H. A.","family":"Mohamed Ahmed","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9251-2318","authenticated-orcid":false,"given":"Astrid","family":"Leck","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-9169","authenticated-orcid":false,"given":"Mathew J.","family":"Burton","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine London International Centre for Eye Health"},{"name":"London National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"e49-e57","DOI":"10.1016\/S1473-3099(20)30448-5","article-title":"The global incidence and diagnosis of fungal keratitis.","volume":"21","author":"L Brown","year":"2021","journal-title":"Lancet Infect Dis."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"121-131","DOI":"10.1080\/09286586.2019.1700533","article-title":"Epidemiology of Microbial Keratitis in Uganda: a cohort study.","volume":"27","author":"S Arunga","year":"2020","journal-title":"Ophthalmic Epidemiol."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"311-320","DOI":"10.1080\/09286586.2019.1616775","article-title":"Delay along the care seeking journey of patients with Microbial Keratitis in Uganda.","volume":"26","author":"S Arunga","year":"2019","journal-title":"Ophthalmic Epidemiol."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"1226-1231","DOI":"10.1038\/eye.2012.99","article-title":"Predictors of outcome in fungal keratitis.","volume":"26","author":"N Venkatesh Prajna","year":"2012","journal-title":"Eye (Lond)."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"276-278","DOI":"10.1136\/bjo.2005.076083","article-title":"Corneal ulceration in South East Asia. I: a model for the prevention of bacterial ulcers at the village level in rural Bhutan.","volume":"90","author":"K Getshen","year":"2006","journal-title":"Br J Ophthalmol."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"388-392","DOI":"10.1136\/bjo.85.4.388","article-title":"The Bhaktapur eye study: ocular trauma and antibiotic prophylaxis for the prevention of corneal ulceration in Nepal.","volume":"85","author":"M Upadhyay","year":"2001","journal-title":"Br J Ophthalmol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"1472-1475","DOI":"10.1136\/bjo.2006.103028","article-title":"Corneal ulceration in south-east Asia III: prevention of fungal keratitis at the village level in South India using topical antibiotics.","volume":"90","author":"M Srinivasan","year":"2006","journal-title":"Br J Ophthalmol."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"968-970","DOI":"10.1136\/bjo.2006.094706","article-title":"Corneal ulceration in South East Asia. II: a strategy for the prevention of fungal keratitis at the village level in Burma.","volume":"90","author":"N Maung","year":"2006","journal-title":"Br J Ophthalmol."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"89","DOI":"10.12688\/wellcomeopenres.15259.2","article-title":"Traditional Eye Medicine use in Microbial Keratitis in Uganda: a mixed methods study [version 2; peer review: 2 approved].","volume":"4","author":"S Arunga","year":"2019","journal-title":"Wellcome Open Res."},{"key":"ref-10","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.915293","article-title":"Delay in accessing definitive care for patients with Microbial Keratitis in Nepal.","volume":"9","author":"J Hoffman","year":"2022","journal-title":"Front Med (Lausanne)."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"141","DOI":"10.12688\/wellcomeopenres.15463.1","article-title":"The management of Microbial Keratitis within Uganda\u2019s primary health system: a situational analysis [version 1; peer review: 3 approved].","volume":"4","author":"S Arunga","year":"2019","journal-title":"Wellcome Open Res."},{"key":"ref-12","article-title":"The National Drug Policy and Authority Act"},{"key":"ref-13","first-page":"67","article-title":"How to make fluorescein strips.","volume":"31","author":"G Arinda","year":"2018","journal-title":"Community Eye Health."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"i6637","DOI":"10.1136\/bmj.i6637","article-title":"Arclight: a pocket ophthalmoscope for the 21st century.","volume":"355","author":"A Blaikie","year":"2016","journal-title":"BMJ."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:39:12Z","timestamp":1781084352000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":14,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.22594.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.24892.r127140","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.24892.r126864","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.24892.r127140","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.24892.r126864","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.24892.r127140, Travis K Redd, Casey Eye Institute, Portland, 19 Aug 2025, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1#referee-response-127140","order":0,"name":"referee-response-127140","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.24892.r126864, Jennifer Enright, Washington University in St Louis, St. Louis, Missouri, 25 Aug 2025, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/10-30\/v1#referee-response-126864","order":1,"name":"referee-response-126864","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome [207472]. In addition, SA is supported by a Research Fellowship from the Commonwealth Eye Health Consortium, funded by The Queen Elizabeth Diamond Jubilee Trust and Velux Stiftung Switzerland.). The funding organizations were not involved in the design, collection, analysis, and review of this manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}