Aetiology of uveitis in the Gambia, West Africa

Abstract

Objective: To determine the causes of uveitis in the Gambia.
Background: Uveitis is diverse group of disease entities leading to the inflammation of the uveal tract and are estimated to cause about 10% of blindness worldwide. The condition is often idiopathic but can be triggered by autoimmune, genetic, post traumatic or from infectious diseases. Uveitis is broadly classified into anterior, intermediate, posterior and panuveitis, based on the anatomical involvement of the eye.
Methods: The patients recruited for this study for a period of one year were initially diagnosed by the cataract surgeons in the regional hospitals, and the tertiary hospital. These suspected cases were referred to the Sheikh Zayyed Regional Eye Care Centre, Banjul where the only ophthalmologist works and were further examined.
Only those with established clinical findings were included in the study. A prepared proforma with patients’ demographics such as age, name, sex and address were included. Others were presenting complaints, duration, medical and drug history, and exposure to pets. Patients had both general and ocular examinations. Patients with symptoms were sent for various investigations according to the needs, such as X-rays, blood for retroviral screening, VDRL and ESR.
Results: A total of 9,513 patients presented in the outpatient clinic of the hospital between January 2010 and December 2010 out of which 63 (0.66%) were diagnosed with uveitis. Thirty-two (50.8%) patients were males, with a mean age of 36.7 years at presentation. The most common type of uveitis was anterior uveitis seen in 40 (63.5%) patients, followed by posterior uveitis. Nine (14.3%), intermediate uveitis 8(12.7%) and panuveitis 6(9.5%) patients. The aetiology was unknown for 42.9% of the cases, HIV-related cases were 12 (19.0%), while toxoplasmosis and trauma accounted for 11 (17.5%) and 7 (11.1%) cases respectively.
Conclusion: Most of the uveitis seen in our study is of unknown cause, others were HIV-related, toxoplasmosis and trauma. More facilities are needed for better diagnosis in the eyes centres.