Ocular manifestations in paediatric patients with Acquired Immunodeficiency Syndrome (AIDS) at Muhimbili medical centre, Dar es Salaam

Abstract

This study was conducted among 109 children admitted in paediatric wards at Muhimbili Medical Centre. Amongst them, . there were 62 HIV seropositive and 47 HIV seronegative. The main objective was to study the prevalence of ocular manifestations of HIV in African children. The results indicated that the prevalence of ocular manifestations was 38 % in HIV seropositive children as compared to 25 % in HIV seronegative children. The lesions of the conjunctiva were common in both groups, while corneal and fundus lesions were more prevalent in HIV positive children. Conjunctival xerosis was a common finding, in both groups of children, indicating poor nutritional status rather than HIV infection. Corneal lesions were more prevalent in HIV seropositive children than in HIV seronegative children. Fundus lesions were markedly high in HIV seropositi~e children as compared seronegative children. Common lesions were macular edema, haemorrhages and sheathing of the vessels. These findings suggested that the incidence of retinal involvement was high in HIV seropositive children.

111 In HIV seropositive children the prevalence of abnormal visual acuity was 10% as compared to 6 % in HIV seronegative children, indicating that it was not significantly associated with in HIV positivity. In conclusion, the prevalence of ocular manifestations in African children is high, probably due to the poor nutritional status of the children. In non ocular manifestation, pulmonary tuberculosis was the most frequent diagnosis. Children with systemic diagnosis of tuberculosis, or any other opportunistic infection should be screened for HIV and ocular examination should be performed giving special attention to anterior segment and the fundus.