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Uveitis is predominantly of infectious origin in a high HIV and TB prevalence setting in rural South Africa
  1. Erik Schaftenaar1,2,
  2. Christina Meenken3,
  3. G Seerp Baarsma4,
  4. N Sellina Khosa2,
  5. Ad Luijendijk5,
  6. James A McIntyre2,6,
  7. Albert D M E Osterhaus7,
  8. Georges M G M Verjans1,7,
  9. Remco P H Peters2,8
  1. 1Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
  2. 2Anova Health Institute, Johannesburg, South Africa
  3. 3Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands
  4. 4Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
  5. 5Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
  6. 6School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
  7. 7Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany
  8. 8Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
  1. Correspondence to Professor Dr Remco P H Peters, Anova Health Institute, 12 Sherborne Road, Johannesburg 2193, South Africa; rph.peters{at}gmail.com

Abstract

Aims To determine the burden of disease in a unique sample of patients with uveitis from a rural South African setting.

Methods Data in this cross-sectional study were collected from patients presenting with uveitis (n=103) at the ophthalmology outpatient department of three hospitals in rural South Africa. Demographic and clinical data were collected, and laboratory analysis of aqueous humour, serological evaluation and routine diagnostics for tuberculosis (TB) were performed.

Results Sixty-six (64%) participants were HIV infected. Uveitis was predominantly of infectious origin (72%) followed by idiopathic (16%) and autoimmune (12%). Infectious uveitis was attributed to herpes virus (51%), Mycobacterium tuberculosis (24%) and Treponema pallidum (7%) infection. HIV-infected individuals were more likely to have infectious aetiology of uveitis compared with HIV-uninfected individuals (83% vs 51%; p=0.001).

Conclusions Microbial aetiology of uveitis is common in areas where HIV and TB are endemic. In these settings, a high index of suspicion for infectious origin of uveitis is warranted.

  • Infection
  • Epidemiology
  • Microbiology
  • Public health

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