Uveitis is predominantly of infectious origin in a high HIV and TB prevalence setting in rural South Africa.
OBJECTIVE
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.
Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands Anova Health Institute, Johannesburg, South Africa.
Erik
http://orcid.org/0000-0003-3339-0271
E
Schaftenaar
Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.
Christina
C
Meenken
Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.
G Seerp
GS
Baarsma
Anova Health Institute, Johannesburg, South Africa.
N Sellina
NS
Khosa
Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands.
Ad
A
Luijendijk
Anova Health Institute, Johannesburg, South Africa School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
James A
JA
McIntyre
Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany.
Albert D M E
AD
Osterhaus
Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany.
Georges M G M
GM
Verjans
Anova Health Institute, Johannesburg, South Africa Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.
Remco P H
RP
Peters
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D015818:Eye Infections, Bacterial / Q000453:epidemiology*; D015828:Eye Infections, Viral; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*; D014605:Uveitis / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D055815:Young Adult
Epidemiology; Infection; Microbiology; Public health